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1.
Artículo en Inglés | MEDLINE | ID: mdl-32610364

RESUMEN

OBJECTIVE: To explore the association between obesity, type 2 diabetes, hypertension, and severe COVID-19 on admission. METHODS: In the present study, a total of 23,593 patient samples were evaluated by a laboratory from the Mexican Institute of Epidemiological Diagnosis and Reference (InDRE, for its acronym in Spanish). Of these: 18,443 were negative for COVID-19, 3,844 were positive for COVID-19, and 1,306 were positive for other respiratory viruses. Severe types of respiratory disease were defined by the presence of pneumonia and other organ failure that requires intensive care. Multivariable logistic regression models were used to explore factors associated with severe COVID-19 on admission. RESULTS: Patients who tested positive for COVID-19 had a higher proportion of obesity (17.4%), diabetes (14.5%), and hypertension (18.9%), compared to those without a confirmed diagnosis. Compared to non-obese patients, those with obesity showed a 1.43-fold higher odds of developing severe COVID-19 on admission, while subjects with diabetes and hypertension showed a 1.87-fold and 1.77-fold higher odds of developing severe COVID-19 on admission, respectively. CONCLUSION: Obesity, diabetes, and hypertension were significantly associated with severe COVID-19 on admission and the association of obesity was stronger in patients < 50 y.

2.
Artículo en Inglés | MEDLINE | ID: mdl-32610523

RESUMEN

OBJECTIVE: To analyze the characteristics of YouTube videos in Spanish on the basic measures to prevent coronavirus disease 2019 (COVID-19). METHODS: On 18 March 2020, a search was conducted on YouTube using the terms "Prevencion Coronavirus" and "Prevencion COVID-19". We studied the associations between the type of authorship and the country of publication with other variables (such as the number of likes and basic measures to prevent COVID-19 according to the World Health Organization, among others) with univariate analysis and a multiple logistic regression model. RESULTS: A total of 129 videos were evaluated; 37.2% were produced in Mexico (25.6%) and Spain (11.6%), and 56.6% were produced by mass media, including television and newspapers. The most frequently reported basic preventive measure was hand washing (71.3%), and the least frequent was not touching the eyes, nose, and mouth (24.0%). Hoaxes (such as eating garlic or citrus to prevent COVID-19) were detected in 15 videos (10.9%). In terms of authorship, papers produced by health professionals had a higher probability of reporting hand hygiene (OR (95% CI) = 4.20 (1.17-15.09)) and respiratory hygiene (OR (95% CI) = 3.05 (1.22-7.62)) as preventive measures. CONCLUSION: Information from YouTube in Spanish on basic measures to prevent COVID-19 is usually not very complete and differs according to the type of authorship. Our findings make it possible to guide Spanish-speaking users on the characteristics of the videos to be viewed in order to obtain reliable information.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Infecciones por Coronavirus/prevención & control , Educación en Salud/normas , Pandemias/prevención & control , Neumonía Viral/prevención & control , Medios de Comunicación Sociales , Grabación en Video , Betacoronavirus , Estudios Transversales , Decepción , Higiene de las Manos , Humanos , Lenguaje , Medios de Comunicación de Masas , México , España
3.
MMWR Morb Mortal Wkly Rep ; 69(26): 830-835, 2020 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-32614814

RESUMEN

On March 27, 2020, a University of Texas at Austin student with cough, sore throat, and shortness of breath had a positive test result for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). On March 28, two more symptomatic students had positive test results, alerting the COVID-19 Center at the University of Texas Health Austin (UTHA) to a potential outbreak; the center initiated an outbreak investigation the same day. UTHA conducted contact tracing, which linked the students' infections to a spring break trip to Cabo San Lucas, Mexico, during March 14-19. Among 231 persons tested for SARS-CoV-2 in this investigation, 64 (28%) had positive test results, including 60 (33%) of 183 Cabo San Lucas travelers, one of 13 (8%) household contacts of Cabo San Lucas travelers, and three (9%) of 35 community contacts of Cabo San Lucas travelers. Approximately one fifth of persons with positive test results were asymptomatic; no persons needed hospitalization, and none died. This COVID-19 outbreak among a young, healthy population with no or mild symptoms was controlled with a coordinated public health response that included rapid contact tracing and testing of all exposed persons. A coordinated response with contact tracing and testing of all contacts, including those who are asymptomatic, is important in controlling future COVID-19 outbreaks that might occur as schools and universities consider reopening.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Neumonía Viral/epidemiología , Estudiantes/estadística & datos numéricos , Enfermedad Relacionada con los Viajes , Adulto , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Pandemias , Texas/epidemiología , Universidades , Adulto Joven
4.
J Virol ; 2020 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-32641486

RESUMEN

The COVID-19 pandemic has affected most countries in the world. Studying the evolution and transmission patterns in different countries is crucial to implement effective strategies for disease control and prevention. In this work, we present the full genome sequence for 17 SARS-CoV-2 isolates corresponding to the earliest sampled cases in Mexico. Global and local phylogenomics, coupled with mutational analysis, consistently revealed that these viral sequences are distributed within 2 known lineages, the SARS-CoV-2 lineage A/G, containing mostly sequences from North America, and the lineage B/S containing mainly sequences from Europe. Based on the exposure history of the cases and on the phylogenomic analysis, we characterized fourteen independent introduction events. Additionally, three cases with no travel history were identified. We found evidence that two of these cases represent local transmission cases occurring in Mexico during mid-March 2020, denoting the earliest events described for the country. Within this local transmission cluster, we also identified the H49Y amino acid change in the Spike protein. This mutation is a homoplasy occurring independently through time and space, and may function as a molecular marker to follow on any further spread of these viral variants throughout the country. Our results depict the general picture of the SARS-CoV-2 variants introduced at the beginning of the outbreak in Mexico, setting the foundation for future surveillance efforts.IMPORTANCE Understanding the introduction, spread and establishment of SARS-CoV-2 within distinct human populations is crucial to implement effective control strategies as well as the evolution of the pandemics. In this work, we describe that the initial virus strains introduced in Mexico came from Europe and the United States and the virus was circulating locally in the country as early as mid-March. We also found evidence for early local transmission of strains having the mutation H49Y in the Spike protein, that could be further used as a molecular marker to follow viral spread within the country and the region.

5.
Thorac Cancer ; 2020 Jul 06.
Artículo en Inglés | MEDLINE | ID: mdl-32627963

RESUMEN

To date, the impact, timeline and duration of COVID-19 pandemic remains unknown and more than ever it is necessary to provide safe pathways for cancer patients. Multiple triage systems for nonemergent surgical procedures have been published, but potentially curative cancer procedures are essential surgery rather than elective surgery. In the present and future scenario of our country, thoracic oncology teams may have the difficult decision of weighing the utility of surgical intervention against the risk for inadvertent COVID-19 exposure for patients and medical staff. In consequence, traditional pathways of surgical care must be adjusted to reduce the risk of infection and the use of resources. It is recommended that all thoracic cancer patients should be offered treatment according to the accepted standard of care until shortage of services require a progressive reduction in surgical cases. Here, we present a consensus of recommendations discussed by a multidisciplinary panel of experts on thoracic oncology and based on the best available evidence, and hope it will provide a modifiable framework of guidance for local strategy planners in thoracic cancer care services in Mexico. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: This article provides recommendations to guarantee the continuity of surgical care for thoracic oncology cases during COVID-19 pandemic, whilst maintaining the safety of patients and medical staff. WHAT THIS STUDY ADDS: This guideline is the result of an expert consensus on thoracic surgical oncology with recommendations adapted to medical, economic and social realities of Mexico.

6.
BMJ ; 370: m2753, 2020 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-32646860
7.
A A Pract ; 14(9): e01273, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32633929

RESUMEN

In January 2020, a global pandemic was declared by the World Health Organization authorities for coronavirus disease 2019 (COVID-19). Since then, we have looked for ways to avoid transmission with mitigation measures and social distancing. However, areas with a high incidence of COVID-19 have struggled to maintain adequate supplies of personal protective equipment (PPE) essential for health workers. Many innovations have been proposed to assist providers including barriers to use during airway management. We present adaptations to previously described intubation or "aerosol" boxes.

8.
Salud Publica Mex ; 2020 Jul 02.
Artículo en Español | MEDLINE | ID: mdl-32614545

RESUMEN

The bioethical inquiry about allocating fairly scarce health resources is not new, all countries around the world that were seriously afflicted by SARS-CoV-2 have issued triage guidelines in order to address the dilemmas raised by the pandemic. There is no question about the need to create bioethical guidelines, since its creation provides a degree of certainty that fair and ethical decisions are taken. This also prevents that decisions are made in solitary and maybe motivated by corrupted actions. In Mexico, the creation of this guidelines was a proactive and preventive measure to what was unavoidable, the exponential contagion phase of the pandemical scenario caused by Covid-19. On April 30, 2020 the General Sanitary Council published the Bioethical Guide to Allocate Scarce Resources on Critical Care Medicine in Emergency Situation. This guide has at the core of its principal that of upmost importance: social justice principle which main thesis is "All lives have the same value". The aim of this contribution is to provide the ethical and legal principles established in the aforementioned bioethical guideline. In sum, a brief exploration of the ethical reasons that supports a specific way to allocate scarce health resources is provided, as well as the foundations of the procedural part from a human rights-based approach.

9.
Gac Med Mex ; 156(3): 208-216, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32539016

RESUMEN

Introduction: As of March 23, 2020, suspension of non-essential activities was declared in Mexico throughout the country in order to mitigate the spread of the COVID-19 pandemic. Objective: To analyze data on the first 1,510 laboratory-confirmed cases of COVID-19 in Mexico, and to describe the geographical distribution of the disease and its transmission dynamics. Method: Description of the first COVID-19 cases with real-time RT-PCR-positive test, as well as evaluation of epidemiological measures, cumulative incidence, rate of transmission, and mortality and lethality rates during the first month of the epidemic. Results: Average age was 43 years, and 58 % were males; 44 % of initial cases were imported. Lethality in the population during the first month went from 1.08 to 3.97 per 100 cases; however, the trend is linear and similar to that observed in Europe. Conclusions: In Mexico, social distancing is being applied, but studies are still required on the dynamics of the epidemic, person-to-person transmission, incidence of subclinical infections, and patient survival.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Aislamiento Social , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , México/epidemiología , Persona de Mediana Edad , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Sobrevida , Adulto Joven
13.
Rev Clin Esp ; 2020 May 27.
Artículo en Inglés, Español | MEDLINE | ID: mdl-32560915

RESUMEN

BACKGROUND: The first case of COVID-19 detected in Mexico was on the 27th of February 2020. On the 30th of April, 64 days after this first diagnosis, the number of patients had increased exponentially, reaching 19 224 confirmed cases and 1859 (9.67%) deaths. In response to this global outbreak, we summarize the current state of our understanding regarding COVID-19 in Mexico. METHODS: We obtained the data from the official website of the Ministry of Health in Mexico. The study period was between the 27th of February and the 30th of April 2020. The cases were confirmed using real-time reverse transcription-polymerase chain reaction, and we analysed epidemiological, demographic and clinical data. RESULTS: In Mexico, most cases of COVID-19 were located in Mexico City. The mean age of the patients was 46 years. Of the 12 656 confirmed cases, most infected individuals were between the ages of 30 and 59 years (65.85%), and there was a higher incidence rate in men (58.18%) than in women (41.82%). The patients who died had one or more comorbidities, mainly hypertension (45.53%), diabetes (39.39%) and obesity (30.4%). In the first 64 days of the epidemic, China had reported 80 304 cases with a mortality rate of 3.66%. CONCLUSIONS: Our results indicate an early transmission of COVID-19 in Mexico. The descriptive epidemiology shows similarities between the cases of COVID-19 in Mexico and those in China. In the same period of the epidemic curve, we observed a reduction in the number of confirmed cases of COVID-19 in Mexico and a higher mortality rate compared with that of China.

14.
Obes Res Clin Pract ; 2020 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-32536475

RESUMEN

Some comorbidities are associated with severe coronavirus disease (Covid-19) but it is unclear whether some increase susceptibility to Covid-19. In this case-control Mexican study we found that obesity represents the strongest predictor for Covid-19 followed by diabetes and hypertension in both sexes and chronic renal failure in females only. Active smoking was associated with decreased odds of Covid-19. These findings indicate that these comorbidities are not only associated with severity of disease but also predispose for getting Covid-19. Future research is needed to establish the mechanisms involved in each comorbidity and the apparent "protective" effect of cigarette smoking.

15.
Psychol Trauma ; 2020 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-32551758

RESUMEN

It is estimated that more than 300,000 people have died because of COVID-19 globally. The vast majority of documented deaths have occurred within hospitals, leading to psychological impacts on both family members and health care workers. This paper describes the actions (online death notification education, remote crisis intervention, and support for health care professionals) taken at a hospital in Mexico to address the psychological impacts of the notification of a COVID-19-related death on both the deceased's relatives and the health care personnel involved. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

16.
J Clin Endocrinol Metab ; 105(8)2020 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-32474598

RESUMEN

BACKGROUND: The SARS-CoV-2 outbreak poses a challenge to health care systems due to its high complication rates in patients with cardiometabolic diseases. Here, we identify risk factors and propose a clinical score to predict COVID-19 lethality, including specific factors for diabetes and obesity, and its role in improving risk prediction. METHODS: We obtained data of confirmed and negative COVID-19 cases and their demographic and health characteristics from the General Directorate of Epidemiology of the Mexican Ministry of Health. We investigated specific risk factors associated to COVID-19 positivity and mortality and explored the impact of diabetes and obesity on modifying COVID-19-related lethality. Finally, we built a clinical score to predict COVID-19 lethality. RESULTS: Among the 177 133 subjects at the time of writing this report (May 18, 2020), we observed 51 633 subjects with SARS-CoV-2 and 5,332 deaths. Risk factors for lethality in COVID-19 include early-onset diabetes, obesity, chronic obstructive pulmonary disease, advanced age, hypertension, immunosuppression, and chronic kidney disease (CKD); we observed that obesity mediates 49.5% of the effect of diabetes on COVID-19 lethality. Early-onset diabetes conferred an increased risk of hospitalization and obesity conferred an increased risk for intensive care unit admission and intubation. Our predictive score for COVID-19 lethality included age ≥ 65 years, diabetes, early-onset diabetes, obesity, age < 40 years, CKD, hypertension, and immunosuppression and significantly discriminates lethal from non-lethal COVID-19 cases (C-statistic = 0.823). CONCLUSIONS: Here, we propose a mechanistic approach to evaluate the risk for complications and lethality attributable to COVID-19, considering the effect of obesity and diabetes in Mexico. Our score offers a clinical tool for quick determination of high-risk susceptibility patients in a first-contact scenario.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Diabetes Mellitus/mortalidad , Obesidad/mortalidad , Neumonía Viral/mortalidad , Adulto , Factores de Edad , Anciano , Comorbilidad , Infecciones por Coronavirus/inmunología , Bases de Datos Factuales , Susceptibilidad a Enfermedades , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Huésped Inmunocomprometido , Masculino , México/epidemiología , Persona de Mediana Edad , Pandemias , Neumonía Viral/inmunología , Pronóstico , Modelos de Riesgos Proporcionales , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Insuficiencia Renal Crónica/mortalidad , Medición de Riesgo/métodos , Factores de Riesgo , Factores Sexuales
17.
Artículo en Inglés | MEDLINE | ID: mdl-32549337

RESUMEN

This study's objective is to analyze the incidence, lethality, hospitalization, and confirmation of COVID-19 cases in Mexico. Sentinel surveillance for COVID-19 cases in Mexico began after the confirmation of the first patient with community transmission. Methods: This epidemiologic, cross-sectional study includes all clinically suspected, and laboratory-confirmed cases nationwide from the beginning of the outbreak to 21 April 2020. State-cluster demographic data and health indicators were analyzed in reference to epidemiologic measures, with logistic regressions for the dependent variables of incidence, confirmation, and lethality. Results: The national incidence was 13.89/100,000 inhabitants with a 6.52% overall lethality and a confirmed-case mortality of 11.1%. The incidence variation significantly correlated with migration, but not urbanization. Pediatric patients were less prone to be tested (OR = -3.92), while geriatric individuals were a priority. State lethality positively correlated with the proportion of the population assisted at public hospitals and correlated inversely to the number of hospitals and clinics in the state. Conclusions: Migration strongly correlated with incidence; elderly patients had lower odds of being hospitalized but were likely to die. Patients aged <15 were less prone to be laboratory-confirmed. Case confirmation was not performed in all hospitalized patients, but 72.15% of hospitalized patients had favorable outcomes to date.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Hospitalización/estadística & datos numéricos , Neumonía Viral/epidemiología , Adolescente , Adulto , Anciano , Betacoronavirus , Infecciones por Coronavirus/mortalidad , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , México/epidemiología , Persona de Mediana Edad , Pandemias , Neumonía Viral/mortalidad , Vigilancia de Guardia , Adulto Joven
18.
Artículo en Inglés | MEDLINE | ID: mdl-32598450

RESUMEN

BACKGROUND: COVID-19 has had a disproportionate impact on older adults. Mexico's population is younger, yet COVID-19's impact on older adults is comparable to countries with older population structures. Here, we aim to identify health and structural determinants that increase susceptibility to COVID-19 in older Mexican adults beyond chronological aging. METHODS: We analyzed confirmed COVID-19 cases in older adults using data from the General Directorate of Epidemiology of Mexican Ministry of Health. We modeled risk factors for increased COVID-19 severity and mortality, using mixed models to incorporate multilevel data concerning healthcare access and marginalization. We also evaluated structural factors and comorbidity profiles compared to chronological age for COVID-19 mortality risk prediction. RESULTS: We analyzed 20,804 confirmed SARS-CoV-2 cases in adults aged ≥60 years. Male sex, smoking, diabetes, and obesity were associated with pneumonia, hospitalization and ICU admission in older adults, CKD and COPD were associated with hospitalization. High social lag indexes and access to private care were predictors of COVID-19 severity and mortality. Age was not a predictor of COVID-19 severity in individuals without comorbidities and combination of structural factors and comorbidities were better predictors of COVID-19 lethality and severity compared to chronological age alone. COVID-19 baseline lethality hazards were heterogeneously distributed across Mexican municipalities, particularly when comparing urban and rural areas. CONCLUSIONS: Structural factors and comorbidity explain excess risk for COVID-19 severity and mortality over chronological age in older Mexican adults. Clinical decision-making related to COVID-19 should focus away from chronological aging onto more a comprehensive geriatric care approach.

19.
Preprint en Español | SciELO Preprints | ID: pps-756

RESUMEN

The objective was to evaluate the levels of anxiety, depression, stress and the perception of the health status of Mexican university students during 7 weeks of confinement due to the Covid-19 pandemic. Method: Observational and cross-sectional study, the sample was made up by convenience and not random. N = 644 (276 women and 368 men) with an average age of 21.95 years (σ = 3.56), who completed an online survey to detect psychological symptoms, the content of which was composed by the Inventory of State Anxiety, Perceived Stress Scale (PSS-14) and the General Health Questionnaire (GHQ-28) and sociodemographic data. Results: symptoms (moderate to severe): stress (31.92%), psychosomatics (5.9%), sleep problems (36.3%), social dysfunction in daily activity (9.5%) and depressive (4.9%), especially in the group of women and the youngest students (18-25 years). In this latter group, anxiety (40.3%) was also detected with higher levels in men. Conclusions: It is necessary to implement prevention, control and reduction programs for the psychological effects generated by confinement during pandemics with the aim of guaranteeing the well-being and mental health of the university students.   Key words: Psychological impact, confinement, university students.


El objetivo de esta investigación consistió en evaluar los niveles de ansiedad, depresión, estrés y la percepción del estado de salud de estudiantes universitarios mexicanos durante 7 semanas de confinamiento por la pandemia de Covid-19. Método: estudio observacional-transeccional, la muestra se conformó por conveniencia y no aleatoria. N= 644 (276 mujeres y 368 hombres) con edad promedio de 21.95 años (σ= 3.56), quienes llenaron una encuesta en línea para la detección de síntomas psicológicos, cuyo contenido se estructuró por el Inventario de Ansiedad Estado, Escala de Estrés percibido (PSS-14), Cuestionario General de Salud (GHQ-28) y datos sociodemográficos. Resultados: se encontraron síntomas (moderados a severos): estrés (31.92%), psicosomáticos (5.9%), problemas para dormir (36.3%), disfunción social en la actividad diaria (9.5%) y depresivos (4.9%), especialmente en el grupo de las mujeres y en los estudiantes más jóvenes (18-25 años). En este último grupo, también se detectó ansiedad (40.3%) con mayores niveles en los hombres. Conclusiones: es necesario implementar programas de prevención, control y disminución de los efectos psicológicos generados por el confinamiento durante las pandemias con el objetivo de garantizar el bienestar y la salud mental de los estudiantes universitarios. Palabras clave: Impacto psicológico, confinamiento, estudiantes universitarios.

20.
Med Hypotheses ; 144: 109905, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32535456

RESUMEN

COVID-19 has become disastrous for world and spread all over. Researchers all around the globe are working to discover a drug to cure from COVID-19. RNA dependent RNA polymerase plays a key role in SARS-CoV-2 replication and thus it could be a potential target for SARS-CoV-2. This study revealed that Protopine, Allocryptopine and (±) 6- Acetonyldihydrochelerythrine could be potential RdRp inhibitors of SARS-CoV-2.

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