Influencia de la resiliencia y el afrontamiento en salud mental positiva en jóvenes mexicanos durante la pandemia de COVID-19 / Influence of resilience and coping on positive mental health in young Mexicans during the COVID-19 pandemic

Resumen El objetivo de este estudio consistió en explicar en qué medida la resiliencia y las estrategias de afrontamiento influyeron en la salud mental positiva de jóvenes mexicanos universitarios que vivieron la pandemia de COVID-19. La muestra se conformó por 1042 universitarios mexicanos de 18 a 24 años de edad (M = 20.5 DS = 1.9). El 78.4 % son mujeres (817). Se aplicaron en formato online los instrumentos: Mental Health Continuum-Short Form, Escala de Resiliencia, Escala de Afrontamiento y Escala de miedo al COVID-19. Se obtuvo un modelo con índices de bondad de ajuste satisfactorios (X 2 = 532.913, df = 114, X 2 /df = 4.6, SRMR = .053, RMSEA = .059, CFI = .927, p = .001), en el cual la resiliencia y el afrontamiento funcional son factores importantes que influyen en SMP, por lo que son variables que deben considerarse en los programas de intervención psicológica para la promoción de la salud de los jóvenes universitarios.

Abstract The objective of this study was to explain to what extent resilience and coping strategies influenced the positive mental health of young Mexican university students who have experienced the COVID-19 pandemic. The sample was made up of 1.042 Mexican university students between 18 and 24 years of age (M = 20.5 SD = 1.9). 78.4% are women (817). The instruments: Mental Health Continuum-Short Form, Resilience Scale, Coping Scale and Fear of COVID-19 Scale were applied in online format. A model was obtained with satisfactory goodness-of-fit indices (X2 = 532.913, df = 114), resilience and functional coping are important factors that influence SMP, so they are variables that should be considered in psychological intervention programs to promote the health of university students.

Socioeconomic factors and COVID-19 mortality in immune-mediated rheumatic diseases patients: regional analysis from Argentina, Mexico and Brazil.

BACKGROUND: SARS-CoV-2 infection has become a major international issue, not only from a medical point of view, but also social, economic and political. Most of the available information comes from the United States, Europe, and China, where the population and the socioeconomic status are very different from Latin American countries. This study evaluates the effect of regional socioeconomic characteristics on mortality due SARS-CoV-2 infection in patients with immune-mediated rheumatic diseases (IMRD) from Argentina, Mexico and Brazil. METHODS: Data from three national registries, SAR-COVID (Argentina), CMR-COVID (Mexico) and ReumaCoV-Brasil (Brazil), were combined. Adult IMRD patients with SARS-CoV-2 infection were recruited. National data for each province/state, including population density, number of physicians per inhabitant, income, unemployment, GINI index, Municipal Human Development Index (MHDI), stringency index, vaccination rate and most frequent viral strains per period were assessed as risk factors for mortality due to COVID-19. RESULTS: A total of 4744 patients were included, 2534 (53.4%) from SAR-COVID, 1166 (24.6%) from CMRCOVID and 1044 (22.0%) from ReumaCoV-Brasil. Mortality due to COVID-19 was 5.4%. In the multivariable analysis, higher number of physicians per 1000 inhabitants and being infected during the vaccination period of each country were associated with lower mortality. After adjustment for socioeconomic factors, there was no association with country of residence and mortality. CONCLUSION: These findings corroborate the complex interplay between socioeconomic factors, rheumatic disease activity, and regional disparities as determinants of death due to COVID-19 in Argentina, Brazil and Mexico. Thus, this research provides valuable insights for guiding public health policies and clinical practice in the ongoing fight against the COVID-19 pandemic.

COVID-19 policy response: Perspectives of key stakeholders in Mexico's health system and implications for resilience.

PURPOSE: This study aims to analyze the perspectives of key stakeholders within Mexico's health system regarding the policy response to COVID-19 in 2020 to inform future policy formulation. METHODS: This qualitative study is based on a secondary data analysis (SDA) derived from a broader primary research on governance in Mexico during the COVID-19 pandemic. The analysis adopted a grounded theory approach to examine 15 semi-structured interviews with prominent figures in the health system between June and November 2020. The interviews were audio-recorded and analyzed through the lens of the Health Policy Triangle which includes context, key actors, and the Mexican health policy process. Moreover, the analysis was enriched by incorporating the framework outlined in the World Health Organization's COVID-19 Strategic Preparedness and Response Plan (SPRP). RESULTS: The findings indicate that key stakeholders perceived a centralized approach to policymaking with a strong emphasis on cross-sector communication, expert panels, equity-focused measures, accessibility to healthcare services (promoting portability), and improvements in the health information system. CONCLUSION: Key stakeholders recognized the response to COVID-19 was complex, involving multiple dimensions and levels of action. The importance of preparedness and response in building health system resilience is emphasized. Recommendations include explicitly integrating resilience into national and local policy agendas, addressing systemic structural deficiencies, promoting equity in the pandemic response, improving risk governance, strengthening coordination mechanisms, ensuring supply chain resilience, improving personnel training, and enhancing local diagnostic capacity to better prepare for future public health emergencies.

The Model for End-Stage Liver Disease (MELD) Score Predicting Mortality Due to SARS-CoV-2 in Mexican Patients.

Background/Objectives: Coronavirus Disease 2019 (COVID-19) can cause liver injury and a deterioration of hepatic function. The Model for End-Stage Liver Disease (MELD) score is a good predictor for poor prognosis of hospitalized COVID-19 patients in the United States, Egypt and Turkey. Nevertheless, the best cut-off value for the MELD score to predict mortality in the Mexican population has yet to be established. Methods: A total of 234 patients with COVID-19 were studied in a tertiary-level hospital. Patients were stratified into survivors (n = 139) and non-survivors (n = 95). Receiver operating characteristic curves, Cox proportional hazard models, Kaplan-Meier method, and Bonferroni corrections were performed to identify the predictors of COVID-19 mortality. Results: MELD score had an area under the curve of 0.62 (95% CI: 0.56-0.68; p = 0.0009), sensitivity = 53.68%, and specificity = 73.38%. Univariate Cox proportional hazard regression analysis suggested that the leukocytes > 10.6, neutrophils > 8.42, neutrophil-to-lymphocyte ratio (NLR) > 8.69, systemic immune-inflammation index (SII) > 1809.21, MELD score > 9, and leukocyte glucose index (LGI) > 2.41 were predictors for mortality. However, the multivariate Cox proportional hazard model revealed that only the MELD score >9 (Hazard Ratio [HR] = 1.83; 95% confidence interval [CI]: 1.2-2.8; Pcorrected = 0.03) was an independent predictor for mortality of COVID-19. Conclusions: Although the MELD score is used for liver transplantation, we suggest that a MELD score >9 could be an accurate predictor for COVID-19 mortality at admission to ICU requiring mechanical ventilation.

Table of life for beneficiaries of the Institute of Security and Social Services of State Workers (ISSSTE), Mexico 2021.

OBJECTIVE: Determine the life expectancy in the covered population of the Institute of Security and Social Services of State Workers in México for 2021. METHOD: We used the abrogated method from Reed-Merrel, for calculate the life expectancy in age groups. RESULTS: By 2021, life expectancy general was 79.51 years; 81.40 years and 78.91 years for woman and men, respectively. CONCLUSIONS: The calculated life expectancy not show a reduction in the population of federal and State employees in Mexico.

OBJETIVO: Determinar la esperanza de vida en la población amparada del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado en México para 2021. MÉTODO: Se utilizó el método abreviado de Reed-Merrel para calcular la esperanza de vida en grupos quinquenales de edad. RESULTADOS: Para 2021, la esperanza de vida general fue de 79.51 años; de 81.40 años y 78.91 años para mujeres y para hombres, respectivamente. CONCLUSIONES: La esperanza de vida calculada no presentó reducción después de la pandemia de COVID-19 para la población de empleados federales de México en 2021.

Acute kidney injury and mortality in patients with critical COVID-19 in Mexico: case-control study.

OBJECTIVE: We aimed to test the association between acute kidney injury (AKI) and mortality in critically ill patients with Coronavirus disease 2019 (COVID-19). METHOD: We conducted a single-center case-control study at the intensive care unit (ICU) of a second-level hospital in Mexico. We included 100 patients with critical COVID-19 from January to December 2021, and collected demographic characteristics, comorbidities, APACHE II, SOFA, NEWS2, and CO-RADS scores at admission, incidence of intrahospital complications, length of hospital and ICU stay, and duration of mechanical ventilation, among others. RESULTS: The median survival of deceased patients was 20 days. After multivariable logistic regression, the following variables were significantly associated to mortality: AKI (adjusted odds ratio [AOR] 6.64, 95% confidence intervals [CI] = 2.1-20.6, p = 0.001), age > 55 years (AOR 5.3, 95% CI = 1.5-18.1, p = 0.007), and arrhythmias (AOR 5.15, 95% CI = 1.3-19.2, p = 0.015). Median survival was shorter in patients with AKI (15 vs. 22 days, p = 0.043), as well as in patients with overweight/obesity (15 vs. 25 days, p = 0.026). CONCLUSION: Our findings show that the development of AKI was the main risk factor associated with mortality in critical COVID-19 patients, while other factors such as older age and cardiac arrhythmias were also associated with this outcome. The management of patients with COVID-19 should include renal function screening and staging on admission to the Emergency Department.

OBJETIVO: Probar la asociación entre lesión renal aguda y mortalidad en pacientes con COVID-19 grave. MÉTODO: Realizamos un estudio de casos y controles unicéntrico en la unidad de cuidados intensivos (UCI) de un hospital de segundo nivel en México. Incluimos 100 pacientes con COVID-19 grave de enero a diciembre 2021, recolectando características demográficas, comorbilidad, APACHE II, SOFA, NEWS2 y CO-RADS al ingreso, incidencia de complicaciones intrahospitalarias, duración de la estancia hospitalaria y en la UCI, duración de ventilación mecánica, etc. RESULTADOS: La mediana de supervivencia de los pacientes que fallecieron fue de 20 días. Al realizar el análisis de regresión logística multivariable, las siguientes variables se asociaron significativamente con la mortalidad: lesión renal aguda (odds ratio ajustada [ORa]: 6.64; intervalo de confianza del 95% [IC95%]: 2.1-20.6; p = 0.001), edad > 55 años (ORa: 5.3; IC95%: 1.5-18.1; p = 0.007) y arritmias (ORa: 5.15; IC95%: 1.3-19.2; p = 0.015). La supervivencia fue menor en pacientes con lesión renal aguda (15 vs. 22 días; p = 0,043), así como en pacientes con sobrepeso u obesidad (15 vs. 25 días; p = 0.026). CONCLUSIONES: Nuestros resultados muestran que el desarrollo de lesión renal aguda es el principal factor de riesgo asociado a mortalidad en pacientes con COVID-19 grave, mientras que otros factores, como la edad > 55 años y la presencia de arritmias cardiacas, también se asocian a mortalidad por COVID-19. El manejo de pacientes con COVID-19 debe incluir el tamizaje y la estadificación de la función renal al ingreso a urgencias.

Emerging psychosocial factors and work overload perceptions of Mexican university teachers and students working and studying from home during the COVID-19 pandemic.

Introduction: In Mexico, academic activities during the COVID-19 pandemic were conducted from home for over 2 years. Especially during the initial months of the pandemic, the lockdown conditions necessitated a reorganization and a new understanding of social dynamics. Therefore, this study aimed to explore the perceptions of university students and teachers regarding emerging psychosocial factors that either encouraged or hindered work and/or study from home during confinement, as well as their perceptions of work overload. Furthermore, the differences between students and teachers in the studied variables were analyzed. Method: A predominantly quantitative, cross-sectional, and correlational study was conducted with 108 participants (42.6% university teachers; 57.4% graduate or postgraduate students) who filled out an online questionnaire encompassing two open-ended inductors to identify the positive and negative aspects of working or studying from home and their frequency of perceptions, the COVID-19 Work Overload from Home Scale (ESTC-COVID-19), and questions about the hours per day devoted to different activities. The open responses were categorized by two independent groups of the research team; the emerging categories were then consensually agreed upon and further transformed into dummy and continuous variables. These variables and the results of the ESTC-COVID-19 were analyzed with SPSS 19 using Pearson's correlation coefficient, the Chi-squared test, and Student's t-test. The results identified 9 positive and 10 negative emerging psychosocial factors attributed to at least 10% of the sample's open answers. In addition, work overload correlated negatively with the emerging factor of "Making better use of time" and positively with "Work, school, and/or domestic activities overload;" moreover, students perceived more work overload than teachers. Discussion: Differences between students and teachers were observed in the following psychosocial factors: "Self-management," "Comfort," and "Enjoying home" (as positive factors) and "Domestic work" and "Interruptions, distractors, noise" (as negative factors), with students generally reporting more discomfort than teachers. The study analyzes these differences in relation to the demands and nature of the study and work activities undertaken by both groups, as well as the previous training of the skills and the resources required to carry them out.

Evaluation and Future Challenges in a Self-Guided Web-Based Intervention With and Without Chat Support for Depression and Anxiety Symptoms During the COVID-19 Pandemic: Randomized Controlled Trial.

BACKGROUND: The COVID-19 pandemic has had an impact on mental health worldwide. Low- and middle-income countries were largely affected by it. Mexico was one of the most affected countries. Extended periods of lockdowns, isolation, and social distancing, among other factors, highlighted the need to introduce web-based psychological interventions to the Mexican population. In this context, Mental Health COVID-19 emerged as a self-guided web-based intervention (SGWI) aimed at adults to improve mental health during the COVID-19 pandemic. OBJECTIVE: This study aims to assess the efficacy of 2 modalities of a self-guided intervention (with and without chat support) in reducing depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation. In addition, it aimed to compare the moderating role of coping strategies, acceptance, and satisfaction in participants' symptom reduction. We hypothesize that the self-guided, chat-supported modality will show higher efficacy than the modality without chat support in achieving clinical change and better performance as a moderator of depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation, as well as an increase in participants' satisfaction and acceptability. METHODS: A randomized controlled trial was conducted. Data were collected from May 2020 to June 2022. We performed intrasubject measures at 4 evaluation periods: pretest, posttest, and follow-up measurements at 3 and 6 months. Differences between intervention groups were assessed through the Mann-Whitney U test for continuous variables and the chi-square test for categorical variables. Changes due to intervention were analyzed using Wilcoxon W test. Moderated regression analysis was performed to test the hypothesized moderating role of coping strategies, usability, and opinion about treatment on clinical change. RESULTS: A total of 36 participants completed the intervention; of these, 5 (14%) were part of the SGWI group, and 31 (86%) were on the SGWI plus chat support (SGWI+C) group, which included a chat service with therapists. The perceived high complexity of the system for the SGWI group had a moderating effect associated with a lack of efficacy of the intervention regarding depression, but not when controlled for sociodemographic variables. A perception of lower helpfulness of the intervention was associated with poorer outcomes. Coping strategies did not show moderating effects. CONCLUSIONS: Enhancing the utility of web-based interventions for reducing clinical symptoms by incorporating a support chat to boost treatment adherence seemed to improve the perception of the intervention's usefulness. Web-based interventions face several challenges, such as eliminating complexities in platform use and increasing the users' perceived utility of the intervention, among other issues identified in the study. TRIAL REGISTRATION: ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/study/NCT04468893?tab=results. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/23117.

Spatial scales of COVID-19 transmission in Mexico.

During outbreaks of emerging infectious diseases, internationally connected cities often experience large and early outbreaks, while rural regions follow after some delay. This hierarchical structure of disease spread is influenced primarily by the multiscale structure of human mobility. However, during the COVID-19 epidemic, public health responses typically did not take into consideration the explicit spatial structure of human mobility when designing nonpharmaceutical interventions (NPIs). NPIs were applied primarily at national or regional scales. Here, we use weekly anonymized and aggregated human mobility data and spatially highly resolved data on COVID-19 cases at the municipality level in Mexico to investigate how behavioral changes in response to the pandemic have altered the spatial scales of transmission and interventions during its first wave (March-June 2020). We find that the epidemic dynamics in Mexico were initially driven by exports of COVID-19 cases from Mexico State and Mexico City, where early outbreaks occurred. The mobility network shifted after the implementation of interventions in late March 2020, and the mobility network communities became more disjointed while epidemics in these communities became increasingly synchronized. Our results provide dynamic insights into how to use network science and epidemiological modeling to inform the spatial scale at which interventions are most impactful in mitigating the spread of COVID-19 and infectious diseases in general.

Evaluation of dental emergency during the COVID-19 pandemic in the Social Rehabilitation Centre of San Francisco Kobén (Campeche, Mexico).

INTRODUCTION: During the COVID-19 pandemic, access to dental treatment by persons deprived of their liberty (PPL) was affected due to dentist-patient proximity and the risk of generation of aerosols in dental procedures and treatments. The risks of infection for oral health personnel are considered high, mainly from cross-infection between patients. OBJECTIVES: Differentiate between a true and false dental consultation emergency during the SARS-CoV-2 outbreak for a better and effective screening of inmates of the Social Rehabilitation Center (CERESO) of San Francisco Kobén (Campeche, Mexico). MATERIAL AND METHOD: An observational, cross-sectional, descriptive, and prospective study was designed for a sample of 100 inmates of the CERESO San Francisco Kobén, the data was collected in the prison's dental office, the participants signed a letter of informed consent to be voluntarily included in the study during the SARS-CoV-2 outbreak. The questionnaire "Assessment of a true Dental Emergency" previously validated for the Mexican population was applied, the personnel was standardized and an intra- examiner and inter-examiner reliability of k = 0.98 was obtained. To prepare the database and the analysis of the information collected, the Statistical Package for Social Science v. 21 (SPSS v.21) was used. RESULTS: When evaluating emergencies at the dental clinic, 84% were determined according to the instrument as a false emergency and 16% were a true emergency. DISCUSSION: In the population of CERESO of San Francisco Kobén, the figures for medical-dental care show that inmates face a proportionally low dental morbidity-mortality.

Fungal coinfection/superinfection in COVID-19 patients in a tertiary hospital in Mexico / Coinfección o sobreinfección fúngica en pacientes con COVID-19 en un hospital de tercer nivel en México

Introduction: Data on the prevalence of fungal coinfections/superinfections in patients with COVID-19 are limited. Objective: To describe the prevalence of fungal coinfections/superinfections in patients with COVID-19, as well as risk factors and demographic, clinical, and microbiological characteristics. Material and methods: We included patients with a confirmed COVID-19 diagnosis and a confirmed fungal infection hospitalized in the ICU from March 2020 to December 2021. We collected data on age, sex, comorbidities, hospital length of stay (days), laboratory (ferritin) and microbiological results, treatment for COVID-19, antifungal therapy, and outcomes obtained from the clinical records. Results: Only 11 out of 740 patients met the inclusion criteria. The coinfection rate was 0.3% and the superinfection was 1.2%. The most affected population was male adults. The coinfections/superinfections diagnosed were candiduria and candidemia, caused by Candida albicans, C. tropicalis, C. glabrata, C. lusitaniae, and Kluyveromyces marxianus (C. kefyr). In addition, tracheobronchitis due to Aspergillus fumigatus was found. The most used antifungals were fluconazole and caspofungin. The lethality in patients with fungal coinfections was 50% and superinfections, 22%. The length of hospital stay was 11-65 days. Eight patients required mechanical ventilation and six received corticosteroids. The main comorbidity was diabetes mellitus (81.8%). Conclusions: The rate of fungal coinfections/superinfections in COVID-19 patients was low, but the lethality found urges for routine fungal screening in patients with severe COVID-19 to timely detect fungal infections that may further compromise the patient's life.

Introducción: Los datos sobre la prevalencia de coinfecciones o sobreinfecciones fúngicas en pacientes con COVID-19 son limitados. Objetivo: Describir la prevalencia de coinfecciones o sobreinfecciones fúngicas en pacientes con COVID-19, así como los factores de riesgo y las características demográficas, clínicas y microbiológicas. Material y métodos: Se incluyeron pacientes con diagnóstico confirmado de COVID-19, hospitalizados en la unidad de cuidados intensivos y con infección fúngica confirmada entre marzo del 2020 y diciembre del 2021. Del expediente clínico se obtuvieron datos sobre edad, sexo, comorbilidades, días de estancia hospitalaria, resultados de laboratorio (ferritina) y microbiológicos, tratamiento contra COVID-19, terapia antifúngica y desenlace. Resultados: Once de 740 pacientes cumplieron con los criterios de inclusión. La tasa de coinfección fue del 0,3 % y la de sobreinfección fue del 1,2 %. La población más afectada fue la de hombres adultos. Las coinfecciones o sobreinfecciones diagnosticadas fueron candiduria y candidemia, causadas por Candida albicans, C. tropicalis, C. glabrata, C. lusitaniae y Kluyveromyces marxianus (C. kefyr). Además, se encontró una traqueobronquitis por Aspergillus fumigatus. Los antifúngicos más administrados fueron fluconazol y caspofungina. La letalidad en pacientes con coinfecciones fue del 50 % y con sobreinfecciones fúngicas, del 22 %. El tiempo de estancia intrahospitalaria fue de 11 a 65 días. Ocho de los pacientes requirieron asistencia respiratoria mecánica y seis recibieron corticoides. La principal comorbilidad fue diabetes mellitus (81,8 %). Conclusiones: La tasa de coinfecciones o sobreinfecciones por hongos en pacientes con COVID-19 fue baja, pero la letalidad de estas requiere, con urgencia, la realización de pruebas de rutina para detectar hongos en pacientes con COVID-19 grave para diagnosticar oportunamente infecciones fúngicas que puedan comprometer aún más la vida del paciente.

Fungal coinfection/superinfection in COVID-19 patients in a tertiary hospital in Mexico / Coinfección o sobreinfección fúngica en pacientes con COVID-19 en un hospital de tercer nivel en México

Introduction. Data on the prevalence of fungal coinfections/superinfections in patients with COVID-19 are limited. Objective. To describe the prevalence of fungal coinfections/superinfections in patients with COVID-19, as well as risk factors and demographic, clinical, and microbiological characteristics. Materials and methods. We included patients with a confirmed COVID-19 diagnosis and a confirmed fungal infection hospitalized in the ICU from March 2020 to December 2021. We collected data on age, sex, comorbidities, hospital length of stay (days), laboratory (ferritin) and microbiological results, treatment for COVID-19, antifungal therapy, and outcomes obtained from the clinical records. Results. Only 11 out of 740 patients met the inclusion criteria. The coinfection rate was 0.3% and the superinfection was 1.2%. The most affected population was male adults. The coinfections/superinfections diagnosed were candiduria and candidemia, caused by Candida albicans, C. tropicalis, C. glabrata, C. lusitaniae, and Kluyveromyces marxianus (C. kefyr). In addition, tracheobronchitis due to Aspergillus fumigatus was found. The most used antifungals were fluconazole and caspofungin. The lethality in patients with fungal coinfections was 50% and superinfections, 22%. The length of hospital stay was 11-65 days. Eight patients required mechanical ventilation and six received corticosteroids. The main comorbidity was diabetes mellitus (81.8%). Conclusions. The rate of fungal coinfections/superinfections in COVID-19 patients was low, but the lethality found urges for routine fungal screening in patients with severe COVID-19 to timely detect fungal infections that may further compromise the patient's life.

Introducción. Los datos sobre la prevalencia de coinfecciones o sobreinfecciones fúngicas en pacientes con COVID-19 son limitados. Objetivo. Describir la prevalencia de coinfecciones o sobreinfecciones fúngicas en pacientes con COVID-19, así como los factores de riesgo y las características demográficas, clínicas y microbiológicas. Materiales y métodos. Se incluyeron pacientes con diagnóstico confirmado de COVID-19, hospitalizados en la unidad de cuidados intensivos y con infección fúngica confirmada entre marzo del 2020 y diciembre del 2021. Del expediente clínico se obtuvieron datos sobre edad, sexo, comorbilidades, días de estancia hospitalaria, resultados de laboratorio (ferritina) y microbiológicos, tratamiento contra COVID-19, terapia antifúngica y desenlace. Resultados. Once de 740 pacientes cumplieron con los criterios de inclusión. La tasa de coinfección fue del 0,3 % y la de sobreinfección fue del 1,2 %. La población más afectada fue la de hombres adultos. Las coinfecciones o sobreinfecciones diagnosticadas fueron candiduria y candidemia, causadas por Candida albicans, C. tropicalis, C. glabrata, C. lusitaniae y Kluyveromyces marxianus (C. kefyr). Además, se encontró una traqueobronquitis por Aspergillus fumigatus. Los antifúngicos más administrados fueron fluconazol y caspofungina. La letalidad en pacientes con coinfecciones fue del 50 % y con sobreinfecciones fúngicas, del 22 %. El tiempo de estancia intrahospitalaria fue de 11 a 65 días. Ocho de los pacientes requirieron asistencia respiratoria mecánica y seis recibieron corticoides. La principal comorbilidad fue diabetes mellitus (81,8 %). Conclusiones. La tasa de coinfecciones o sobreinfecciones por hongos en pacientes con COVID-19 fue baja, pero la letalidad de estas requiere, con urgencia, la realización de pruebas de rutina para detectar hongos en pacientes con COVID-19 grave para diagnosticar oportunamente infecciones fúngicas que puedan comprometer aún más la vida del paciente.

Risk perception increase due to COVID-19 impacted antenatal care utilization among women in an indigenous community.

BACKGROUND: Risk perception varies greatly among individuals, affecting their behavior and decision-making in risky situations. The COVID-19 pandemic affected worldwide, but the role of risk perception related to COVID-19 in ethnic minorities in Mexico is unclear. This study quantifies the impact of COVID-related risk perception (susceptibility and severity) and perceived fear on the utilization of antenatal care services among indigenous women in San Cristobal de las Casas, Chiapas, Mexico. METHODS: We conducted a retrospective crossover study between June and December 2021, interviewing 98 women from San Cristóbal de las Casas, Chiapas. In a crossover design, each subject acts as their own control, so we required the participants to have a previous pregnancy experience. A logistic model was used to calculate the odds ratio for the outcome of having an adequate number of antenatal care visits. The analysis considered the period (during or before the pandemic) as well as perceived severity and susceptibility levels as independent variables. RESULTS: COVID-19 reduced antenatal care utilization by 50%. During the pandemic, the adjusted odds ratio for attending health antenatal care services was 0.83 (95% CI: 4.8, 14.5) compared to pre pandemics. Adjusted for fear of contagion, the mother's perception of severity was associated with an increased likelihood of an insufficient number of antenatal visits. OR = 0.25 (95% CI: 0.10, 0.65). CONCLUSION: The risk perception for COVID-19 decreased the likelihood of receiving an adequate number of antenatal care visits.

The role of racial bias and pathways to self-harm outcomes for Mexican-descent college students during the COVID-19 pandemic.

The COVID-19 pandemic highlighted preexisting health disparities and impacted the mental health of many Latine/x in the United States. Emerging adults are at increased risk for anxiety, depression (Ganson et al., 2021; Kujawa et al., 2020), and suicidal ideation (Tasnim et al., 2020). There is a scarcity of research that has examined sociocultural factors (i.e., racial bias, pandemic-related stress) associated with mental health outcomes (i.e., depression) and how they may be associated with self-harm resulting from the COVID-19 pandemic for Mexican-descent emerging adults. Using socioecological framework, we examined how COVID-19-related racial bias and perceived pandemic stress related to self-harm among Mexican-descent emerging adults. We used serial mediation to identify indirect effects between these factors. The present study examined the experiences of Mexican-descent college students during the COVID-19 pandemic. The participants (N = 818) were college students (ages 18-25) and completed an online survey. Rates of self-harm were as follows: 10.5% (suicide ideation), 6.9% (nonsuicidal self-injury), and 2.9% (suicide attempts). Results showed a significant indirect effect of COVID-19-related racial bias on suicide attempts via COVID-19-related perceived stress and depression symptoms (ß = .17, SE = .05, 95% CI [.10, .30]). Findings were consistent across self-harm outcomes (i.e., suicide ideation, nonsuicidal self-injury, and suicide attempts). This study elucidated novel processes from perceived COVID-19-related racial bias to self-harm outcomes via pandemic-related stress and depression symptoms. Findings inform culturally responsive interventions aimed at reducing self-harm in young adults faced with pervasive discrimination. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Clinical characteristics and severity markers in hospitalized COVID-19 patients from western Mexico: a comparative analysis of Delta and Omicron variants.

Introduction: COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a virus notable for its rapid mutation rate, which has led to the emergence of various variants such as Delta and Omicron, each with potentially different levels of transmissibility and virulence. Therefore, this study aims to compare clinical charactheristics and markers associated with the severity of COVID-19 in hospitalized patients from western Mexico who were infected with the Delta and Omicron variants of SARS-CoV-2. Methods: This cross-sectional study involved 66 patients hospitalized for COVID-19, diagnosed by RT-qPCR. SARS-CoV-2 variants were identified through whole genome sequencing using the COVIDseq platform from Illumina. Upon admission, patients underwent a clinical history assessment, blood gas analysis, and blood biometry. Additionally, several tests and markers were measured, including the percentage of neutralizing antibodies, erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNFα), D-dimer, lactate dehydrogenase (LDH), C-reactive protein (CRP), and ferritin. Results and discussion: Patients hospitalized with the Omicron were found to be older, compared to those infected with the Delta (64 vs. 54 years, p = 0.006). Additionally, a higher proportion of male patients were observed in the Omicron compared to the Delta (p = 0.029). Both Omicron and Delta variants were associated with lymphopenia, although the lymphocyte count was lower in Omicron (0.9 vs. 0.56 10x3/L; p = 0.007). The COVID-GRAM scale indicated a high risk for severe disease in both groups, but the score was higher in Omicron compared to Delta (157 vs. 128 points; p = 0.0004). Patients infected with Omicron exhibited a lower percentage of neutralizing antibodies than those with Delta (35.99 vs. 81%; p < 0.05), regardless of their vaccination status. Among the markers assessed, globular ESR was found to be lower in Omicron compared to Delta (30.5 vs. 41.5 mm/h; p = 0.001), while ferritin levels were higher in patients infected with the Omicron (1,359 vs. 960.6 µg/L; p = 0.007). In patients with severe COVID-19, markers such as lymphopenia, neutralizing antibody levels, ferritin, and COVID-GRAM scores are elevated in the Omicron variant, while only the leukocyte count and ESR for the Delta variant.

Coping, connection appraisal, and well-being during COVID-19 in the U.S., Japan, and Mexico.

Introduction: The COVID-19 pandemic has affected nearly every facet of life, constituting a "new normal" and prompting an ongoing collective psychological crisis. People's ways of coping with the pandemic and corresponding well-being are of particular research interest; however, these constructs have largely been examined using deductive quantitative approaches, deficit-based lenses, and mononational samples. Methods: The current mixed-methods study used inductive-sequential (QUAL → QUAN) approaches to explore positive coping strategies (approach coping style and COVID-related connection appraisal) and well-being (loneliness, distress, and happiness) across individuals from the United States, Japan, and Mexico. Qualitative data were gathered from N = 141 U.S., Japanese, and Mexican adults to examine how people perceived connection during the pandemic. Results: Qualitative analyses illuminated common themes in which people appraised the pandemic as an opportunity for connection and strengthened interpersonal relationships. Quantitative measures, including a newly-developed questionnaire on COVID-related connection appraisal, were then administered to a separate sample of N = 302 adults in the U.S, Japan, and Mexico to assess associations among approach coping style, COVID-related connection appraisal, and well-being outcomes (loneliness, distress, happiness). Quantitative analyses found significant associations among approach coping style, COVID-related connection appraisal, and all well-being outcomes. Of note, these associations did not differ by country. COVID-related connection appraisal mediated the relationship between approach coping style and two well-being outcomes (loneliness and happiness). Discussion: Findings point to approach coping style and connection appraisal as pathways for resilience and growth in the face of global suffering.

Inter-institutional laboratory standardization for SARS-CoV-2 surveillance through wastewater-based epidemiology applied to Mexico City.

Objectives: Wastewater-based surveillance applied to SARS-CoV-2 viral load quantification for COVID-19 has become one of the most relevant complementary tools in epidemiologic prevention programs worldwide. However, this valuable decision-making tool still requires fine-tuning to produce comparable results between laboratories, especially when applied to the surveillance of megacities. Methods: Six laboratories across Mexico and one from the United States executed an interlaboratory study to set up a singular standardized protocol considering method cost, installed infrastructure, materials available, and supply availability for SARS-CoV-2 quantification from five Mexico City sampling sites across this megacity. Results: Comparable data from processing outcomes in the Mexican laboratories and in the external international laboratory serve as a validating data source. The Bland-Altman comparison showed consistency, with cycle threshold values within ±1.96 SD of SARS-CoV-2 genetic copies for the standard curve quantification, with a mismatch of two laboratories. In addition, MS2 bacteriophage recovery rates varied between 35% and 67% among all participating laboratories. Finally, the efficiency of viral genetic material recovered from all participating laboratories varied between 65% and 93% for the participating laboratories. Conclusion: This work lays the foundation for extensive and continuous wastewater-based surveillance application across independent Mexican laboratories in a time- and resource-effective manner.

Machine learning-ready mental health datasets for evaluating psychological effects and system needs in Mexico city during the first year of the COVID-19 pandemic.

The prevalence of mental health problems constitutes an open challenge for modern societies, particularly for low and middle-income countries with wide gaps in mental health support. With this in mind, five datasets were analyzed to track mental health trends in Mexico City during the pandemic's first year. This included 33,234 responses to an online mental health risk questionnaire, 349,202 emergency calls, and city epidemiological, mobility, and online trend data. The COVID-19 mental health risk questionnaire collects information on socioeconomic status, health conditions, bereavement, lockdown status, and symptoms of acute stress, sadness, avoidance, distancing, anger, and anxiety, along with binge drinking and abuse experiences. The lifeline service dataset includes daily call statistics, such as total, connected, and abandoned calls, average quit time, wait time, and call duration. Epidemiological, mobility, and trend data provide a daily overview of the city's situation. The integration of the datasets, as well as the preprocessing, optimization, and machine learning algorithms applied to them, evidence the usefulness of a combined analytic approach and the high reuse potential of the data set, particularly as a machine learning training set for evaluating and predicting anxiety, depression, and post-traumatic stress disorder, as well as general psychological support needs and possible system loads.

Symptom Persistence Following COVID-19 Infection among an Indigenous Community Residing in the Isthmus of Tehuantepec, Oaxaca, Mexico.

Introduction/Objectives: Several studies have documented the development and persistence of symptoms related to COVID-19 and its secondary complications up to 12 months after the infection. We aimed to identify the medical complications following COVID-19 infection in the Indigenous Zapotec population of the Isthmus of Tehuantepec region in Oaxaca, Mexico. Methods: This is a cross-sectional analytical study that included 90 Indigenous Zapotec participants (30 males and 60 females) from the Tehuantepec region, Oaxaca, Mexico, who had an infectious process due to SARS-CoV-2. Sociodemographic and clinical data were identified through questionnaires. Results: Among the 201 participants, 90 individuals (66.7% women, 33.3% men) had contracted COVID-19. Out of these, 61 individuals reported persistent symptoms post-infection, with a mean symptom duration of 13.87 months. The results show significant variations in symptom duration based on age, marital status, educational attainment, vaccination status, and blood group. The most commonly reported symptoms included a dry cough, fever, myalgia, fatigue, headache, and depressive symptoms. Conclusions: This study highlights the post-COVID-19 symptoms and their prevalence within a specific sample of the Indigenous Zapotec population in Oaxaca, along with the sociodemographic and clinical factors influencing the duration of these symptoms. It underscores the necessity of personalized recovery strategies and highlights the critical role of vaccination in mitigating the long-term impacts of SARS-CoV-2.

The TIRS trial: Enrollment procedures and baseline characterization of a pediatric cohort to quantify the epidemiologic impact of targeted indoor residual spraying on Aedes-borne viruses in Merida, Mexico.

Aedes mosquito-borne viruses (ABVs) place a substantial strain on public health resources in the Americas. Vector control of Aedes mosquitoes is an important public health strategy to decrease or prevent spread of ABVs. The ongoing Targeted Indoor Residual Spraying (TIRS) trial is an NIH-sponsored clinical trial to study the efficacy of a novel, proactive vector control technique to prevent dengue virus (DENV), Zika virus (ZIKV), and chikungunya virus (CHIKV) infections in the endemic city of Merida, Yucatan, Mexico. The primary outcome of the trial is laboratory-confirmed ABV infections in neighborhood clusters. Despite the difficulties caused by the COVID-19 pandemic, by early 2021 the TIRS trial completed enrollment of 4,792 children aged 2-15 years in 50 neighborhood clusters which were allocated to control or intervention arms via a covariate-constrained randomization algorithm. Here, we describe the makeup and ABV seroprevalence of participants and mosquito population characteristics in both arms before TIRS administration. Baseline surveys showed similar distribution of age, sex, and socio-economic factors between the arms. Serum samples from 1,399 children were tested by commercially available ELISAs for presence of anti-ABV antibodies. We found that 45.1% of children were seropositive for one or more flaviviruses and 24.0% were seropositive for CHIKV. Of the flavivirus-positive participants, most were positive for ZIKV-neutralizing antibodies by focus reduction neutralization testing which indicated a higher proportion of participants with previous ZIKV than DENV infections within the cohort. Both study arms had statistically similar seroprevalence for all viruses tested, similar socio-demographic compositions, similar levels of Ae. aegypti infestation, and similar observed mosquito susceptibility to insecticides. These findings describe a population with a high rate of previous exposure to ZIKV and lower titers of neutralizing antibodies against DENV serotypes, suggesting susceptibility to future outbreaks of flaviviruses is possible, but proactive vector control may mitigate these risks.