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Infectio ; 25(4): 296-299, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286726


Resumen La identificación del nuevo Coronavirus tipo 2 en marzo de 2020 en Colombia ha generado paradigmas e incógnitas en la epidemiología nacional con respecto a la llegada aproximada del virus y sus mecanismos de diseminación local en los departamentos y ciudades principales. Presentamos el caso de un paciente con COVID-19 que tuvo su inicio de síntomas dos semanas antes de la declaración del primer caso en Colombia, lo que sugiere circulación del virus y transmisión local en Colombia previo a la declaración de la epidemia.

Abstract The identification of Coronavirus type 2 in March 2020 in Colombia has generated paradigms and unknows in the national epidemiology regarding the approxi mate arrival of the virus and its mechanisms of local dissemination in the main departments and cities. We present the case of a patient with COVID-19 that had its onset of symptoms two weeks before the declaration of the first case in Colombia, wich moves the circulation of the virus and local transmission in Colombia prior the declaration of the epidemic.

Humanos , Masculino , Adulto , Coronavirus , COVID-19 , Pneumonia , Vírus , Epidemiologia , Colômbia , Epidemias , Infecções
Infectio ; 25(4): 262-269, oct.-dic. 2021. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1286720


Abstract Objective: To analyse the clinic characteristics, risk factors and evolution of the first cohort of hospitalised patients with confirmed infection by COVID-19 in 5 Colombian institutions. Materials and methods: Is a retrospective observational study of consecutive hospitalized patients with a diagnosis of COVID-19 confirmed from March 01 to May 30, 2020 in Colombia. Results: A total of 44 patients were included. The median age was 62 years. 43.2% had a history of smoking, while 69.8% were overweight or obese. 88.6% had at least one comorbidity and 52.3% had three or more comorbidities. Hypertension and dyslipidaemia were the most frequent comorbidities (40.9% and 34.1%, respectively). The 30-day mortality rate was 47.7% with a median of 11 days. The composite outcome occurred in the 36.4%. The biomarkers associated with mor tality risk included troponin higher than 14 ng/L (RR: 5.25; 95% CI 1.37-20.1, p = 0.004) and D-dimer higher than 1000 ng/ml (RR: 3.0; 95% CI 1.4-6.3, p = 0.008). Conclusions: The clinical course of SARS-CoV-2 infection in hospitalized Colombian was characterised by a more advanced stage of the infection.

Resumen Objetivo: Analizar las características, clínicas, factores de riesgo, y la evolución de pacientes hospitalizados con infección confirmada por COVID-19 en 5 Institu ciones de Colombia. Material y método: Es un estudio observacional retrospectivo de pacientes consecutivos hospitalizados con diagnóstico de COVID-19 confirmado entre 01 de Febrero de 2020 y 30 de Mayo de 2020 en Colombia. Resultados: Un total de 44 pacientes fueron incluidos. La mediana de edad fue de 62 años y la mayoría del sexo masculino. El 43.2% tenían historia de tabaquismo, mientras que el 69.8% tenían sobrepeso u obesidad. El 88.6% tenían al menos una comorbilidad y el 52.3% tenían tres o más comorbilidades. La hipertensión arterial fue la comorbilidad más frecuente (40.9%), seguido de la dislipidemia (34.1%). La tasa de letalidad a 30 días fue de 47.7% y ocurrió con una mediana de 11 días. El 36.4% presentó el desenlace compuesto. Los biomarcadores asociados con el riesgo de muerte fue troponina > 14 ng/mL (RR:5.25, IC95% 1.37-20.1, p=0.004) y dímero D mayor a 1000 mg/dL (RR: 3.0, IC95% 1.4-6.3, p=0.008). Conclusiones: El curso clínico de la infección por SARS-CoV-2 en colombianos hospitalizados fue un estadio más avanzado de la infección.

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Biomarcadores , COVID-19 , Pacientes , Tabagismo , Comorbidade , Risco , Fatores de Risco , Mortalidade , Colômbia , Sobrepeso , Cursos , Infecções , Obesidade
Artigo em Inglês | MEDLINE | ID: mdl-34523858


BACKGROUND: The integration of health services with other sectors is hypothesised to support adaptation of health systems in response to coronavirus disease 2019 (COVID-19). This study identified barriers and enablers associated with intersectoral coordination at an early stage of the pandemic. The study focused on the roles played by the academic and private sector in different areas of public health planning and delivery concerning COVID-19 in Colombia. METHODS: A qualitative approach was used to understand stakeholders' experiences and perceptions of intersectoral working in response to COVID-19 in three Colombian cities (Bogotá, Cali and Cartagena). Between March and November 2020, data was collected via semi-structured interviews conducted online with 42 key actors, including representatives of governmental bodies, universities, and professional associations. The dataset was analysed thematically using a combination of inductive and deductive methods. RESULTS: Organizations adjacent to the health system, including universities and the private sector, supported responses to COVID-19 by providing evidence to inform decision-making, additional service capacity, and supporting coordination (eg, convening intersectoral "roundtables"). The academic and private sector involvement in intersectoral coordination was stimulated by solidarity (being the "right thing to do") and motivation for supporting local companies (reopening the economy). Intersectoral working was influenced by pre-existing (substantive) and emerging (situational) enablers and barriers. CONCLUSION: This study showed that intersectoral coordination has played an important role in responding to COVID-19 in Colombia. Coordination was influenced by substantive and situational enablers and barriers. Based on our findings, policy-makers should focus on addressing substantive barriers to coordination, including the pre-existing tensions and mistrust among national and local healthcare actors, strict regulations and limited financial and human resources, while providing support for situational enablers, including alignment of public and private actors' interests, intersectoral government support and establishing frequent communication channels and formal spaces of interaction among sector, in processes of decision-making.

Int J Ment Health Addict ; : 1-3, 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34539280


A paper reporting the psychometric properties of the Spanish Fear of COVID-19 Scale (FCV-19S) among Colombian physicians was recently published in the International Journal of Mental Health and Addiction. Although we welcome the translation and validation of our seven-item scale, this commentary outlines some major concerns we have with the study especially the removal of two items in developing a five-item FCV-19S. Based on these concerns, we strongly recommend that healthcare providers and researchers should use the five-item FCV-19S with caution.

Artigo em Inglês | MEDLINE | ID: mdl-34467554


BACKGROUND: Multiple studies have described increased risk of severe coronavirus disease (COVID-19) among pregnant women compared to nonpregnant women. The risk in middle-income countries where the distributions of age groups and preexisting conditions may differ is less known. OBJECTIVES: To determine whether pregnant women with SARS-CoV-2 infection are at increased risk for severe COVID-19 compared to nonpregnant women in Colombia. METHODS: We analysed national surveillance data from Colombia, of women aged 15-44 years with laboratory-confirmed infection with SARS-CoV-2 by molecular or antigen testing, from 6 March 2020 to 12 December 2020. An enhanced follow-up of pregnant women with COVID-19 was established to monitor pregnancy and birth outcomes. RESULTS: Of 371,363 women aged 15-44 years with laboratory-confirmed SARS-CoV-2 infection, 1.5% (n = 5614) were reported as pregnant; among those, 2610 (46.5%) were considered a complete pregnancy for reporting purposes at the time of analysis. Hospitalisation (23.9%) and death (1.3%) occurred more frequently among pregnant symptomatic women compared to nonpregnant symptomatic women (2.9% and 0.3%, respectively). Compared to nonpregnant symptomatic women, pregnant symptomatic women were at increased risk of hospitalisation (adjusted risk ratio (RR) 2.19, 95% confidence interval (CI) 2.07, 2.32) and death (RR 1.82, 95% CI 1.60, 2.07), after adjusting for age, type of health insurance and presence of certain underlying medical conditions. Among complete pregnancies, 55 (2.1%) were pregnancy losses, 72 (2.8%) resulted in term low birthweight infants and 375 (14.4%) were preterm deliveries. CONCLUSIONS: Although pregnant women were infrequently reported with laboratory-confirmed SARS-CoV-2 infection, pregnant symptomatic women with COVID-19 were at increased risk for hospitalisation and death compared to nonpregnant symptomatic women. Almost all infections we reported on were third-trimester infections; ongoing follow-up is needed to determine pregnancy outcomes among women infected earlier in pregnancy. Healthcare providers should counsel pregnant women about preventive measures to protect from SARS-CoV-2 infection and when to seek care.

Rev Colomb Psiquiatr (Engl Ed) ; 50(3): 184-188, 2021.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34479844


INTRODUCTION: The COVID-19 pandemic is having an impact on multiple levels, one being the way of providing mental health care services. A study was proposed in order to identify the standpoints regarding the role we must assume as psychiatrists in the setting of this pandemic in Colombia. METHODS: A study was developed employing a Delphi-type methodology. Three types of psychiatrist were included for the application of the instrument: directors of academic psychiatry programmes, directors of mental health institutions and private practitioners. RESULTS: Responses were collected over the course of a month (between April and May) by 24 participants corresponding to 14 private practitioners (58.3%), 6 heads of academic programmes (25.1%) and 4 directors of mental health services (16.6%). The results, grouped around the psychiatric work, describe the impact generated by the pandemic and the possible role of the specialist. CONCLUSIONS: Consistency was identified around the need to provide a differential approach according to the vulnerabilities of each group of people exposed to the pandemic; as well as the remote provision of health care through technology, often using videoconferencing.

Rev Colomb Obstet Ginecol ; 72(2): 162-170, 2021 06 30.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34506703


Objective: To make an approximation to the prevalence of sleep disorders in Colombian menopausal women during the COVID-19 pandemic Materials and Methods: Cross-sectional study as part of the Quality of Life in Menopause and Colombian Ethnic Groups research project [CAVIMEC+COVID STUDY]. The population consisted of women born and residing in Colombia, 40 to 59 years of age, who signed an informed consent and agreed to participate by completing an online form, freely and anonymously, in the first five days of June 2020. Sleep disorders were identified using the third item on the Menopause Rating Scale. Sociodemographic characteristics, presence and severity of sleep disorders and menopause status were explored. Descriptive statistics are provided. Results: Overall, 984 women aged 47.0 [IQR: 42.0-53.5] years were included: 84.5% mestizo, 13.7% Afro-Colombian, 1.7% indigenous; 39.3% were postmenopausal; 70% lived in the Caribbean region of Colombia. Sleep disorders were reported by 637 women (64.7%), and 112 (11.3%) had severe sleep disorders. Among postmenopausal women, 65.1% reported sleep disorders with 10.1% reporting severe disorders, while 64.5% of premenopausal reported sleep disorders, and 12.2% severe disorders. Conclusions: Sleep disorders could be a frequent problem among premenopausal as well as postmenopausal women in the pandemic time. This issue should be explored during gynecological visits in order to offer solutions. Population studies that confirm these observations are required.

PLoS One ; 16(9): e0256566, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469472


BACKGROUND: Adequate testing is critically important for control of the SARS-CoV-2 pandemic. Antibody testing is an option for case management and epidemiologic studies, with high specificity and variable sensitivity. However, characteristics of local populations may affect performance of these tests. For this reason, the National Institute of Health (INS) and regulatory agencies in Colombia require verification of diagnostic accuracy of tests introduced to the Colombian market. METHODS: We conducted a validation study of the Abbott SARS-CoV-2 test for qualitative detection of IgG using the Abbott Architect i2000SR. Participants and retrospective samples were included from patients with suspected SARS-CoV-2 infection, age ≥18 years, and ≥8 days elapsed since initiation of symptoms. Pre-pandemic plasma samples (taken before October 2019) were used as controls. We estimated the sensitivity, specificity and agreement (kappa) of the Abbott IgG test compared to the gold standard (RT-PCR). RESULTS: The overall sensitivity was 83.1% (95% CI: 75.4-100). Sensitivity among patients with ≥14 days since the start of symptoms was 85.7%, reaching 88% in samples collected from patients with COVID-19 symptoms onset >60 days. Specificity was 100% and the kappa index of agreement was 0.804 (95% CI: 0.642-0.965). CONCLUSIONS: Our findings show high sensitivity and specificity of the Abbott IgG test in a Colombian population, which meet the criteria set by the Colombian INS to aid in the diagnosis of COVID-19. Data from our patient groups also suggest that IgG response is detectable in a high proportion of individuals (88.1%) during the first two months following onset of symptoms.

Anticorpos Antivirais/sangue , Teste Sorológico para COVID-19/instrumentação , COVID-19/sangue , Imunoglobulina G/sangue , Pandemias , SARS-CoV-2/metabolismo , Adulto , Idoso , COVID-19/epidemiologia , Colômbia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Sensibilidade e Especificidade
Ann Clin Microbiol Antimicrob ; 20(1): 66, 2021 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521428


BACKGROUND: To date, there is no specific antiviral therapy for severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) that causes Coronavirus disease 2019 (Covid-19). Since there is no specific therapy against SARS-CoV2, current efforts aim to prevent contagion through public health measures and develop a protective vaccine. While waiting for the latter, it is necessary to evaluate the drugs that at least, in initial studies, suggested some degree of utility in the management of Covid-19 or its complications. The main objective of the study was to describe the clinical manifestations and outcomes of patients with severe Covid-19 Pneumonia treated with corticosteroids and colchicine. MATERIALS AND METHODS: A cross sectional study of 301 adult patients with Covid-19 Pneumonia confirmed by Real-Time Polymerase Chain Reaction for SARS-CoV2 (RT-PCR SARS-CoV2), Berlin protocol, who required hospitalization in three hospitals in Antioquia, Colombia. Patients were treated according to the institutional protocol (from March 20, 2020 to June 30, 2020) with corticosteroid if the patient required supplemental oxygen. From July 1, 2020, the management protocol changed with the addition of colchicine to all patients admitted to the institutions. The treatment was supervised and monitored by the same specialist in Infectology of the institutions. We describe the clinical manifestations and outcomes of the patients who received these treatments. The information of the patients was analyzed according to the outcome of interest (alive/dead) with univariate, bivariate, and multivariate measures to adjust the variables that presented statistical association. RESULTS: All patients had pneumonia documented by chest computed tomography with ground glass images and presented an alveolar pressure/inspired oxygen fraction (PaFi) less than 300. Three hundred one patients were included, 240 (79.7%) received corticosteroids, within these 145 (48.2%) received colchicine also, and the remaining 61 (20.3%) patients did not receive corticosterioids or colchicine. Mortality in the group that received colchicine was lower compared to the group that did not receive it (9.6 vs 14.6%, p-value = 0.179). CONCLUSIONS: Treatment with corticosteroids and colchicine for managing patients with severe Covid-19 Pneumonia was associated with low mortality at the hospital level. Randomized, placebo-controlled studies are required to evaluate the effect of corticosteroids and colchicine on complications or death from Covid-19.

Artigo em Espanhol | PAHO-IRIS | ID: phr-54837


[RESUMEN]. Objetivo. Describir los resultados de una estrategia de acompañamiento virtual y presencial, con base en el cuidado centrado en la persona durante la atención a pacientes hospitalizados por sospecha o confirmación de enfermedad por el nuevo coronavirus 2019 (COVID-19, por su sigla en inglés). Método. Estudio observacional descriptivo retrospectivo realizado en cinco instituciones de salud de la red de clínica Colsanitas que implementaron una estrategia de acompañamiento con siete modalidades: información virtual, dispositivos móviles personales, visitas virtuales, contactos con otros medios, acompañante permanente, visita presencial y contacto compasivo. Se utilizó estadística descriptiva para el análisis de los datos. Resultados. La estrategia de acompañamiento se aplicó a 871 pacientes con estancia hospitalaria de 1 a 90 días, 70% fueron positivos para COVID-19; en la modalidad de información virtual, se contactaron a familias de 764 pacientes realizando 3984 llamadas; en promedio se realizaron 71 visitas virtuales al día; se recibieron 428 cartas, mensajes de voz y videos, entre otros; 114 pacientes tuvieron un acompañante permanente; 154 pacientes tuvieron visita presencial; y 20 familias realizaron visita presencial póstuma al paciente. Conclusión. Los resultados de la estrategia de acompañamiento virtual y presencial con enfoque centrado en la persona mostraron que la participación de las familias es importante en el cuidado del paciente y mejora la comunicación e interacción entre los pacientes, las familias y el equipo de salud.

[ABSTRACT]. Objective. To describe the results of a virtual and in-person accompaniment strategy based on person-centered care of patients hospitalized for suspected or confirmed disease due to the novel 2019 coronavirus (COVID-19). Method. Retrospective descriptive observational study conducted in five health facilities of the Colsanitas clinic network that implemented an accompaniment strategy with seven modalities: virtual information, personal mobile devices, virtual visits, contacts by other means, round-the-clock companion, in-person visit, and compassionate contact. Descriptive statistics were used for data analysis. Results. The accompaniment strategy was used with 871 patients with hospital stays ranging from 1 to 90 days; 70% were positive for COVID-19. The families of 764 patients were contacted through 3984 calls in the virtual information modality; an average of 71 virtual visits per day occurred; 428 letters, voice messages, and videos, among others, were received; 114 patients had a round-the-clock companion; 154 patients had an in-person visit; and 20 families made a posthumous in-person visit to the patient. Conclusion. The results of the virtual and in-person accompaniment strategy with a person-centered approach showed that family involvement is important to patient care and improves communication and interaction among patients, families, and the healthcare team.

[RESUMO]. Objetivo. Descrever os resultados de uma estratégia de acompanhamento virtual e presencial, baseada no cuidado centrado na pessoa, durante o atendimento de pacientes internados por doença do novo corona-vírus de 2019 (COVID-19) suspeita ou confirmada. Métodos. Estudo observacional descritivo retrospectivo realizado em cinco instituições de saúde da rede clínica Colsanitas, que implementaram uma estratégia de acompanhamento com sete modalidades: informação virtual, dispositivos móveis pessoais, visitas virtuais, contatos por outros meios, acompanhante permanente, visita presencial e contato solidário. Foram utilizadas estatísticas descritivas para análise dos dados. Resultados. A estratégia de acompanhamento foi aplicada em 871 pacientes com 1 a 90 dias de internação, dos quais 70% positivaram para COVID-19. Na modalidade de informação virtual, as famílias de 764 pacientes foram contatadas por meio de 3.984 ligações; em média, foram realizadas 71 visitas virtuais por dia; foram recebidas 428 cartas, mensagens de voz e vídeos, entre outros meios; 114 pacientes contaram com um acompanhante permanente; 154 pacientes receberam visita presencial; e 20 famílias fizeram uma visita presencial póstuma ao paciente. Conclusões. Os resultados da estratégia de acompanhamento virtual e presencial com abordagem centrada na pessoa mostraram que a participação da família é importante no cuidado ao paciente e melhora a comunicação e a interação entre paciente, família e equipe de saúde.

Assistência Centrada no Paciente , COVID-19 , Hospitalização , Comunicação , Cuidadores , Empatia , Colômbia , Assistência Centrada no Paciente , Hospitalização , Cuidadores , Empatia , Assistência Centrada no Paciente , Hospitalização , Empatia
Braz J Biol ; 83: e250235, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34550294


The Neotropical freshwater cladoceran Bergamina lineolata (Sars, 1901) was found in a small temporal pond in the Magdalena department. Hitherto, it has been reported in Brazil and El Salvador. It was originally described as Alonella lineolata by Sars, 1901 from Brazil and then placed to the genus Bergamina by Elmoor-Loureiro et al. (2013). This is the first record of this species in Colombia. B. lineolata can be identified by a unique combination of characters including: 1) a remarkably large and oblong postabdomen, with three denticles on distal corner; 2) basal spine of the claw very short, length less than the half claw diameter at base; 3) IDL with two setae shorter than ODL seta, armed with fine setules unilaterally in terminal half; 4) endite 1 of trunk limb I with a long smooth seta between endites 1 and 2.

Infectio ; 25(3): 145-152, jul.-set. 2021. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1250084


Abstract Objectives: To determine the prevalence of antibodies to SARS-CoV-2 and the incidence of seroconversion in the first month of follow-up among interns, residents, and medical doctors attending patients at a University Hospital in Bogota (Colombia). Design or methods: A cross-sectional and a prospective study were performed during June, July, and August 2020 to assess seroprevalence and seroconversion rates using CLIA IgG for SARS-CoV-2. LFA IgG and IgM and ELFA IgM were also determined to explore concordance with CLIA IgG. Results: At baseline, 8 (2.28% 95%CI 1.16-4.43%) participants were IgG positive for SARS-CoV-2 by CLIA. At the end of the study, 21 (5.98% 95%CI 3.94-8.97%) individuals seroconverted by CLIA IgG. In all, 29 individuals had IgG by CLIA and of these 11 (3.13% 95%CI 1.76-5.52%) were asymptomatic. No associations with risk factors for infection were identified. CLIA IgG had moderate concordance (>962 samples) with LFA IgG and ELFA IgM, but minimal with LFA IgM. Conclusions: Our report is the first in Latina America on seroprevalence and seroconversion rates in medical healthcare workers. The relatively high rate (>3%) of asymptomatic health care workers with evidence of previous SARS-CoV-2 infection underscores the need to screen this population for infection to prevent infection/disease spread.

Resumen Objetivos: Determinar la prevalencia de anticuerpos frente al SARS-CoV-2 y la incidencia de seroconversión en el primer mes de seguimiento en internos, residentes y médicos que atienden pacientes en un Hospital Universitario de Bogotá (Colombia). Diseño y métodos: Se realizó un estudio transversal y prospectivo durante junio, julio y agosto de 2020 para evaluar las tasas de seroprevalencia y seroconversión utilizando CLIA IgG para SARS-CoV-2. También se determinaron LFA IgG e IgM y ELFA IgM para explorar la concordancia con CLIA IgG. Resultados: Al inicio del estudio, 8 (2,28% IC del 95% 1,16-4,43%) participantes fueron IgG positivos para SARS-CoV-2 por CLIA. Al final del estudio, 21 (5,98% IC 95% 3,94-8,97%) individuos seroconvirtieron por CLIA IgG. En total, 29 individuos tenían IgG por CLIA y de estos 11 (3,13% 95% IC 1,76-5,52%) eran asintomáticos. No se identificaron asociaciones con factores de riesgo de infección. El CLIA IgG tuvo una concordancia moderada (> 962 muestras) con LFA IgG y ELFA IgM, pero mínima con el LFA IgM. Conclusiones: Nuestro informe es el primero en América Latina sobre tasas de seroprevalencia y seroconversión en trabajadores médicos de la salud. La tasa relativamente alta (> 3%) de trabajadores de la salud asintomáticos con evidencia de infección previa por SARS-CoV-2 resalta la necesidad de realizar pruebas de detección de infección en esta población para prevenir la propagación de la infección.

Infectio ; 25(3): 176-181, jul.-set. 2021. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1250089


Abstract Objective: To determine the mortality and survival of COVID-19 cases in Colombia between March and July 2020. Materials and methods: A retrospective cohort study in the Colombian population between March 6 to July 8, 2020, with the data reported to the National Institute of Health. Survival analysis was performed considering the real-time PCR results, died or recovered, the onset of symptoms until the date of death, or the final time of the cohort. The actuarial variation and Long-Rank test were applied for survival. Risk factors were determined by Cox regression. Results: The overall survival rate was 100%, 98%, 97%, and 95% for day 1, 10, 20 and 30, respectively. Differences were found in survival in age, sex, region, and hospitaliza tion time spending (p <0.01), the 30-day survival rate was 96% and 95% for females and males, respectively. The region with the highest survival was Antioquia with 99% and the lower Barranquilla with 93%. The age group with the lowest survival was ≥80 years of age with 60%, and being hospitalized represented a survival rate of 68%. Conclusions: This study is one of the first to estimate survival in the Colombian population diagnosed with COVID-19.

Resumen Objetivo: determinar la mortalidad y supervivencia de casos de COVID-19 en Colombia entre marzo y julio de 2020. Materiales y métodos: Estudio de cohorte retrospectivo en población colombiana entre el 6 de marzo al 8 de julio de 2020, con los datos reportados al Instituto Nacional de Salud. El análisis de supervivencia se realizó considerando los resultados de la PCR en tiempo real, fallecido o recuperado, el inicio de los síntomas hasta la fecha del fallecimiento o el momento final de la cohorte. Para la supervivencia se aplicó la variación actuarial y la prueba de rango largo. Los factores de riesgo se determinaron mediante regresión de Cox. Resultados: La tasa de supervivencia general fue del 100%, 98%, 97% y 95% para los días 1, 10, 20 y 30, respectivamente. Se encontraron diferencias en la su pervivencia en cuanto a edad, sexo, región y tiempo de hospitalización (p <0,01), la tasa de supervivencia a 30 días fue del 96% y 95% para mujeres y hombres, respectivamente. La región con mayor supervivencia fue Antioquia con 99% y la Baja Barranquilla con 93%. El grupo de edad con menor supervivencia fue el ≥80 años con 60%, y la hospitalización representó una tasa de supervivencia del 68%. Conclusiones: Este estudio es uno de los primeros en estimar la supervivencia en la población colombiana diagnosticada con COVID-19.

Int J Hyg Environ Health ; 238: 113833, 2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34461424


The coronavirus disease 2019 (COVID-19) is still spreading fast in several tropical countries after more than one year of pandemic. In this scenario, the effects of weather conditions that can influence the spread of the virus are not clearly understood. This study aimed to analyse the influence of meteorological (temperature, wind speed, humidity and specific enthalpy) and human mobility variables in six cities (Barranquilla, Bogota, Cali, Cartagena, Leticia and Medellin) from different biomes in Colombia on the coronavirus dissemination from March 25, 2020, to January 15, 2021. Rank correlation tests and a neural network named self-organising map (SOM) were used to investigate similarities in the dynamics of the disease in the cities and check possible relationships among the variables. Two periods were analysed (quarantine and post-quarantine) for all cities together and individually. The data were classified in seven groups based on city, date and biome using SOM. The virus transmission was most affected by mobility variables, especially in the post-quarantine. The meteorological variables presented different behaviours on the virus transmission in different biogeographical regions. The wind speed was one of the factors connected with the highest contamination rate recorded in Leticia. The highest new daily cases were recorded in Bogota where cold/dry conditions (average temperature <14 °C and absolute humidity >9 g/m3) favoured the contagions. In contrast, Barranquilla, Cartagena and Leticia presented an opposite trend, especially with the absolute humidity >22 g/m3. The results support the implementation of better local control measures based on the particularities of tropical regions.

Vaccines (Basel) ; 9(7)2021 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-34358213


Coronavirus disease (COVID-19) pandemic caused by the coronavirus SARS-CoV-2 represents an enormous challenge to global public health, with thousands of infections and deaths in over 200 countries worldwide. The purpose of this study was to identify SARS-CoV-2 epitopes with potential to interact in silico with the alleles of the human leukocyte antigen class I (HLA I) and class II (HLA II) commonly found in the Colombian population to promote both CD4 and CD8 immune responses against this virus. The generation and evaluation of the peptides in terms of HLA I and HLA II binding, immune response, toxicity and allergenicity were performed by using computer-aided tools, such as NetMHCpan 4.1, NetMHCIIpan 4.0, VaxiJem, ToxinPred and AllerTop. Furthermore, the interaction between the predicted epitopes with HLA I and HLA II proteins frequently found in the Colombian population was studied through molecular docking simulations in AutoDock Vina and interaction analysis in LigPlot+. One of the promising peptides proposed in this study is the HLA I epitope YQPYRVVVL, which displayed an estimated coverage of over 82% and 96% for the Colombian and worldwide population, respectively. These findings could be useful for the design of new epitope-vaccines that include Colombia among their population target.

Vacunas ; 2021 Aug 04.
Artigo em Espanhol | MEDLINE | ID: mdl-34366753


OBJECTIVE: Colombia designed and adopted a vaccination plan against COVID-19 that will immunize 35 million people. The aim study was to know the willingness to accept the vaccination against COVID-19. METHODS: A telephone survey of 11,721 people aged 80 and over, affiliated with a health insurer, was carried. The respondents were the affiliates or their relatives or caregivers. RESULTS: The average age was 85.0 years (SD: 4.5), with no differences between sexes. 3 344 (28.5%) referred a previous diagnostic test for COVID-19. 73 were positive for an incidence of 622.8 per 100 thousand people (95% CI 491-778). Regarding the attitude with the vaccination against COVID-19, one in four respondents refrained from giving an opinion or was neutral. When the respondent was a relative, the acceptance of the vaccine was 60.4% (95% CI 59.5 - 61.3) with differences by sex: men 62.2% (95% CI: 60.8 - 63.6) and women of 59.2 (95% CI: 58.0 - 60.3) p <0.05. When the respondent was the potential recipient of the vaccine, the acceptance of the vaccine was 61.7% (95% CI 59.4 - 64.0) and also differed by sex: 70.2% in men (95% CI: 66, 9 - 73.5) and 55.1% in women (95% CI: 52.0 - 58.3) p <0.05. CONCLUSION: The relatively low acceptance of vaccination against COVID-19 in Colombia poses significant challenges to achieve herd immunity that allows control of the pandemic.

Nat Commun ; 12(1): 4726, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34354078


Latin America has been severely affected by the COVID-19 pandemic but estimations of rates of infections are very limited and lack the level of detail required to guide policy decisions. We implemented a COVID-19 sentinel surveillance study with 59,770 RT-PCR tests on mostly asymptomatic individuals and combine this data with administrative records on all detected cases to capture the spread and dynamics of the COVID-19 pandemic in Bogota from June 2020 to early March 2021. We describe various features of the pandemic that appear to be specific to a middle income countries. We find that, by March 2021, slightly more than half of the population in Bogota has been infected, despite only a small fraction of this population being detected. The initial buildup of immunity contributed to the containment of the pandemic in the first and second waves. We also show that the share of the population infected by March 2021 varies widely by occupation, socio-economic stratum, and location. This, in turn, has affected the dynamics of the spread with different groups being infected in the two waves.

COVID-19/epidemiologia , COVID-19/transmissão , COVID-19/diagnóstico , Colômbia/epidemiologia , Controle de Doenças Transmissíveis/métodos , Geografia , Humanos , SARS-CoV-2 , Estudos Soroepidemiológicos , Fatores Socioeconômicos
Lancet Reg Health Am ; : 100048, 2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34458886


Background: Epidemiologic surveillance of COVID-19 is essential to collect and analyse data to improve public health decision making during the pandemic. There are few initiatives led by public-private alliances in Colombia and Latin America. The CoVIDA project contributed with RT-PCR tests for SARS-CoV-2 in mild or asymptomatic populations in Bogotá. The present study aimed to determine the factors associated with SARS-CoV-2 infection in working adults. Methods: COVID-19 intensified sentinel epidemiological surveillance study, from April 18, 2020, to March 29, 2021. The study included people aged 18 years or older without a history of COVID-19. Two main occupational groups were included: healthcare and essential services workers with high mobility in the city. Social, demographic, and health-related factors were collected via phone survey. Afterwards, the molecular test was conducted to detect SARS-CoV-2 infection. Findings: From the 58,638 participants included in the study, 3,310 (5·6%) had a positive result. A positive result was associated with the age group (18-29 years) compared with participants aged 60 or older, participants living with more than three cohabitants, living with a confirmed case, having no affiliation to the health system compared to those with social health security, reporting a very low socioeconomic status compared to those with higher socioeconomic status, and having essential occupations compared to healthcare workers. Interpretation: The CoVIDA study showed the importance of intensified epidemiological surveillance to identify groups with increased risk of infection. These groups should be prioritised in the screening, contact tracing, and vaccination strategies to mitigate the pandemic.

PLoS One ; 16(8): e0255594, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34352012


INTRODUCTION: Implementation of evidence-based care for heavy drinking and depression remains low in global health systems. We tested the impact of providing community support, training, and clinical packages of varied intensity on depression screening and management for heavy drinking patients in Latin American primary healthcare. MATERIALS AND METHODS: Quasi-experimental study involving 58 primary healthcare units in Colombia, Mexico and Peru randomized to receive: (1) usual care (control); (2) training using a brief clinical package; (3) community support plus training using a brief clinical package; (4) community support plus training using a standard clinical package. Outcomes were proportion of: (1) heavy drinking patients screened for depression; (2) screen-positive patients receiving appropriate support; (3) all consulting patients screened for depression, irrespective of drinking status. RESULTS: 550/615 identified heavy drinkers were screened for depression (89.4%). 147/230 patients screening positive for depression received appropriate support (64%). Amongst identified heavy drinkers, adjusting for country, sex, age and provider profession, provision of community support and training had no impact on depression activity rates. Intensity of clinical package also did not affect delivery rates, with comparable performance for brief and standard versions. However, amongst all consulting patients, training providers resulted in significantly higher rates of alcohol measurement and in turn higher depression screening rates; 2.7 times higher compared to those not trained. CONCLUSIONS: Training using a brief clinical package increased depression screening rates in Latin American primary healthcare. It is not possible to determine the effectiveness of community support on depression activity rates due to the impact of COVID-19.

Consumo de Bebidas Alcoólicas/psicologia , Alcoólicos/psicologia , Depressão/terapia , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/prevenção & controle , Intoxicação Alcoólica/psicologia , Alcoolismo/diagnóstico , Colômbia/epidemiologia , Comorbidade , Atenção à Saúde , Depressão/psicologia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , México/epidemiologia , Pessoa de Meia-Idade , Peru/epidemiologia , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/tendências , Encaminhamento e Consulta , Detecção do Abuso de Substâncias/métodos
Viruses ; 13(7)2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34372606


As demonstrated with the novel coronavirus pandemic, rapid and accurate diagnosis is key to determine the clinical characteristic of a disease and to improve vaccine development. Once the infected person is identified, hematological findings may be used to predict disease outcome and offer the correct treatment. Rapid and accurate diagnosis and clinical parameters are pivotal to track infections during clinical trials and set protection status. This is also applicable for re-emerging diseases like dengue fever, which causes outbreaks in Asia and Latin America every 4 to 5 years. Some areas in the US are also endemic for the transmission of dengue virus (DENV), the causal agent of dengue fever. However, significant number of DENV infections in rural areas are diagnosed solely by clinical and hematological findings because of the lack of availability of ELISA or PCR-based tests or the infrastructure to implement them in the near future. Rapid diagnostic tests (RDT) are a less sensitive, yet they represent a timely way of detecting DENV infections. The purpose of this study was to determine whether there is an association between hematological findings and the probability for an NS1-based DENV RDT to detect the DENV NS1 antigen. We also aimed to describe the hematological parameters that are associated with the diagnosis through each test.

COVID-19/diagnóstico , COVID-19/epidemiologia , Dengue/diagnóstico , Adolescente , Adulto , Ásia/epidemiologia , Criança , Pré-Escolar , Colômbia/epidemiologia , Dengue/virologia , Vírus da Dengue/isolamento & purificação , Testes Diagnósticos de Rotina/métodos , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Masculino , Pandemias , Reação em Cadeia da Polimerase , Kit de Reagentes para Diagnóstico , SARS-CoV-2/isolamento & purificação , Adulto Jovem