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1.
J Infect Dis ; 2025 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-39891540

RESUMO

BACKGROUND: In 2020, countries implemented universal surveillance to detect and monitor SARS-CoV-2 cases. Although crucial for early monitoring efforts, universal surveillance is resource intensive. To understand the implications of transitioning from universal to sentinel surveillance for monitoring SARS-CoV-2 transmissibility, morbidity and mortality, and disease seriousness, we compared measures of SARS-CoV-2 reported from both surveillance strategies in Argentina, Chile, and Mexico. METHODS: We obtained weekly case counts in Argentina, Chile, and Mexico, in periods when both universal and sentinel surveillance were ongoing. To assess the countries' surveillance strategies, we measured the proportion of total sites that were included in sentinel surveillance. We compared eight measures of SARS-CoV-2 transmissibility, morbidity and mortality, and disease seriousness between sentinel and universal surveillance and assessed the correlation between the two strategies for the eight measures. Pearson's and Spearman's correlation was classified as very strong (r(s)=0.8-1.0), strong (r(s)=0.60-0.79), moderate (r(s)=0.50-0.59), or poor (r<0.50). RESULTS: The proportion of total sites included in sentinel surveillance was 5.8% for Argentina, 1.1% for Chile, and 7.6% for Mexico. A total of 21 measures were calculated (8 for Mexico, 8 for Chile, and 5 for Argentina). Of these, 17 showed consistency between the two surveillance strategies, with strong or very strong correlations (r=0.66-0.99): all 8 measures for Mexico, 6 of 8 measures for Chile, and 3 out of 5 measures for Argentina.. Each country had at least one measure reflecting transmissibility and at least one reflecting morbidity and mortality for which the correlation was strong or very strong. Chile and Mexico also had at least one measure of disease seriousness for which the correlation was strong. CONCLUSIONS: Our findings suggest that the integration of SARS-CoV-2 into national sentinel surveillance can yield information comparable to that provided by nationwide universal surveillance for measures related to SARS-CoV-2 transmissibility, morbidity and mortality, and seriousness of disease.

2.
Arch Med Res ; 56(4): 103162, 2025 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-39893859

RESUMO

BACKGROUND: Monitoring reinfections helps predict peaks, variant emergence, and immunity trends. While reinfection rates between 3 and 31 % have been reported, a better understanding of their variation in different geographical areas could guide prevention and vaccination efforts. AIMS: This study examines the incidence of COVID-19 reinfection and associated factors in Mexico over six pandemic waves. Rapid mutation of SARS-CoV-2 generates variants that affect reinfection rates and population immunity. METHODS: In this retrospective cohort study, data from 3,236,259 primary infections were analyzed, and 212,892 reinfections were identified. RESULTS: Sex, age, vaccination status, and initial infection severity were found to be significant predictors of reinfection. Furthermore, the risk of reinfection decreased with wave progression, especially for those infected during the first wave. Reduced risk of reinfection after hospitalization suggests improved exposure prevention. Results indicated increased reinfection rates during the Omicron wave, particularly for those who were originally infected during the first wave, with women and middle-aged groups at higher risk. CONCLUSIONS: Our results highlight the intricate relationship between viral evolution, immunity, and demographics, which is crucial for effective pandemic management and vaccination strategies.

3.
Clin Appl Thromb Hemost ; 31: 10760296241297647, 2025.
Artigo em Inglês | MEDLINE | ID: mdl-39763448

RESUMO

INTRODUCTION: Persistent elevation of biomarkers associated with endothelial dysfunction in convalescent COVID-19 patients has been linked to an increased risk of long-term cardiovascular complications, including long COVID syndrome. Sulodexide, known for its vascular endothelial affinity, has demonstrated pleiotropic protective properties. This study aims to evaluate the impact of sulodexide on serum levels of endothelial dysfunction biomarkers in patients during the convalescent phase of COVID-19. METHODS: We conducted a double-blind, single-center, randomized, placebo-controlled trial in Mexico, comparing sulodexide (250 LRU orally, twice daily) with placebo over 8 weeks in adult patients during early COVID-19 convalescence. Differences in serum biomarkers between the groups were analyzed using repeated measures and post hoc tests, with Thrombomodulin (TM) as the primary endpoint. RESULTS: Among 206 analyzed patients (103 in each group), at week 8, the sulodexide group exhibited significantly lower mean levels of Thrombomodulin (TM) (25.2 ± 7.9 ng/mL vs 29.9 ± 14.7 ng/mL, P = .03), von Willebrand Factor (vWF) (232 ± 131 U/dL vs 266 ± 122 U/dL, P = .02) and Interleukin-6 (IL-6) (12.5 ± 13.2 pg/mL vs 16.2 ± 16.5 pg/mL, P = .03) compared to the placebo group. D-dimer and C reactive protein (CRP) in the sulodexide group were also lowered. No significant differences were observed for P-selectin, fibrinogen, VCAM-1, or ICAM-1 levels. CONCLUSIONS: Patients in the convalescent phase of COVID-19 who received sulodexide for eight weeks showed a reduction in TM, vWF, D-dimer, CRP, and IL-6 serum levels compared to placebo. These findings suggest a potential protective effect of sulodexide against thromboinflammation and endothelial damage.


Assuntos
Biomarcadores , Tratamento Farmacológico da COVID-19 , COVID-19 , Endotélio Vascular , Glicosaminoglicanos , Trombomodulina , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Proteína C-Reativa/análise , Convalescença , COVID-19/sangue , COVID-19/complicações , Método Duplo-Cego , Regulação para Baixo , Endotélio Vascular/efeitos dos fármacos , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Glicosaminoglicanos/uso terapêutico , Interleucina-6/sangue , México , Trombomodulina/sangue
4.
Int J Equity Health ; 24(1): 10, 2025 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-39800679

RESUMO

BACKGROUND: Ethnic and racial discrimination in maternal health care has been overlooked in academic literature and yet it is critical for achieving universal health coverage (UHC). There is a lack of empirical evidence on its impact on the effective coverage of maternal health interventions (ECMH) for Indigenous women in Mexico. Documenting progress in reducing maternal health inequities, particularly given the disproportionate impact of the Covid-19 pandemic on ethnic minorities, is essential to improving equity in health systems. METHODS: We conducted a population-based, pooled cross-sectional, and retrospective analysis for 2009-2023, using data from the last three waves (2014, 2018, and 2023) of a nationally representative demographic survey (ENADID). Our study included n = 72,873 (N = 23,245,468) Mexican women aged 12-54 with recent live births. We defined ECMH as adequate antenatal care (ANC), skilled and/or institutional delivery care, timely postpartum care, and complication-free postpartum/puerperium. After describing sociodemographic characteristics and maternal health coverage by Indigenous status, we estimated a pooled fixed-effects multivariable regression model to adjust ECMH for relevant covariates. We used the Blinder-Oaxaca decomposition for nonlinear regression models to quantify inequities in ECMH due to ethnic-racial discrimination, defined as differences in outcomes attributable to differential treatment. FINDINGS: Indigenous women had lower education, labor market participation, and socioeconomic position, higher parity, and more rural, poorer state residence than non-Indigenous women. They faced significant health coverage loss due to the dismantling of Seguro Popular, a public health insurance mechanism in place until the end of 2019, right before the start of the Covid pandemic. Adjusted ECMH was 25.3% for non-Indigenous women and 18.3% for Indigenous women, peaking at 28.8% and 21.2% in 2013-2018, declining to 25.7% and 18.7% pre-Covid (January 2019 to March 2020), and further declining to 24.0% and 17.4% during Covid, with an increase to 26.6% for non-Indigenous women post-Covid, while remaining similar for Indigenous women. Decomposition analyses revealed that during the analyzed period, 30.8% of the gap in ECMH was due to individual characteristics, 51.7% to ethnic-racial discrimination, and 17.5% to their interaction. From 2009 to 2012, 42.2% of the gap stemmed from observable differences, while 40.4% was due to discrimination. In the pre-Covid-19 phase, less than 1% was from observable characteristics, with 75.3% attributed to discrimination, which remained in the post-Covid-19 stage (78.7%). CONCLUSIONS: Despite modest health policy successes, the ethnic gap in ECMH remains unchanged, indicating insufficient action against inequity-producing structures. Ethnic and racial discrimination persists, exacerbated during the pandemic and coinciding with the government's cancellation of targeted social programs and public health insurance focused on the poorest populations, including Indigenous peoples. Thus, prioritizing maternal and child health underscores the need for comprehensive policies, including specific anti-racist interventions. Addressing these inequities requires the recognition of both observable and unobservable factors driven by discriminatory ideologies and the implementation of targeted measures to confront the complex interactions driving discrimination in maternal health care services for Indigenous women.


Assuntos
COVID-19 , Serviços de Saúde Materna , Racismo , Cobertura Universal do Seguro de Saúde , Humanos , Feminino , Racismo/estatística & dados numéricos , Adulto , Estudos Transversais , México/etnologia , Serviços de Saúde Materna/estatística & dados numéricos , Estudos Retrospectivos , Adolescente , Adulto Jovem , COVID-19/epidemiologia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Gravidez , Criança , Minorias Étnicas e Raciais/estatística & dados numéricos , Etnicidade/estatística & dados numéricos
5.
Appl Neuropsychol Adult ; : 1-8, 2025 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-39887688

RESUMO

Over the past three years, conflicting evidence has emerged regarding the impact of COVID-19 on executive functions and the frontal lobe. In this study, we evaluated executive functions in individuals from the state of Jalisco who had contracted COVID-19. Sixty individuals with a history of mild COVID-19 were included and compared to historical controls from the Mexican population, who had been assessed prior to the pandemic during the validation of the Trail Making Test Form B, the Stroop Color and Word Test, and the Modified Wisconsin Card Sorting Test (M-WCST). The post-infection group exhibited lower scores only on the M-WCST. Therefore, we concluded that individuals who have recovered from mild COVID-19 do not display widespread impairments in executive functions, with the exception of deficits observed on the M-WCST. This suggests possible neurophysiological alterations in the prefrontal cortex during SARS-CoV-2 infection, given that cognitive flexibility is primarily mediated in this region. These findings contribute to the growing body of evidence indicating that even non-hospitalized COVID-19 patients can experience executive function deficits, providing a foundation for further neurophysiological research into the mechanisms underlying this phenomenon.

6.
Public Health Rep ; : 333549241308166, 2025 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-39871530

RESUMO

OBJECTIVES: Cardiometabolic diseases (CMDs) are highly prevalent in Mexico. We analyzed the evolution of mortality from CMDs in Mexico at the national and state level, as well as their contribution to years of life lost (YLL), from 1998 through 2022. METHODS: We conducted an observational study based on a public database. We calculated age-standardized mortality rates, conducted joinpoint regression analyses to determine changes in the trend and magnitude of mortality over time, and calculated YLL from CMDs among people in Mexico nationally and by state. RESULTS: From 1998 through 2022, the age-standardized mortality rate from CMDs increased by 14.9% in Mexico. These rates reached their highest levels in 2020 and 2021 during the COVID-19 pandemic. In 2022, people aged 0 through 84 years had 3.9 YLL from CMDs, which represented an increase of 0.4 years compared with 1998. From 1998 through 2022, age-standardized mortality rates increased for heart disease, diabetes mellitus, and hypertension but decreased for stroke. CONCLUSIONS: Mortality and YLL from CMDs have steadily increased among people in Mexico, driven mainly by heart disease and diabetes mellitus. YLL attributable to CMDs could be prevented by early care and health prevention policies. Decision makers should work to implement robust and enduring health policies focused on shared risk factors underlying these diseases.

7.
Trop Med Infect Dis ; 10(1)2025 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-39852671

RESUMO

BACKGROUND: Rocky Mountain spotted fever (RMSF) is a challenge for physicians because the disease can mimic other endemic febrile illnesses, such as dengue and COVID-19. The comparison of their main clinical and epidemiological manifestations in hospitalized children can help identify characteristics that improve empirical suspicion and timely therapeutic interventions. METHODS: A cross-sectional study was conducted on a series of patients aged 0 to 18 years, hospitalized between 2015 and 2022, with a diagnosis of RMSF, dengue, or COVID-19. Data were retrieved from medical records. Subjects were categorized as patients with RMSF (group I) and patients with dengue and COVID-19 (group II). Descriptive statistics were used, and differences were evaluated using Student's t-test and the chi-squared test. RESULTS: A series of 305 subjects were studied, with 252 (82.6%) in group I. Subjects in both groups presented fever, myalgias, arthralgias, and rash, but exposure to ticks distinguished group I. The fatality rate (21.0%) in group I was higher than in group II (3.8%). CONCLUSIONS: Although fever, myalgias, arthralgias, and rash are common in all three illnesses, they are more prevalent in hospitalized patients with RMSF. In the presence of such symptoms, a history of tick exposure can guide clinical decisions in regions where all three diseases are endemic.

8.
Viruses ; 17(1)2025 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-39861892

RESUMO

This study investigates the relationship between SARS-CoV-2 RT-PCR cycle threshold (Ct) values and key COVID-19 transmission and outcome metrics across five years of the pandemic in Jalisco, Mexico. Utilizing a comprehensive time-series analysis, we evaluated weekly median Ct values as proxies for viral load and their temporal associations with positivity rates, reproduction numbers (Rt), hospitalizations, and mortality. Cross-correlation and lagged regression analyses revealed significant lead-lag relationships, with declining Ct values consistently preceding surges in positivity rates and hospitalizations, particularly during the early phases of the pandemic. Granger causality tests and vector autoregressive modeling confirmed the predictive utility of Ct values, highlighting their potential as early warning indicators. The study further observed a weakening association in later pandemic stages, likely influenced by the emergence of new variants, hybrid immunity, changes in human behavior, and diagnostic shifts. These findings underscore the value of Ct values as scalable tools for public health surveillance and highlight the importance of contextualizing their analysis within specific epidemiological and temporal frameworks. Integrating Ct monitoring into surveillance systems could enhance pandemic preparedness, improve outbreak forecasting, and strengthen epidemiological modeling.


Assuntos
COVID-19 , SARS-CoV-2 , Carga Viral , Humanos , COVID-19/epidemiologia , COVID-19/transmissão , COVID-19/virologia , SARS-CoV-2/genética , México/epidemiologia , Pandemias , Hospitalização/estatística & dados numéricos , Teste de Ácido Nucleico para COVID-19/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos
9.
Viruses ; 17(1)2025 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-39861898

RESUMO

Detection and quantification of disease-related biomarkers in wastewater samples, denominated Wastewater-based Surveillance (WBS), has proven a valuable strategy for studying the prevalence of infectious diseases within populations in a time- and resource-efficient manner, as wastewater samples are representative of all cases within the catchment area, whether they are clinically reported or not. However, analysis and interpretation of WBS datasets for decision-making during public health emergencies, such as the COVID-19 pandemic, remains an area of opportunity. In this article, a database obtained from wastewater sampling at wastewater treatment plants (WWTPs) and university campuses in Monterrey and Mexico City between 2021 and 2022 was used to train simple clustering- and regression-based risk assessment models to allow for informed prevention and control measures in high-affluence facilities, even if working with low-dimensionality datasets and a limited number of observations. When dividing weekly data points based on whether the seven-day average daily new COVID-19 cases were above a certain threshold, the resulting clustering model could differentiate between weeks with surges in clinical reports and periods between them with an 87.9% accuracy rate. Moreover, the clustering model provided satisfactory forecasts one week (80.4% accuracy) and two weeks (81.8%) into the future. However, the prediction of the weekly average of new daily cases was limited (R2 = 0.80, MAPE = 72.6%), likely because of insufficient dimensionality in the database. Overall, while simple, WBS-supported models can provide relevant insights for decision-makers during epidemiological outbreaks, regression algorithms for prediction using low-dimensionality datasets can still be improved.


Assuntos
Algoritmos , COVID-19 , Aprendizado de Máquina , SARS-CoV-2 , Águas Residuárias , COVID-19/epidemiologia , COVID-19/diagnóstico , México/epidemiologia , Humanos , Águas Residuárias/virologia , SARS-CoV-2/isolamento & purificação , Tomada de Decisões , Medição de Risco/métodos , Vigilância Epidemiológica Baseada em Águas Residuárias , Monitoramento Epidemiológico , Pandemias
10.
BMC Med Educ ; 25(1): 57, 2025 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-39806406

RESUMO

BACKGROUND: In medicine, empathy refers to a predominantly cognitive attribute (rather than an emotional one), which is important as a foundation for positive physician-patient relationships. Physicians with a narcissistic personality trait have an assortment of characteristics that undermine their interpersonal functioning in clinical encounters with their patients. Evidence suggests an inverse relationship between empathy and certain characteristics of a narcissistic personality trait in general population. The aim of this study was to characterize the relationship between cognitive empathy and covert narcissistic personality trait in newly enrolled medical students. METHODS: A cross-sectional study was conducted in a Mexican school of medicine during the COVID-19 lockdown. The study sample included first-year medical students attending on-line classes. The Spanish version for medical students of the Jefferson Scale of Empathy (JSE-S), and the Hypersensitive Narcissism Scale (HSNS), were used as measures of cognitive empathy and covert narcissism, respectively. In addition, gender, age, speciality interest, and semester of enrolment were collected. Comparative, correlation and multiple regression analyses were performed among the variables analysed. RESULTS: In a sample of 283 students (207 females), differences in cognitive empathy and covert narcissism were observed by gender (p < 0.001). Comparison analyses showed that covert narcissism was greater in students enrolled after one semester attending on-line classes than those who were starting their first semester (p = 0.01). A correlation analysis confirmed an inverse association between empathy and covert narcissism (ρ=-0.23; p < 0.001). Based on this, a multiple regression model was created explaining 12% of the variance of covert narcissism based on a lineal regression with empathy (p < 0.001), gender (p = 0.01), and semester (p = 0.003). This model complied with the necessary conditions for statistic inference and showed an effect size from medium to large. CONCLUSIONS: These findings provide novel information of the relationship between cognitive empathy and covert narcissism in newly enrolled medical students.


Assuntos
COVID-19 , Empatia , Narcisismo , Estudantes de Medicina , Humanos , Estudantes de Medicina/psicologia , Estudos Transversais , Feminino , Masculino , COVID-19/psicologia , COVID-19/epidemiologia , Adulto Jovem , Adulto , Relações Médico-Paciente , México , Cognição , SARS-CoV-2
11.
Virology ; 603: 110401, 2025 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-39808891

RESUMO

Bats, which play a vital role in maintaining ecosystems, are also known as natural reservoirs of coronaviruses (CoVs), thus have raised concerns about their potential transmission to humans, particularly in light of the emergence of MERS-CoV, SARS-CoV, and SARS-CoV-2. The increasing impact of human activities and ecosystem modifications is reshaping bat community structure and ecology, heightening the risk of the emergence of potential epidemics. Therefore, continuous monitoring of these viruses in bats is necessary. Despite the rich diversity of bats species in México, few studies have been conducted to search for CoVs in these group of mammals. In the present study we conducted CoV surveillance across previously unexplored sites in the state of Yucatán, a state located within the ecologically diverse Yucatán Peninsula, a tropical region undergoing pronounced anthropogenic changes, including deforestation, agricultural expansion and urbanization. We captured 191 bats between 2021 and 2022 in three different habitats: diversified rural (Tzucacab), rural (Tizimín) and urban (Mérida). Molecular analyses had revealed a 5.4% CoV prevalence, with the diversified rural site exhibiting a notably elevated rate (26.3%). Subsequent sequencing and phylogenetic assessment revealed four distinct Alphacoronavirus genotypes, indicating host-specific clustering among Phyllostomidae bats. Notably, one was detected for the first time in a Sturnira species. Our findings suggest a reduced likelihood of transmission of these viruses to humans or other species, evidenced by clustering patterns and sequence dissimilarity with known CoVs. We emphasize that maintaining sustained virus surveillance in bats is crucial to understanding viral diversity and identifying potential risks to human and animal health.


Assuntos
Quirópteros , Ecossistema , Filogenia , Animais , Quirópteros/virologia , México/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/veterinária , Infecções por Coronavirus/virologia , Infecções por Coronavirus/transmissão , Humanos , Coronavirus/classificação , Coronavirus/genética , Coronavirus/isolamento & purificação , Reservatórios de Doenças/virologia , SARS-CoV-2/genética , SARS-CoV-2/classificação
12.
Artigo em Inglês | MEDLINE | ID: mdl-39636355

RESUMO

The COVID-19 pandemic was associated with decreases in moderate-to-vigorous physical activity and increases in sedentary time for children and adults, and there is some evidence that Latino populations were particularly affected. This article leverages a two-wave panel, mixed-method social network dataset collected before and during the pandemic with Mexican American immigrants living in New York City to examine social networks and other factors associated with physical activity and explore participants' perceptions about how the pandemic affected their physical activity. Participants (n = 49) completed in-person, egocentric social network interviews between January and June 2019 and virtual follow-up egocentric social network interviews between May and November 2021. Qualitative data collection with a subsample (n = 25) occurred between October and December 2022. Social network quantitative analyses found that age and female sex were negatively associated with participants' baseline physical activity level, but the proportion of alters (important persons identified by the participant) with whom the participant did physical activity at baseline was positively associated. Baseline physical activity level was inversely related to the change in physical activity, and the change in the proportion of alters who were close to the participant was negatively associated with physical activity change at follow-up. Qualitative results supported the quantitative findings, providing rich narratives regarding the importance of social support for physical activity during the pandemic. Social networks among Mexican American immigrants in New York City provided motivation and support for physical activity but became harder to sustain during a pandemic. The findings can inform strategies to create environments that are conducive to physical activity while also protecting public health.

14.
PLoS One ; 19(12): e0308015, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39621641

RESUMO

In the current era, a lot of research is being done in the domain of disease diagnosis using machine learning. In recent times, one of the deadliest respiratory diseases, COVID-19, which causes serious damage to the lungs has claimed a lot of lives globally. Machine learning-based systems can assist clinicians in the early diagnosis of the disease, which can reduce the deadly effects of the disease. For the successful deployment of these machine learning-based systems, hyperparameter-based optimization and feature selection are important issues. Motivated by the above, in this proposal, we design an improved model to predict the existence of respiratory disease among patients by incorporating hyperparameter optimization and feature selection. To optimize the parameters of the machine learning algorithms, hyperparameter optimization with a genetic algorithm is proposed and to reduce the size of the feature set, feature selection is performed using binary grey wolf optimization algorithm. Moreover, to enhance the efficacy of the predictions made by hyperparameter-optimized machine learning models, an ensemble model is proposed using a stacking classifier. Also, explainable AI was incorporated to define the feature importance by making use of Shapely adaptive explanations (SHAP) values. For the experimentation, the publicly accessible Mexico clinical dataset of COVID-19 was used. The results obtained show that the proposed model has superior prediction accuracy in comparison to its counterparts. Moreover, among all the hyperparameter-optimized algorithms, adaboost algorithm outperformed all the other hyperparameter-optimized algorithms. The various performance assessment metrics, including accuracy, precision, recall, AUC, and F1-score, were used to assess the results.


Assuntos
Algoritmos , COVID-19 , Aprendizado de Máquina , Humanos , COVID-19/virologia , COVID-19/diagnóstico , SARS-CoV-2/isolamento & purificação , México
15.
BMC Infect Dis ; 24(1): 1383, 2024 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-39633274

RESUMO

BACKGROUND: The global setback in tuberculosis (TB) prevalence and mortality in the post-COVID-19 era has been partially attributed to pandemic-related disruptions in healthcare systems. The additional biological contribution of COVID-19 to TB is less clear. The goal of this study was to determine if there is an association between COVID-19 in the past 18 months and a new TB episode, and the role played by type 2 diabetes mellitus (DM) comorbidity in this relationship. METHODS: A cross-sectional study was conducted among 112 new active TB patients and 373 non-TB controls, identified between June 2020 and November 2021 in communities along the Mexican border with Texas. Past COVID-19 was based on self-report or positive serology. Bivariable/multivariable analysis were used to evaluate the odds of new TB in hosts with past COVID-19 and/or DM status. RESULTS: The odds of new TB were higher among past COVID-19 cases vs. controls, but only significant among DM patients (aOR 2.3). The odds of TB in people with DM was 2.7-fold higher among participants without past COVID-19 and increased to 7.9-fold among those with past COVID-19. CONCLUSION: DM interacts with past COVID-19 synergistically to magnify the risk of TB. Latent TB screening and prophylactic treatment, if positive, is recommended in past COVID-19 persons with DM. Future studies are warranted with a longitudinal design and larger sample size to confirm our findings.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 2 , Tuberculose , Humanos , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , COVID-19/epidemiologia , COVID-19/complicações , Masculino , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Tuberculose/epidemiologia , Tuberculose/complicações , Adulto , Texas/epidemiologia , SARS-CoV-2 , México/epidemiologia , Comorbidade , Idoso , Prevalência , Fatores de Risco
16.
Ann Med ; 56(1): 2424448, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39623785

RESUMO

BACKGROUND: The COVID-19 pandemic raised concerns about whether individuals with chronic respiratory diseases, such as asthma, were at higher risk of severe outcomes. Although several studies were published on this topic, not all included asthma as a risk factor. Therefore, describing the clinical characteristics of COVID-19-infected asthma patients in a specialized respiratory center is valuable as a real-life study. OBJECTIVE: To investigate the clinical characteristics and disease severity in SARS-CoV-2-infected adults with pre-existing asthma hospitalized at the National Institute of Respiratory Diseases (INER) in Mexico City. METHODS: We conducted a retrospective, observational study on adults with confirmed COVID-19 hospitalized from March 2020 to June 2021. Out of 2,249 reviewed medical records, we identified asthmatic patients and compared them with a matched non-asthmatic control group to assess asthma's impact on COVID-19 severity and outcomes. RESULTS: Based on the clinical records, asthma prevalence among hospitalized patients was low (1.51%); of these, 73% had allergic and 27% had non-allergic asthma. COVID-19 severity did not vary significantly between asthma phenotypes, although there was higher mortality among patients with non-allergic asthma. Most patients in both groups developed a severe form of the disease and higher mortality rates than non-asthmatics, though the differences were not statistically significant. CONCLUSION: Asthma prevalence among patients with COVID-19 was low, but mortality was higher in asthma patients. Although the small sample size limits the generalizability of these findings, this study in a Mexican population hospitalized in a reference hospital provides insights for improving asthma management in future pandemics.


Assuntos
Asma , COVID-19 , Hospitalização , Índice de Gravidade de Doença , Humanos , COVID-19/epidemiologia , COVID-19/mortalidade , COVID-19/complicações , Asma/epidemiologia , Asma/complicações , México/epidemiologia , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Hospitalização/estatística & dados numéricos , Adulto , SARS-CoV-2 , Idoso , Fatores de Risco , Prevalência
17.
IJID Reg ; 13: 100474, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39624253

RESUMO

Objectives: Bacterial infections are important causes of death. Some reports have shown that the COVID-19 pandemic may have had an impact on drug resistance. The objective of this work was to compare the resistance profiles between 2019 and 2020 in the emergency department, non-intensive care units (ICU), and ICU areas in Mexican hospitals. Methods: Databases from 15 hospitals from eight states in Mexico including susceptibility results for Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa collected from blood, urine, respiratory, and intra-abdominal secretions were analyzed. Different hospital areas were included: emergency department, non-ICU wards, and ICU. The databases were converted using the BacLink2 tool and analyzed using the WHONET 2022 platform. The percentage of antibiotic resistance was compared for each species and clinical specimen between years (2019 vs 2020) by a chi-square test using the criterion of P <0.05 for statistical significance. Results: A statistically significant decrease in resistance to imipenem was observed for P. aeruginosa recovered from respiratory specimens in the ICU (55.6% vs 39.3%) and from urine samples from non-ICU areas (52.9% vs 37.3%). Also, an increase in resistance was detected in blood isolates from non-ICU areas for carbapenems in P. aeruginosa imipenem (23.3% vs 54.5%) and meropenem (27.4% vs 49%) and in E. coli, ertapenem (2.4% vs 10.1%), imipenem (1.9% vs 13.2%), and meropenem (1.6% vs 6.8%). Furthermore, an increase in resistance forimipenem (20.0% vs 57.5%) and meropenem (17.6% vs 48.7%) was detected in the emergency department for P. aeruginosa in respiratory isolates. Conclusions: A decrease in carbapenem resistance for P. aeruginosa recovered from respiratory specimens in the ICU and from urine samples from non-ICU areas was detected. In contrast, an increase in carbapenem resistance was detected for P. aeruginosa in blood isolates from non-ICU areas and respiratory isolates from the emergency department. Regarding respiratory samples, a higher resistance for meropenem was detected in 2020 than in 2019 for K. pneumoniae (2.6 vs 10.6%, P = 0.05). These results underline the analysis of antimicrobial resistance in different hospital wards to focus efforts on antimicrobial resistance reduction.

18.
Coron Artery Dis ; 2024 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-39692460

RESUMO

BACKGROUND: Mortality after percutaneous coronary intervention (PCI) remains a problem. Clinical databases such as the American College of Cardiology National Cardiovascular Data CathPCI Registry do not contain enough information to determine the specific cause of death after PCI, and thus are not able to identify opportunities for improvement (OFIs) that might have prevented the death of specific patients. We reviewed cases of death after coronary intervention to identify specific OFIs. METHODS: The University of New Mexico electronic medical record system was used to identify PCI patients who died before discharge from 1 January 2019 to 30 June 2021. Electronic medical records for each patient were reviewed by two physicians to identify presentation before PCI, procedural success of PCI, complications of PCI, contribution of PCI complications to death, and causes of death after PCI. RESULTS: During the study period, 48 of 894 PCI patients died before discharge. Presentation was ST elevation myocardial infarction in 23 (48%) and out of hospital cardiac arrest in 17 (35%). PCI success rate was 90%. Causes of death were most frequently cardiac (80%), septic shock (4%), mixed cardiogenic and septic shock (4%), COVID (8%), and anoxic brain injury (4%). CONCLUSION: All post-PCI deaths in this series occurred in acutely unstable patients, with cardiac comorbidities and myocardial infarction or cardiac arrest prior to catheterization. PCI reduced culprit stenosis to ≤50% in 96% of cases with an overall procedural success rate of 90% and only one major complication. No deaths were clearly related to operator error.

19.
Rev Panam Salud Publica ; 48: e106, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-39697271

RESUMO

Objective: To describe the process of restructuring the National Expert Committee and its impact on the causality assessment of events supposedly attributable to vaccination or immunization (ESAVI) in the context of vaccine safety monitoring during the COVID-19 pandemic, 2020-2023. Method: A report was prepared on the experience of creating and operating Mexico's National Expert Committee during the aforementioned period. Results: During the 2020-2023 period, 1293 severe ESAVIs were reported after COVID-19 vaccination; after 98.6% (1275) of them had been assessed and classified, 10 specialized subcommittees were formed. Conclusions: Restructuring of the committee, assessment of adverse events with a series of prior steps, and use of the World Health Organization's causality assessment tool made it possible to generate scientific documents to validate vaccine safety and maintain trust in vaccination.


Objetivo: Descrever o processo de reestruturação do Comitê Nacional de Especialistas e seu impacto na análise de causalidade de eventos supostamente atribuíveis à vacinação ou imunização (ESAVI) no contexto do monitoramento da segurança das vacinas durante a pandemia de COVID-19, no período de 2020 a 2023. Método: Relato da experiência de formação e funcionamento do Comitê Nacional de Especialistas do México durante o período mencionado. Resultados: No período de 2020 a 2023, foram notificados 1293 ESAVI graves pós-vacinação contra a COVID­19; após avaliação e classificação de 1275 (98.6%) desses eventos, foram formados 10 subcomitês para diferentes especialidades. Conclusões: A reestruturação do Comitê de Especialistas e avaliação dos eventos adversos por meio de uma série de passos anteriores, juntamente com o uso da ferramenta de análise de causalidade da Organização Mundial da Saúde, possibilitaram a geração de documentos científicos que corroboram a segurança das vacinas e mantêm a confiança na vacinação.

20.
BMC Infect Dis ; 24(1): 1376, 2024 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-39627719

RESUMO

BACKGROUND:  Indigenous populations globally face significant health disparities compared to non-Indigenous groups, primarily due to marginalization and limited access to healthcare. In Mexico, which is home to the largest Indigenous population in the Americas, these disparities were further exacerbated by the COVID-19 pandemic, with impacts intensified by factors such as marginalization, discrimination, and inadequate access to essential services. METHODS: This study aimed to investigate the COVID-19 pandemic's impact on mortality, vaccination access and uptake, and official birth registration among a predominantly Indigenous population in San Juan Chamula, Chiapas. We conducted an online survey among high school students at the Colegio de Bachilleres del Estado de Chiapas, supplemented with epidemiological and socio-demographic data (N = 107). RESULTS: The survey revealed that 14% of respondents reported being infected with COVID-19, while national dashboard data indicated only 212 confirmed cases and one death in Chamula between April 2021 and June 2023. Additionally, 79.4% of respondents were unvaccinated, with significant communication barriers and a lack of information in Indigenous languages contributing to low vaccination rates. Additionally, 5.6% of surveyed family members and 4.7% of community residents lacked official birth certificates, significantly impeding their ability to access essential services such as education, healthcare, and vaccinations. CONCLUSION: Our findings highlight significant underreporting of COVID-19 cases and deaths in Indigenous communities, likely due to inadequate diagnostic resources and medical evaluation. The study underscores the urgent need for tailored public health strategies that integrate local Indigenous languages, cultures, and knowledge systems supported by trusted Indigenous leaders. Investing in education in Indigenous languages is crucial for improving vaccination adherence and overall public health outcomes. These strategies can inform national preparedness and response plans to address the unique challenges faced by Indigenous populations during pandemics and other public health crises.


Assuntos
COVID-19 , Povos Indígenas , Vacinação , Humanos , México/epidemiologia , México/etnologia , COVID-19/prevenção & controle , COVID-19/epidemiologia , Feminino , Masculino , Vacinação/estatística & dados numéricos , Adolescente , Povos Indígenas/estatística & dados numéricos , SARS-CoV-2 , Inquéritos e Questionários , Declaração de Nascimento , Adulto Jovem , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Vacinas contra COVID-19/administração & dosagem
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