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Artigo em Espanhol | LILACS | ID: biblio-1119089


La revisión teórica aborda la educación física virtual establecida en México a partir delconfinamiento social por COVID-19, basada en el problema, ya existente en México, de sedentarismo y obesidad infantil en niños de educación primaria, en quienes, derivado del confinamiento social, se estima un aumento de masa cor-poral, lo que conlleva mayores riesgos de salud. Al analizar la bibliografía reciente, que relaciona al COVID-19 con la educación física y la actividad física, se identificala oportunidad del profesorado de educación física, de conducir esquemas virtuales en los contenidos del programa educativo para, de esta manera, coadyuvar en la disminución del sedentarismo en estudiantes de primaria, teniendo como prioridad la alfabetización física.(AU)

The theoretical review addresses the virtual physical education established in Mexico based on social con-finement by COVID-19, based on the problem, already existing in Mexico, of sedentary lifestyle and childhood obesity in primary school children, in whom, derived from social confinement, an increase in body mass is estimated, which carries greater health risks. When analyzing the recent bibliography, which relates COVID-19 with physical education and physical activity, the opportunity for physical education teachers to conduct virtual schemes in the contents of the educational program is identified, in this way, to contribute to the decreasein sedentary lifestyle in primary school students, prioritizing physical literacy.(AU)

Humanos , Educação Física e Treinamento/métodos , Isolamento Social , Infecções por Coronavirus/epidemiologia , Educação a Distância/métodos , Ensino Fundamental e Médio , Comportamento Sedentário , México/epidemiologia
Rev Invest Clin ; 2020 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33201872


BACKGROUND: Artificial intelligence (AI) in radiology has improved diagnostic performance and shortened reading times of coronavirus disease 2019 (COVID-19) patients' studies. OBJECTIVES: The objectives pf the study were to analyze the performance of a chest computed tomography (CT) AI quantitative algorithm for determining the risk of mortality/mechanical ventilation (MV) in hospitalized COVID-19 patients and explore a prognostic multivariate model in a tertiary-care center in Mexico City. METHODS: Chest CT images of 166 COVID-19 patients hospitalized from April 1 to 20, 2020, were retrospectively analyzed using AI algorithm software. Data were collected from their medical records. We analyzed the diagnostic yield of the relevant CT variables using the area under the ROC curve (area under the curve [AUC]). Optimal thresholds were obtained using the Youden index. We proposed a predictive logistic model for each outcome based on CT AI measures and predetermined laboratory and clinical characteristics. RESULTS: The highest diagnostic yield of the assessed CT variables for mortality was the percentage of total opacity (threshold >51%; AUC = 0.88, sensitivity = 74%, and specificity = 91%). The AUC of the CT severity score (threshold > 12.5) was 0.88 for MV (sensitivity = 65% and specificity = 92%). The proposed prognostic models include the percentage of opacity and lactate dehydrogenase level for mortality and troponin I and CT severity score for MV requirement. CONCLUSION: The AI-calculated CT severity score and total opacity percentage showed good diagnostic accuracy for mortality and met MV criteria. The proposed prognostic models using biochemical variables and imaging data measured by AI on chest CT showed good risk classification in our population of hospitalized COVID-19 patients.

PLoS One ; 15(11): e0241954, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33166336


Evidence-based models may assist Mexican government officials and health authorities in determining the safest plans to respond to the coronavirus disease 2019 (COVID-19) pandemic in the most-affected region of the country, the Mexico City Metropolitan Area. This study aims to present the potential impacts of COVID-19 in this region and to model possible benefits of mitigation efforts. The COVID-19 Hospital Impact Model for Epidemics was used to estimate the probable evolution of COVID-19 in three scenarios: (i) no social distancing, (ii) social distancing in place at 50% effectiveness, and (iii) social distancing in place at 60% effectiveness. Projections of the number of inpatient hospitalizations, intensive care unit admissions, and patients requiring ventilators were made for each scenario. Using the model described, it was predicted that peak case volume at 0% mitigation was to occur on April 30, 2020 at 11,553,566 infected individuals. Peak case volume at 50% mitigation was predicted to occur on June 1, 2020 with 5,970,093 infected individuals and on June 21, 2020 for 60% mitigation with 4,128,574 infected individuals. Occupancy rates in hospitals during peak periods at 0%, 50%, and 60% mitigation would be 875.9%, 322.8%, and 203.5%, respectively, when all inpatient beds are included. Under these scenarios, peak daily hospital admissions would be 40,438, 13,820, and 8,650. Additionally, 60% mitigation would result in a decrease in peak intensive care beds from 94,706 to 23,116 beds and a decrease in peak ventilator need from 67,889 to 17,087 units. Mitigating the spread of COVID-19 through social distancing could have a dramatic impact on reducing the number of infected people and minimize hospital overcrowding. These evidence-based models may enable careful resource utilization and encourage targeted public health responses.

Infecções por Coronavirus/prevenção & controle , Assistência à Saúde , Política de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , Hospitalização , Humanos , México , Modelos Teóricos , Pneumonia Viral/patologia , Pneumonia Viral/virologia
Environ Res ; : 110442, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33186578


This study aims to analyze the correlation between environmental factors and confirmed cases of COVID-19 pandemic in Victoria, Mexico. The analysis is performed at the micro-level, filtering only confirmed cases of COVID-19 that are located near air quality monitoring stations, within an approximate coverage of 2.5 km, in order to identify a possible specific association between PM2.5, PM10, carbon monoxide (CO), relative humidity, temperature, absolute humidity, and total confirmed cases of COVID-19. The results evidenced that the cases of COVID-19 were very strongly associated with CO concentration. Our results also suggested that particulate matter pollution (PM2.5 and PM10) exposure have a significant correlation for confirmed cases of COVID-19. Furthermore, we studied the changes in air quality during the COVID-19 outbreak by comparing the average concentration of the four weeks before lockdown (February 16 to March 14, 2020) and the following twelve weeks during the partial lockdown (March 15 to June 06, 2020), revealing a very significant decrease of pollutants.

Public Health ; 189: 66-72, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-33166857


OBJECTIVES: This study aimed to evaluate the association of chronic diseases and indigenous ethnicity on the poor prognosis of outpatients with coronavirus disease 2019 (COVID-19) and hospitalised patients in Mexico. STUDY DESIGN: The study design is an observational study of consecutive COVID-19 cases that were treated in Mexican healthcare units and hospitals between February 27 and April 27, 2020. METHODS: Epidemiological, clinical and sociodemographic data were analysed from outpatients and hospitalised patients. Cox regression models were used to analyse the risk of mortality after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. RESULTS: In total, 15,529 patients with COVID-19 were characterised; 62.6% of patients were aged older than 40 years, 57.8% were men and 1.4% were of indigenous ethnicity. A high proportion had a history of diabetes (18.4%), hypertension (21.9%) and obesity (20.9%). Among hospitalised patients, 11.2% received health care in the intensive care unit. Advanced age, male sex, indigenous ethnicity and having a history of chronic diseases, such as hypertension, diabetes and obesity, were significantly associated with a high risk of death after SARS-CoV-2 infection. Diabetes and obesity were the comorbidities most highly associated with death through the models used in this study. Moreover, living in Mexico City and Mexico State (where there is easy access to medical services) and walking (rather than driving or getting public transport) were negatively associated with mortality after SARS-CoV-2 infection. CONCLUSIONS: Diabetes, hypertension and obesity combined with older age, male sex and indigenous ethnicity increase the risk of death after SARS-CoV-2 infection in the Mexican population. It is recommended that the incidence of COVID-19 is monitored in indigenous communities, and access to health services is increased nationwide.

Sci Total Environ ; : 143183, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33168247


During the COVID-19 pandemic lockdown, emissions of primary criteria pollutants in the Mexico City Metropolitan Area (MCMA) were substantially reduced, as in many other cities in the world. Unexpectedly, the daily average ozone concentration profile was practically indistinguishable from that of the past two years for the same time span in the calendar. So, we compared surface meteorology data, CO, NOx and O3 hourly concentrations in the MCMA from the ozone season (from March 1 to May 31) for the years 2018, 2019, and 2020. Also, TROPOMI satellite data on column count of CO, NO2 and HCHO, above a sparse grid of surface points in the MCMA, were also compared for March, April, and May 2020 with those from 2019. Population density used as a background variable to increase understanding of the observed differences allowed us to propose that reductions in NOx were so drastic that ozone formation moved rapidly from a VOC sensitive region towards a NOx sensitive region. The relevance of that unplanned policy provides impacts of contingent short-term emissions control actions during very high pollution episodes. Further analysis of these and other related data concerning VOC speciation and emissions patterns during the coronavirus lockdown may provide guidelines to enhance emission control policies in the post-COVID-19 times to come.

Int J Infect Dis ; 2020 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-33157295


The best way of preventing the dispersion of an infectious disease is decreasing of transmissibility of pathogen. To achieve such goal, it is important to have an epidemiological surveillance to retrieve data about its routes of transmission and dispersion. OBJECTIVE: In the current work it was probed the possibility of SARS-CoV-2 detection using filtration through 0.22 µm pores. METHODS: It was used a filtration system with vacuum pump for sampling and molecular analysis by RT-PCR technic for the virus detection causing COVID19. RESULTS: In this work, it was could demonstrate that SARS-CoV-2 can be detected in PM trapped on 0.22 µm filters 3 hours after air sampling and the only contaminated areas were that near zones of the patients. CONCLUSIONS: The results confirm the possibility of finding this virus in floating particulate matter (PM) in contaminated zones, with a simple and economic sampling method based on filtration technology through 0.22 µm pores and detection with molecular techniques (RT-PCR) and that the more risk zone was that near patients with COVID19.

Int J Ment Health Addict ; : 1-12, 2020 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-33169075


The presence of COVID-19 has had psychological consequences among health personnel; these include fear, anxiety, and depression. In the current study, we used the Fear of COVID-19 Scale (FCV-19S) to assess the response to fear within health staff in Mexico. This was a cross-sectional survey study in which we administered the Spanish version of the FCV-19S to hospital staff. The FCV-19S is a seven-item questionnaire that assesses the severity of fear caused by COVID-19. A total of 2860 participants-1641 female and 1218 male personnel from three hospitals-were included in the study. The internal reliability of the scale was good, with Cronbach's alpha of .902. A confirmatory factor analysis (CFA) was conducted on the seven items of the FCV-19S, showing good model fit (χ 2 (7) = 29.40, p < .001; CFI = .99; TLI = .99; RMSEA = .03; SRMR = .010; AIC = 71.40). We found a global FCV-19S mean score of 19.3 ± 6.9, with a significant difference in scores between women and men. Our survey shows a significantly higher level of fear in nursing and administrative personnel, which may be explained by the nursing staff being in close contact with infected patients and the administrative staff lacking understanding of the possible implications of the infection, compared with nonclinical hospital personnel. Our results are consistent with those of other researchers. We must remember that fear is a reaction and that we must be courageous enough to trust validated infection prevention practices to provide the highest standard of care, in the safest environment that we can, for as long as we can.

Nephrology (Carlton) ; 2020 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-33184959


Chronic kidney disease (CKD) is a recognized public health problem and key determinant of poor health outcomes. In Mexico, this condition has been associated with high and significant risk of death in COVID-19 patients; however, not enough attention has been given to the vulnerable population as the increasing numbers and fatality rates suggest. This study evaluated the effect of interaction between CKD condition and other risk factors (sex, diabetes, hypertension and obesity) on the survival rate of positive patients for COVID-19 in Mexico. The results from this study support that CKD patients is a population at high risk for mortality for COVID-19 and that COVID-19 positive inpatients with CKD and diabetes are highly vulnerable to death.

Am J Case Rep ; 21: e927628, 2020 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-33151912


BACKGROUND Coinfection with severe acute respiratory syndrome-associated coronavirus 2 (SARS-CoV-2) and Mycobacterium tuberculosis (MBT) has been reported, albeit rarely, in various parts of the world and has received attention from health systems because up to one-third of the world's population has been infected with SARS-CoV-2. Mexico was not included in the first-ever report on a global cohort of patients with this coinfection. We report on a case of SARS-CoV-2/MBT coinfection in a 51-year-old taxi driver from Mexico City that underscores the importance of rapid and accurate laboratory testing, diagnosis, and treatment. CASE REPORT We present the case of a man in the sixth decade of life who was admitted to the National Institute of Respiratory Diseases (INER) with a diagnosis of COVID-19 pneumonia, which was confirmed by nasopharyngeal exudate using real-time polymerase chain reaction (RT-PCR) for the identification of SARS-CoV-2. Findings from imaging studies suggested that the patient might be coinfected with MBT. That suspicion was confirmed with light microscopy of a sputum sample after Ziehl-Neelsen staining and when a Cepheid Xpert MTB/RIF assay, an automated semi-quantitative RT-PCR assay, failed to detect rifampicin resistance. The patient was discharged from the hospital 10 days later. CONCLUSIONS The present report underscores the importance of using validated molecular diagnostic tests to identify coinfections in areas where there is a high prevalence of other causes of pneumonia, such as MBT, as a way to improve clinical outcomes in patients during the COVID-19 pandemic. While it is imperative to control the COVID-19 pandemic, the medical community must not forget about the other pandemics to which populations are still prey, and tuberculosis is one of them. We must remain alert to any clinical subtleties so as to ensure timely and accurate diagnosis and stay one step ahead of COVID-19.

Diabetes Care ; 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33208487


OBJECTIVE: Diabetes is an important risk factor for severe coronavirus disease 2019 (COVID-19), but little is known about the marginal effect of additional risk factors for severe COVID-19 among individuals with diabetes. We tested the hypothesis that sociodemographic, access to health care, and presentation to care characteristics among individuals with diabetes in Mexico confer an additional risk of hospitalization with COVID-19. RESEARCH DESIGN AND METHODS: We conducted a cross-sectional study using public data from the General Directorate of Epidemiology of the Mexican Ministry of Health. We included individuals with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 between 1 March and 31 July 2020. The primary outcome was the predicted probability of hospitalization, inclusive of 8.5% of patients who required intensive care unit admission. RESULTS: Among 373,963 adults with COVID-19, 16.1% (95% CI 16.0-16.3) self-reported diabetes. The predicted probability of hospitalization was 38.4% (37.6-39.2) for patients with diabetes only and 42.9% (42.2-43.7) for patients with diabetes and one or more comorbidities (obesity, hypertension, cardiovascular disease, and chronic kidney disease). High municipality-level of social deprivation and low state-level health care resources were associated with a 9.5% (6.3-12.7) and 17.5% (14.5-20.4) increased probability of hospitalization among patients with diabetes, respectively. In age-, sex-, and comorbidity-adjusted models, living in a context of high social vulnerability and low health care resources was associated with the highest predicted probability of hospitalization. CONCLUSIONS: Social vulnerability contributes considerably to the probability of hospitalization among individuals with COVID-19 and diabetes with associated comorbidities. These findings can inform mitigation strategies for populations at the highest risk of severe COVID-19.

Public Health Rep ; : 33354920969180, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33216679


Project ECHO (Extension for Community Healthcare Outcomes) at the University of New Mexico is a telementoring program that uses videoconferencing technology to connect health care providers in underserved communities with subject matter experts. In March 2020, Project ECHO created 10 coronavirus disease 2019 (COVID-19) telementoring programs to meet the public health needs of clinicians and teachers living in underserved rural and urban regions of New Mexico. The newly created COVID-19 programs include 7 weekly sessions (Community Health Worker [in English and Spanish], Critical Care, Education, First-Responder Resiliency, Infectious Disease Office Hours, and Multi-specialty) and 3 one-day special sessions. We calculated the total number of attendees, along with the range and standard deviation, per session by program. Certain programs (Critical Care, Infectious Disease Office Hours, Multi-specialty) recorded the profession of attendees when available. The Project ECHO research team collected COVID-19 infection data by county from March 11 through May 31, 2020. During that same period, 9765 health care and general education professionals participated in the COVID-19 programs, and participants from 31 of 35 (89%) counties in New Mexico attended the sessions. Our initial evaluation of these programs demonstrates that an interprofessional clinician group and teachers used the Project ECHO network to build a community of practice and social network while meeting their educational and professional needs. Because of Project ECHO's large reach, the results of the New Mexico COVID-19 response suggest that the rapid use of ECHO telementoring could be used for other urgent national public health problems.

Curr Allergy Asthma Rep ; 20(12): 78, 2020 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-33161494


PURPOSE OF REVIEW: To study the prevalence of olfactory loss and its associated factors in a Mexican population a cross-sectional analytical study based on a population interviewed about health, epidemiologic aspects, and sense of smell (tested with four scents: rose, banana, perfume, and gas) was conducted to evaluate olfactory detection, memory, and identification. Levels of sense of smell perception were determined when the participants detected, recognized, or identified all (normosmia), 1-3 (hyposmia), or none (anosmia) of the odorants. Associated factors of olfactory dysfunction were identified by multivariate analysis (odds ratio, 95%CI). RECENT FINDINGS: Olfactory dysfunction is a prevalent disorder affecting up to 20% of the general population. In addition to viral infection, including COVID-19, a number of other causes and factors may also be involved. 1,956 surveys were conducted and 1,921 were analyzed. Most of the participants (62.1%) were women. The general prevalence of olfactory dysfunction, regarding detection, was 7.2% (7.1% hyposmia, 0.1% anosmia). Age-related olfactory deterioration was observed in both sexes from the 5th decade of life (OR 2.74, p = 0.0050). Women showed better olfactory identification (OR 0.73, p = 0.0010). Obesity (OR 1.97, p = 0.0070), low educational level, bad/very bad self-perceived olfactory function (OR 2.74, p = 0.0050), olfactory loss for less than one week (OR 1.35, p = 0.0030), exposure to toxics/irritants (OR 1.31, p = 0.0030), active smoking (OR 1.58, p < 0.0010), and type 2 diabetes mellitus (OR 2.68, 95%CI 1.74-4.10, p < 0.0001) were identified as factors associated with olfactory dysfunction. These results in a Mexican population suggest better olfactory identification (verbalization) in females. Age was a determining factor in the olfactory deterioration process and obesity and diabetes mellitus were also associated with olfactory disorders. Finally, these findings reinforce the differential diagnosis with other potential causes of sense of smell loss, during the COVID-19 outbreak.

Int Health ; 2020 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-33210109


BACKGROUND: To identify trends in the epidemiological and economic burden of diabetes in the elderly. METHODS: Using the Box-Jenkins method to estimate expected cases for the period 2020-2022, costs were determined with the instrumentation technique. The population base was 4 032 189 older adults diagnosed with diabetes in 2019. RESULTS: Regarding the epidemiological burden, there is an increase of 11-15% (p<0.001). Comparing the economic burden for 2020 vs 2022, the increase is estimated as 29% (p<0.05). CONCLUSION: In the framework of the coronavirus disease 2019 pandemic, the increase in diabetes cases and costs in older adults substantially complicates the scope of universal coverage for patients with diabetes.

Rev. bioét. derecho ; (50): 149-166, nov. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191351


Se presenta una reflexión de la valía e importancia de los talleres de filosofía, inscritos en el Proyecto Boecio, que se han llevado a cabo en el Reclusorio Femenil de Santa Martha Acatitla y Reclusorio Varonil Oriente, ambos en Ciudad de México. Se mencionarán los contenidos y aprendizajes de dichos talleres, los cuales han sido significativos para las personas privadas de su libertad, para sobrellevar su proceso judicial, y el sobrevivir su "encierro", así como también, la manera en que sus familiares y amistades han sido beneficiados con dichos aprendizajes de sus seres queridos en reclusión, al brindarles herramientas para sobrellevar el estar "encerrados en casa" por la cuarentena de la COVID-19

This is a reflection about the value and importance of the philosophy workshops, registered in the Boethius Project, which have been carried out at the Santa Martha Acatitla's Womens Prison and East Men's Prison both of them in Mexico City. The contents and learning from these workshops will be mentioned, which have been signicant for the people in prison, to survive their judicial process and "confinement", as well as the way in which their family and friends have been benefitied with these learnings from their loved ones in jail, by providing then with tools to support "Stay in home" by the COVID-19 quarantine

Es presenta una reflexió de la importància dels tallers de filosofia, inscrits en el Projecte Boeci, que s'han dut a terme en el Reclusorio Femenil de Santa Martha Acatitla y Reclusorio Varonil Oriente, tots dos a Ciutat de Mèxic. Es parlarà dels continguts I aprenentatges d'aquests tallers, els quals han estat significatius per a les persones privades de la seva llibertat, per suportar el seu procés judicial, I sobreviure el seu "tancament", així com també, la manera en què els seus familiars I amistats s'han beneficiat d'aquests aprenentatges dels seus éssers estimats en reclusió, en poder brindar-los eines per a suportar l'estar "tancats a casa" per la quarantena de la COVID-19

Humanos , Masculino , Feminino , Prisões/ética , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Bioética , México
Rev. bioét. derecho ; (50): 239-253, nov. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191356


Las carencias sociales de México empeorarán por la pandemia SARS-COV2. A saber, el acceso a la salud, derechos laborales básicos, y la infructuosa respuesta del gobierno para erradicar la violencia machista contra las mujeres. El desinterés histórico para fomentar una cultura del apoyo mutuo y el autocuidado ha provocado que gran parte de la ciudadanía se haya desconectado de sus derechos sociales y sanitarios. Así, no se sigue una indicación -quédate en casa- por desigualdades estructurales. Propongo que la libertad efectiva puede conseguirse mediante la aprobación de la renta básica universal desde una perspectiva feminista. Concluyo que las secuelas de la pandemia, que definirán la vida cotidiana, ameritan la aprobación de esta medida. Igualmente, las mujeres como clase sexual requieren protección desde una perspectiva feminista

Many of the social deprivations of Mexico will be worsened due to SARS-COV2 pandemic. Namely, the insufficient access to public health, lack of labor rights, and the unsuccessful government's response to eradicate male violence against women. The historical unconcern in promoting a culture rooted in mutual aid and self-care has provoked many citizens are disconnected from their social and health rights. Thus, people's inability to carry through one direction -stay home- is unfulfilled, in part, due to structural inequalities. I affirm that effective liberty could be obtained by approving a Universal Basic Income from a feminist perspective. I conclude that the aftermath of COVID-19, which will define everyday life for a while, require the endorsement of such measure. Likewise, women as a class deserve protection from a feminist critical framework

Les mancances socials de Mèxic empitjoraran per la pandèmia SARS-COV-2. A saber, l'accés a la salut, els drets laborals bàsics I la infructuosa resposta de govern per eradicar la violència masclista contra les dones. El desinterès històric per fomentar una cultura de suport mutu I l'autocura ha provocat que gran part de la ciutadania s'hagi desconnectat dels seus drets socials I sanitaris. Així, no se segueix una indicació -queda't a casa- per desigualtats estructurals. Proposo que la llibertat efectiva pot aconseguir-se mitjançant l'aprovació de la renda bàsica universal des d'una perspectiva feminista. Concloc que les seqüeles de la pandèmia, que definiran la vida quotidiana, mereixen l'aprovació d'aquesta mesura. Igualment, les dones com a classe sexual requereixen protecció des d'una perspectiva feminista

Humanos , Masculino , Feminino , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Renda per Capita , Apoio Social , Incerteza , Política Pública , Política de Saúde , Fatores Socioeconômicos , México/epidemiologia
Rev. clín. esp. (Ed. impr.) ; 220(8): 463-471, nov. 2020. tab, mapas, graf
Artigo em Espanhol | IBECS | ID: ibc-192195


ANTECEDENTES: El primer caso de COVID-19 se detectó en México el 27 de febrero de 2020. El 30 de abril, 64 días después de este primer diagnóstico, el número de pacientes aumentó exponencialmente, alcanzando un total de 19.224 casos confirmados y 1.859 (9,67%) fallecidos. En respuesta a este brote global, resumimos el estado actual del conocimiento sobre COVID-19 en México. MÉTODOS: Los datos se obtuvieron del sitio web oficial del Ministerio de Salud en México. El período analizado fue entre el 27 de febrero y el 30 de abril de 2020. Los casos se confirmaron mediante RT-PCR en tiempo real y se analizaron los datos epidemiológicos, demográficos y clínicos. RESULTADOS: La mayoría de los casos de COVID-19 se ubicaron en la Ciudad de México. La edad promedio de los pacientes fue de 46 años. De los 12.656 casos confirmados, el mayor número de infectados ocurre en el rango de edad entre 30 y 59 años (65,85%), y hubo una mayor incidencia en hombres (58,18%) que en mujeres (41,82%). Los pacientes fallecidos tenían una o múltiples comorbilidades, principalmente hipertensión (45,53%), diabetes (39,39%) y obesidad (30,4%). En los primeros 64 días de epidemia, China había reportado 80.304 casos con una tasa de mortalidad del 3,66%. CONCLUSIONES: Nuestros resultados indican la transmisión temprana de COVID-19 en México. La epidemiología descriptiva muestra las similitudes entre los casos de COVID-19 de México y China. En el mismo período de la curva epidémica, observamos en México una reducción en el número de casos confirmados de COVID-19 y una mayor tasa de mortalidad en comparación con China

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

Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Controle de Doenças Transmissíveis/tendências , Síndrome Respiratória Aguda Grave/epidemiologia , México/epidemiologia , Infecções por Coronavirus/transmissão , Quarentena/tendências , Pandemias/estatística & dados numéricos , Vírus da SARS/patogenicidade
Heart Lung ; 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33138974


BACKGROUND: As of June 15, 2020, a cumulative total of 7,823,289 confirmed cases of COVID-19 have been reported across 216 countries and territories worldwide. However, there is little information on the clinical characteristics and outcomes of critically ill patients with severe COVID-19 who were admitted to intensive care units (ICUs) in Latin America. The present study evaluated the clinical characteristics and outcomes of critically ill patients with severe COVID-19 who were admitted to ICUs in Mexico. METHODS: This was a multicenter observational study that included 164 critically ill patients with laboratory-confirmed COVID-19 who were admitted to 10 ICUs in Mexico, from April 1 to April 30, 2020. Demographic data, comorbid conditions, clinical presentation, treatment, and outcomes were collected and analyzed. The date of final follow-up was June 4, 2020. RESULTS: A total of 164 patients with severe COVID-19 were included in this study. The mean age of patients was 57.3 years (SD 13.7), 114 (69.5%) were men, and 6.0% were healthcare workers. Comorbid conditions were common in patients with critical COVID-19: 38.4% of patients had hypertension and 32.3% had diabetes. Compared to survivors, nonsurvivors were older and more likely to have diabetes, hypertension or other conditions. Patients presented to the hospital a median of 7 days (IQR 4.5-9) after symptom onset. The most common presenting symptoms were shortness of breath, fever, dry cough, and myalgias. One hundred percent of patients received invasive mechanical ventilation for a median time of 11 days (IQR 6-14). A total of 139 of 164 patients (89.4%) received vasopressors, and 24 patients (14.6%) received renal replacement therapy during hospitalization. Eighty-five (51.8%) patients died at or before 30 days, with a median survival of 25 days. Age (OR, 1.05; 95% CI, 1.02-1.08; p<0.001) and C-reactive protein levels upon ICU admission (1.008; 95% CI, 1.003-1.012; p<0.001) were associated with a higher risk of in-hospital death. ICU length of stay was associated with reduced in-hospital mortality risk (OR, 0.89; 95% CI, 0.84-0.94; p<0.001). CONCLUSIONS: This observational study of critically ill patients with laboratory-confirmed COVID-19 who were admitted to the ICU in Mexico demonstrated that age and C-reactive protein level upon ICU admission were associated with in-hospital mortality, and the overall hospital mortality rate was high. TRIAL REGISTRATION:, NCT04336345.

Air Qual Atmos Health ; : 1-10, 2020 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-33133301


Mexico City is the second most populated city in Latin America, and it went through two partial lockdowns between April 1 and May 31, 2020, for reducing the COVID-19 propagation. The present study assessed air quality and its association with human mortality rates during the lockdown by estimating changes observed in air pollutants (CO, NO2, O3, SO2, PM10 and PM2.5) between the lockdown (April 1-May 31) and prelockdown (January 1-March 31) periods, as well as by comparing the air quality data of lockdown period with the same interval of previous 5 years (2015-2019). Concentrations of NO2 (- 29%), SO2 (- 55%) and PM10 (- 11%) declined and the contents of CO (+ 1.1%), PM2.5 (+ 19%) and O3 (+ 63%) increased during the lockdown compared to the prelockdown period. This study also estimated that NO2, SO2, CO, PM10 and PM2.5 reduced by 19-36%, and O3 enhanced by 14% compared to the average of 2015-2019. Reduction in traffic as well as less emission from vehicle exhausts led to remarkable decline in NO2, SO2 and PM10. The significant positive associations of PM2.5, CO and O3 with the numbers of COVID-19 infections and deaths, however, underscored the necessity to enforce air pollution regulations to protect human health in one of the important cities of the northern hemisphere. Graphical abstract.