Risk of Testing Positive for COVID-19 among Healthcare and Healthcare-Related Workers.

Understanding the risk factors associated with COVID-19 infection among healthcare workers is crucial for infection prevention and control. The aim of this study was to examine the risk of testing positive for COVID-19 among a multicenter cohort of workers, taking into account their occupational roles (medical professionals, staff in operational and administrative roles, or laboratory personnel) in healthcare settings. The data analyzed in this study included 2163 individuals with suggestive COVID-19 symptoms who underwent laboratory testing. The incidence rate in the study sample was calculated to be 15.3 cases per 10,000 person-days. The results from the multiple regression model indicated that job roles were not significantly associated with the risk of testing positive. However, age and the duration of the pandemic were identified as significant risk factors, with increasing age and longer pandemic duration being associated with a higher risk of testing positive. Additionally, vaccination was found to reduce the risk of testing positive. These findings provide valuable insights into COVID-19 transmission among indoor healthcare workers, highlighting the influence of age, pandemic duration, and vaccination on infection risk. Further research is needed to develop evidence-based strategies aimed at protecting healthcare workers and preventing virus spread in healthcare settings.

Ten-Year Single-Center Study Examining Patient Survival after Commencing Long-Term Peritoneal Dialysis.

In patients with end-stage kidney disease (ESKD), peritoneal dialysis (PD) is increasingly being adopted in developing nations due to its cost-effectiveness and advantages as a home-based treatment. However, the survival outcomes of chronic PD patients in Mexico, where the burden of ESKD is high, remain poorly understood. This study aimed to assess the survival experience of long-term PD patients and evaluate its determinants. A single-center cohort study collected clinical and epidemiological data for long-term PD initiations between February 2013 and January 2023. The analysis, which utilized Kaplan-Meier and Cox proportional hazard regression methods, included data from 370 patients. The overall mortality rate was 4.7 per 1000 person-months, with a significant decrease in survival rates observed between months 24 and 36 post-PD initiation. Older age at PD initiation and the use of continuous ambulatory peritoneal dialysis, as compared to the automated modality, were associated with an increased risk of mortality. The study provides valuable insights into the survival outcomes of chronic PD patients in Mexico and suggests the need to optimize treatment strategies to enhance long-term prognoses for patients with ESKD. Further research is needed to better understand the factors influencing survival in this population.

Assessing the Relationship between Annual Surface Temperature Changes and the Burden of Dengue: Implications for Climate Change and Global Health Outcomes.

Dengue fever remains a significant global health concern, imposing a substantial burden on public health systems worldwide. Recent studies have suggested that climate change, specifically the increase in surface temperatures associated with global warming, may impact the transmission dynamics of dengue. This study aimed to assess the relationship between annual surface temperature changes from 1961 to 2019 and the burden of dengue in 185 countries. The dengue burden was evaluated for 2019 using disability-adjusted life years (DALYs) and the annual rate of change (ARC) in DALY rates assessed from 1990 to 2019. A cross-sectional and ecological analysis was conducted using two publicly available datasets. Regression coefficients (ß) and 95% confidence intervals (CI) were used to examine the relationship between annual surface temperature changes and the burden of dengue. The results revealed a significant negative relationship between mean surface temperatures and DALY rates in 2019 (ß = -16.9, 95% CI -26.9 to -6.8). Similarly, a significant negative relationship was observed between the temperature variable and the ARC (ß = -0.99, 95% CI -1.66 to -0.32). These findings suggest that as temperatures continue to rise, the burden of dengue may globally decrease. The ecology of the vector and variations in seasons, precipitation patterns, and humidity levels may partially contribute to this phenomenon. Our study contributes to the expanding body of evidence regarding the potential implications of climate change for dengue dynamics. It emphasizes the critical importance of addressing climate change as a determinant of global health outcomes.

Assessing the Burden of Dengue during the COVID-19 Pandemic in Mexico.

The transmission of the dengue virus in Mexico has historically been high, and its burden during the COVID-19 pandemic is currently not well understood. Our objective was to assess the burden of dengue-related disability-adjusted life years (DALYs) between 2020 and 2022. We conducted a cross-sectional analysis of databases resulting from an epidemiological surveillance of vector-borne diseases and computed DALYs using the protocol of the Global Burden of Disease (GBD) study 2019. Our results showed that there were 218,807 incident cases of dengue during the study period, resulting in 951 deaths. The calculated DALYs (and their 95% confidence intervals) were 8121 (7897-8396), 4733 (4661-4820), and 8461 (8344-8605) in 2020, 2021, and 2022, respectively. The DALY rates (per 100,000) were 6.5 (6.3-6.6), 3.8 (3.7-3.9), and 6.7 (6.6-6.8), respectively. The rates for 2020 and 2022 were similar to the historical mean (6.4, p = 0.884), whereas the rate for 2021 was lower than the mean. Premature mortality (years of life lost, YLL) contributed to 91% of the total burden. Our findings suggest that dengue fever remained a significant cause of disease burden during the COVID-19 pandemic, especially in terms of premature mortality.

Association between Vaccination Status for COVID-19 and the Risk of Severe Symptoms during the Endemic Phase of the Disease.

The global health emergency caused by COVID-19 concluded in May 2023, marking the beginning of an endemic phase. This study aimed to evaluate the association between vaccination status and other patient characteristics and the risk of severe disease during this new endemic period. A nationwide cohort study was conducted in Mexico, where we analyzed data from 646 adults who had received positive confirmation of COVID-19 through PCR testing from May to August 2023. The overall risk of severe symptoms in the study sample was 5.3%. The average time elapsed from the last vaccine shot to symptom onset was over six months in all the immunized groups (1, 2 or 3 vaccine doses). Compared to unvaccinated patients, those with three vaccine doses showed an elevated risk of severe symptoms. Advancing age and various chronic comorbidities (specifically cardiovascular, kidney, and obstructive pulmonary conditions) were associated with a heightened risk of severe COVID-19 manifestations. These findings underscore the ongoing seriousness of COVID-19, even in an endemic phase, underscoring the urgent need for tailored interventions aimed at high-risk patients.

Predictors of Recurrent Laboratory-Confirmed Symptomatic SARS-CoV-2 Infections in a Cohort of Healthcare Workers.

BACKGROUND: Repeated SARS-CoV-2 infections are plausible and related published data are scarce. We aimed to identify factors associated with the risk of recurrent (three episodes) laboratory-confirmed symptomatic SARS-CoV-2 infections. METHODS: A retrospective cohort study was conducted, and 1,700 healthcare workers were enrolled. We used risk ratios (RR) and 95% confidence intervals (CI) to evaluate the factors associated with symptomatic SARS-CoV-2 infections. RESULTS: We identified 14 participants with recurrent illness episodes. Therefore, the incidence rate was 8.5 per 10,000 person months. In a multiple-model study, vaccinated adults (vs. unvaccinated, RR = 1.05 [1.03-1.06]) and those with a severe first illness episode (vs. mild disease, RR = 1.05 [1.01-1.10]) were at increased risk for repeated symptomatic SARS-CoV-2 reinfections. Increasing age showed a protective effect (per each additional year of age: RR = 0.98 [0.97-0.99]). CONCLUSIONS: Our results suggest that recurrent SARS-CoV-2 infections are rare events in adults, and they seem to be determined, partially, by vaccination status and age.

Survival Analysis and Contributing Factors among PCR-Confirmed Adult Inpatients during the Endemic Phase of COVID-19.

In May 2023, the global health emergency status of COVID-19 concluded, marking the onset of an endemic era. This study assessed survival rates among PCR-confirmed adult inpatients during this phase and determined contributing factors. Employing a survival analysis approach, this investigation utilized a nationwide Mexican cohort encompassing 152 adult inpatients. Survival rates were computed using the Kaplan-Meier method, and a proportional Cox model identified mortality risk factors. Survival rates remained above 65% on day 14 after admission. Vaccination status, including the number of doses administered, was not significantly associated with fatal outcomes. Chronic kidney disease or a history of immunosuppression (due to any cause) increased mortality risk. Our findings underscore the persistent severity of COVID-19 beyond the global health emergency, emphasizing the necessity for tailored interventions for vulnerable patients.

Assessing the Influence of COVID-19 Vaccination Coverage on Excess Mortality across 178 Countries: A Cross-Sectional Study.

The COVID-19 pandemic has had a devastating impact on global health, necessitating urgent and effective strategies to mitigate its consequences. Vaccination programs have been implemented worldwide to combat virus transmission and reduce the disease burden. This study aimed to investigate the relationship between COVID-19 vaccination coverage and all-cause excess mortality in 178 nations during the first two years of the pandemic. Multiple regression analysis, after adjusting for life expectancy at birth, confirmed a significant association between higher vaccination coverage and lower all-cause mortality rates (ß = -106.8, 95% CI -175.4 to -38.2, p = 0.002). These findings underscore the importance of vaccination campaigns in reducing overall mortality during the COVID-19 pandemic. Evidence-based decision making and resource allocation can benefit from this information, facilitating the optimization of vaccination strategies for maximal impact on mortality reduction. Further research and continuous monitoring are crucial to understanding the long-term effects of vaccination coverage on population health in the ongoing pandemic.

Erectile dysfunction, lower urinary tract symptoms, and quality of life in men above 50 years of age. / Disfunción eréctil, síntomas del tracto urinario inferior y calidad de vida en varones mayores de 50 años.

BACKGROUND: Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are relevant health problems worldwide, especially in men 50 years of age and older. With the increase in life expectancy, their prevalence is expected to rise in the coming years. AIM: To estimate the prevalence of LUTS and ED in adults 50 years of age and older and evaluate their relation to quality of life. MATERIALS AND METHODS: An analytic cross-section-al study was conducted through a personal interview with the participants. Erectile dysfunction (IIEF-5), prostate symptom (IPSS), and quality of life (EuroQoL) questionnaires were employed. The frequency and grade of LUTS and ED were evaluated and correlated with health-related quality of life perception in 300 men above 50 years of age. Summary measures were calculated. The association of LUTS and ED with quality of life was evaluated with prevalence odds ratios (ORs) and 95% confidence intervals (CIs), calculated using unconditional logistic regression models. RESULTS: Information on 300 subjects was analyzed. The general prevalence of LUTS and ED was 88.3% and 81.7%, respectively. Quality of life was classified as very poor - regular (≤ 60 points) in 18.3% of the subjects. In the multiple analysis, the presence of moderate LUTS (OR = 5.27, 1.08 - 9.73) or severe LUTS (OR = 7.05, 1.84-10.34) was associated with an increase in the possibility of presenting with a lower quality of life. CONCLUSION: Our findings suggest that erectile dysfunction and prostate symptoms were frequent events in the population studied, as was a low perception of quality of life. The opportune and efficacious treatment of those pathologies can potentially improve the individual and social dynamics of the persons affected.

ANTECEDENTES: A nivel mundial, los Síntomas del Tracto Urinario Inferior (STUI) y la Disfunción Eréctil (DE) son un problema relevante de salud pública, especialmente en varones de 50 o más años. Se espera que con el aumento de la esperanza de vida, su prevalencia se incrementa aún más en los próximos años. OBJETIVO: Estimar la prevalencia de los STUI y DE en adultos de 50 años o más de edad y evaluar su relación con la calidad de vida.MATERIAL Y MÉTODOS: Se realizó un estudio transversal analítico a través de una entrevista personal con los participantes. Se emplearon los cuestionarios de disfunción eréctil (IIEF-5), de síntomas prostáticos (IPSS) y la calidad de vida (EuroQoL). Se evaluó la frecuencia y grados de los Síntomas del Tracto Urinario Inferior y Disfunción Eréctil y se correlacionó con la percepción de Calidad de Vida relacionada a la salud en 300 varones mayores de 50 años. Se estimaron medidas sumarias. La asociación de STUI y DE con la calidad de vida fue evaluada con razones de momios (RM) prevalentes e intervalos de confianza (IC) del 95% estimados con modelos de regresión logística no condicional. RESULTADOS: Información de 300 sujetos fue analizada. La prevalencia general de STUI y DE fue 88,3% y 81,7% respectivamente. El 18,3% de los sujetos fueron clasificados como con una calidad de vida muy mala ­ regular (≤ 60 puntos). En el análisis múltiple, la presencia de STUI moderados (RM = 5,27, 1,08 ­ 9,73) o severos (RM = 7,05, 1,84 -10,34) se asoció con un incremento en la posibilidad de presentar una menor calidad de vida.CONCLUSIÓN: Nuestros hallazgos sugieren que la disfunción eréctil y los síntomas prostáticos son eventos frecuentes en la población estudiada, al igual que una baja percepción de la calidad de vida. La atención oportuna y eficaz de estas patologías puede potencialmente mejorar la dinámica individual y social de los sujetos afectados.