Mexico and the COVID-19 Response

Merging socioecological variables to predict risk of Chagas disease

How far are we from predicting the occurrence of zoonotic diseases? In this paper we have made use of both socioecological and ecological variables to predict Chagas disease occurrence. Chagas disease involves, Trypanosoma cruzi, a complex life-cycle parasite which requires two hosts: blood-feeding triatomine insects and vertebrate hosts including humans. We have used a common risk assessment method combined with datasets that imply critical environmental and socioeconomic drivers of Chagas dynamics to predict the occurrence of this disease. We also carried out a network analysis to assess the interactions among triatomines and mammal host species given their human contact via whether hunted, domesticated or associated with anthropogenic landscapes in Mexico. We found that social backwardness variation, lack of health services and altitude had the largest relative influence Chagas events. Triatoma pallidipennis made use of the largest host diversity. Host species shared by the highest number of different triatomines were a woodrat, the highly appreciated bushmeat, and racoon. These results indicate both the predominance of socio-economic factors over ecological ones, and how close we are from predicting zoonotic diseases.

Seroprevalence of IgM/IgG and Neutralizing Antibodies against SARS-CoV-2 in Unvaccinated Young Adults from Mexico Who Reported Not Having Had a Previous COVID-19 Infection

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that causes coronavirus disease 2019 (COVID-19). It is estimated that more than half of new infections are transmitted by asymptomatic people; therefore, the isolation of symptomatic people is not enough to control the spread of the disease.

Methods

A total of 171 unvaccinated young adults (18-35 years) from Sonora, Mexico, who underwent a structured survey to identify prior COVID-19 infections, were included in this study. A qualitative determination of anti-SARS-CoV-2 antibodies in serum was performed by lateral flow immunoassay (Certum IgG/IgM Rapid Test™ cassette kit) and neutralizing antibodies were also determined (GenScript cPass assay).

Results

A total of 36 people reported a history of COVID-19 infection, and 135 reported no history of COVID-19. In contrast, 49.6% (67/135) of individuals who had not reported a previous SARS-CoV-2 infection were seropositive to the rapid anti-SARS-CoV-2 antibody test, and 48.1% (65/135) of them had neutralizing antibodies.

Conclusions

These results suggest that in young adults, SARS-CoV-2 infections could be asymptomatic in a high percentage of individuals, which could contribute in part to the slow control of the current pandemic due to the large number of asymptomatic cases that are contagious and that could be a silent spread of the virus.

Compounding COVID-19 and climate risks: The interplay of banks' lending and government's policy in the shock recovery

We assess the individual and compounding impacts of COVID-19 and climate physical risks in the economy and finance, using the EIRIN Stock-Flow Consistent model. We study the interplay between banks' lending decisions and government's policy effectiveness in the economic recovery process. We calibrate EIRIN on Mexico, being a country highly exposed to COVID-19 and hurricanes risks. By embedding financial actors and the credit market, and by endogenising investors' expectations, EIRIN analyses the finance-economy feedbacks, providing an accurate assessment of risks and policy co-benefits. We quantify the impacts of compounding COVID-19 and hurricanes on GDP through time using a compound risk indicator. We find that procyclical lending and credit market constraints amplify the initial shocks by limiting firms' recovery investments, thus mining the effectiveness of higher government spending. When COVID-19 and hurricanes compound, non-linear dynamics that amplify losses emerge, negatively affecting the economic recovery, banks' financial stability and public debt sustainability.

It Is Not the Virus Exposure: Differentiating Job Demands and Resources That Account for Distress during the COVID-19 Pandemic among Health Sector Workers

A cross-sectional study of 3860 health-sector workers across two data collections was conducted to identify the predictive power of different job demands and job resources during the COVID-19 pandemic based on four indicators of distress (COVID-19 traumatic stress, burnout, generalised anxiety, and depression) among health-sector workers. Exploratory and confirmatory factor analyses, measurement invariance checks, and structural equation models were used to evaluate the dimensionality and the effect of the job demands and resources on distress indictors. The identified job demands were workload, confinement, loss, and virus exposure, while the identified job resources were self-efficacy, momentary recuperation, and meaning making. Loss and workload predicted the distress indicators best, while confinement and virus exposure mainly predicted COVID-19 traumatic stress and were less important for the other distress outcomes. Self-efficacy and meaning making negatively predicted distress, while momentary recuperation, controlled for the other demands and resources, was positively related to the distress indicators. Of the typical pandemic-related demands and resources, the experience of loss due to COVID-19 infection was the most important predictor of distress outcomes. Confinement, and especially the awareness of virus exposure, were far less important predictors.

Clinical presentation and outcomes of hospitalized children with COVID-19 in Mexico City

We describe the demographic, clinical, radiological, and laboratory findings relating them also to the severity and clinical outcome of 129 children (0-18 years) who were admitted to a tertiary care pediatric hospital in Mexico City due to severe acute respiratory syndrome coronavirus 2 infection between April 1, 2020 and March 31, 2021. The infection was confirmed using reverse transcription-polymerase chain reaction Fever (82.2%), tachypnea (72.1%), and cough (71.3%) were the most reported signs at the moment of hospitalization. The most frequent radiological pattern that stood out was the interstitial pattern (66.7%). History of oncologic pathology (25.6%) was the most frequent past medical history. Non-steroidal anti-inflammatory drugs (93%), antibiotics (57.4%), and steroids (40.3%) were the most common medication given. The average hospitalization stay was 14.2 days, and 21.7% of the total patients required transfer to the intensive care unit. At discharge, 20.2% required oxygen on an outpatient basis, and unfortunately, 7.0% of the patients who were admitted to the institute for COVID-19 died. Our findings confirm that COVID-19 in children has a mild presentation except for patients with hematologic/oncologic comorbidities who had severe presentations.

Evaluating the impact of mobility in COVID-19 incidence and mortality: A case study from four states of Mexico

Introduction

The COVID-19 pandemic in Mexico began at the end of February 2020. An essential component of control strategies was to reduce mobility. We aimed to evaluate the impact of mobility on COVID- incidence and mortality rates during the initial months of the pandemic in selected states.

Methods

COVID-19 incidence data were obtained from the Open Data Epidemiology Resource provided by the Mexican government. Mobility data was obtained from the Observatory for COVID-19 in the Americas of the University of Miami. We selected four states according to their compliance with non-pharmaceutical interventions and mobility index. We constructed time series and analyzed change-points for mobility, incidence, and mortality rates. We correlated mobility with incidence and mortality rates for each time interval. Using mixed-effects Poisson models, we evaluated the impact of reductions in mobility on incidence and mortality rates, adjusting all models for medical services and the percentage of the population living in poverty.

Results

After the initial decline in mobility experienced in early April, a sustained increase in mobility followed during the rest of the country-wide suspension of non-essential activities and the return to other activities throughout mid-April and May. We identified that a 1% increase in mobility yielded a 5.2 and a 2.9% increase in the risk of COVID-19 incidence and mortality, respectively. Mobility was estimated to contribute 8.5 and 3.8% to the variability in incidence and mortality, respectively. In fully adjusted models, the contribution of mobility to positive COVID-19 incidence and mortality was sustained. When assessing the impact of mobility in each state compared to the state of Baja California, increased mobility conferred an increased risk of incident positive COVID-19 cases in Mexico City, Jalisco, and Nuevo León. However, for COVID-19 mortality, a differential impact of mobility was only observed with Jalisco and Nuevo León compared to Baja California.

Conclusion

Mobility had heterogeneous impacts on COVID-19 rates in different regions of Mexico, indicating that sociodemographic characteristics and regional-level pandemic dynamics modified the impact of reductions in mobility during the COVID-19 pandemic. The implementation of non-pharmaceutical interventions should be regionalized based on local epidemiology for timely response against future pandemics.

Burden and depression among informal caregivers of visually impaired patients in Mexico

BACKGROUND

The needs of informal caregivers who provide care to family relatives with visual impairment are often neglected, resulting in burden and depression.

OBJECTIVE

To determine the degree of burden and the prevalence of major depression experienced by caregivers, defined as non-paid family relatives, of legally blind individuals in a Mexican population.

METHODS

Observational, single-center, cross-sectional study in adults providing care to their family relatives with visual impairment (visual acuity ≤ 20/200 in the best eye for at least 3 months). According to visual impairment degree, care provided included activities of daily living (ADL) and instrumental ADL. Burden of care was evaluated with the Zarit burden interview (ZBI)-22 and the prevalence of major depression was determined by the patient health questionnaire (PHQ)-9.

RESULTS

115 patients and 115 caregivers were included. Male caregivers had significantly higher ZBI-22 (28.7 ± 15.5 vs. 19.2 ± 12.6, p = 0.001) and PHQ-9 (10.0 ± 5.5 vs. 5.3 ± 5.1, p < 0.001) scores than females. Likewise, parent caregivers of adult children and the hours of daily care were significantly associated with higher burden and depression scores. A significant linear correlation between ZBI-22 and PHQ-9 scores in caregivers was also found (r = 0.649, p < 0.001).

CONCLUSIONS

Male caregivers, parent caregivers of adult children, and caregivers providing greater hours of care were at higher risk of burden and depression. Upon diagnosis of visual impairment, adults providing care to visually impaired family relatives should be screened for burden and depression and referred to a mental health specialist when necessary. Tailored interventions targeting the caregivers' needs are required to reduce burden and depression.

Mental Health Impact of the COVID-19 Pandemic on Mexican Population: A Systematic Review

The COVID-19 pandemic has had an impact on mental health in the general population, but no systematic synthesis of evidence of this effect has been undertaken for the Mexican population. Relevant studies were identified through the systematic search in five databases until December, 2021. The selection of studies and the evaluation of their methodological quality were performed in pairs. The Newcastle-Ottawa Scale (NOS) was used for study quality appraisal. The protocol of this systematic review was registered with PROSPERO (protocol ID: CRD42021278868). This review included 15 studies, which ranged from 252 to 9361 participants, with a total of 26,799 participants. The findings show that COVID-19 has an impact on the Mexican population’s mental health and is particularly associated with anxiety, depression, stress and distress. Females and younger age are risk factors for development mental health symptoms. Mitigating the negative effects of COVID-19 on mental health should be a public health priority in Mexico.

Impact on the Nutritional and Functional Status of Older Mexican Adults in the Absence of Recreational Activities due to COVID-19: A Longitudinal Study From 2018 to 2021

A longitudinal study, from 2018 to 2021, identified impacts on the nutritional and functional status of older adults when face-to-face activities at a social assistance center in Mexico were suspended due to the COVID-19 pandemic. A total of 71 older adults were evaluated at three different periods: 18 months prior, three months before the pandemic, and 12 months after the onset of the pandemic. Seventy-one older adults completed follow up. Anthropometric measurements, dietary intake, physical tests, and health screening for malnutrition, dependence, and physical frailty, were evaluated. There was a significant decrease in lean body mass and body water in the older adults assessed, in addition to a significant reduction in the frailty scale and gait speed. Finally, a significant reduction in ingested energy and several nutrients such as protein, and carbohydrates, was found, yet an increase in sugar and cholesterol intake was noted.

Grace Under Pressure: Resiliency of Quality Monitoring of Stroke Care During the Covid-19 Pandemic in Mexico City

Stroke is one of the leading causes of death and disability among adults worldwide. The World Health Organization (WHO) officially declared a COVID-19 pandemic on March 11, 2020. The first case in Mexico was confirmed in February 2020, subsequently becoming one of the countries most affected by the pandemic. In 2020, The National Institute of Neurology of Mexico started a Quality assurance program for stroke care, consisting of registering, monitoring and feedback of stroke quality measures through the RES-Q platform. We aim to describe changes in the demand for stroke healthcare assistance at the National Institute of Neurology and Neurosurgery during the pandemic and the behavior of stroke quality metrics during the prepandemic and the pandemic periods. For this study, we analyzed data for acute stroke patients registered in the RES-Q platform, in the prepandemic (November 2019 to February 2020) and pandemic (March-December 2020) periods in two groups, one prior to the pandemic. During the pandemic, there was an increase in the total number of assessed acute stroke patients at our hospital, from 474 to 574. The average time from the onset of symptoms to hospital arrival (Onset to Door Time—OTD) for all stroke patients (thrombolyzed and non-thrombolyzed) increased from 9 h (542 min) to 10.3 h (618.3 min) in the pandemic group. A total of 135 acute stroke patients were enrolled in this registry. We found the following results: Patients in both groups were studied with non-contrast computed tomography (NNCT), computed tomography angiography (CTA), magnetic resonance angiography (MRA), digital subtraction angiography (DSA) or more frequently in the pandemic period (early carotid imaging, Holter monitoring) as needed. Treatment for secondary prevention (antihypertensives, antiplatelets, statins) did not differ. Frequency of performing and documenting the performance of NIHSS scale at arrival and early dysphagia test improved. There was an increase in alteplase use from 21 to 42% (p = 0.03). There was a decrease in door to needle time (46 vs. 39 min p = 0.30). After the implementation of a stroke care protocol and quality monitoring system, acute stroke treatment in our institution has gradually improved, a process that was not thwarted during the COVID-19 pandemic.

Geographical network model for COVID-19 spread among dynamic epidemic regions

Pandemic due to SARS-CoV-2 (COVID-19) has affected to world in several aspects: high number of confirmed cases, high number of deaths, low economic growth, among others. Understanding of spatio-temporal dynamics of the virus is helpful and necessary for decision making, for instance to decide where, whether and how, non-pharmaceutical intervention policies are to be applied. This point has not been properly addressed in literature since typical strategies do not consider marked differences on the epidemic spread across country or large territory. Those strategies assume similarities and apply similar interventions instead. This work is focused on posing a methodology where spatio-temporal epidemic dynamics is captured by means of dividing a territory in time-varying epidemic regions, according to geographical closeness and infection level. In addition, a novel Lagrangian-SEIR-based model is posed for describing the dynamic within and between those regions. The capabilities of this methodology for identifying local outbreaks and reproducing the epidemic curve are discussed for the case of COVID-19 epidemic in Jalisco state (Mexico). The contagions from July 31, 2020 to March 31, 2021 are analyzed, with monthly adjustments, and the estimates obtained at the level of the epidemic regions present satisfactory results since Relative Root Mean Squared Error RRMSE is below 15% in most of regions, and at the level of the whole state outstanding with RRMSE below 5%.

An exploration of the political, social, economic and cultural factors affecting how different global regions initially reacted to the COVID-19 pandemic

Responses to the early (February–July 2020) COVID-19 pandemic varied widely, globally. Reasons for this are multiple but likely relate to the healthcare and financial resources then available, and the degree of trust in, and economic support provided by, national governments. Cultural factors also affected how different populations reacted to the various pandemic restrictions, like masking, social distancing and self-isolation or self-quarantine. The degree of compliance with these measures depended on how much individuals valued their needs and liberties over those of their society. Thus, several themes may be relevant when comparing pandemic responses across different regions. East and Southeast Asian populations tended to be more collectivist and self-sacrificing, responding quickly to early signs of the pandemic and readily complied with most restrictions to control its spread. Australasian, Eastern European, Scandinavian, some Middle Eastern, African and South American countries also responded promptly by imposing restrictions of varying severity, due to concerns for their wider society, including for some, the fragility of their healthcare systems. Western European and North American countries, with well-resourced healthcare systems, initially reacted more slowly, partly in an effort to maintain their economies but also to delay imposing pandemic restrictions that limited the personal freedoms of their citizens.

Real-world evidence of the use of glucocorticoids for severe COVID-19

INTRODUCTION

Currently, only glucocorticoids have proved to impact adverse outcomes in COVID-19. However, their risk/benefit balance remains inconclusive and populations' characteristics should be considered.

OBJECTIVE

The objective was to evaluate the real-life use of glucocorticoids in patients with severe COVID-19 hospitalized in a third-level referral center and to determine the type, accumulated doses, and the in-hospital outcomes related with their use.

METHODS

We evaluated a retrospective cohort of 737 patients with criteria for severe COVID-19 and a positive polymerase chain reaction (PCR) test for SARS-CoV-2. We extracted data for epidemiological analysis, medical history, and medications, as well as baseline laboratory tests. Data were analyzed using SPSS 21.0 and nonparametric tests, medians, and interquartile ranges (IQR). A p < 0.05 was considered significant.

RESULTS

A total of 65.3% were men, with a median age of 59 years (IQR 46-70) and a median of 10 days of hospital stay (IQR 6-16), more than 40% had diabetes, hypertension, and/or obesity, and 0.8% used steroids chronically. At the time of the study, 54.0% had been discharged due to improvement and 40.8% died. The most common treatment used was dexamethasone 6 mg/day/10 days (46.6%). Patients with a complete dexamethasone scheme [as proposed by the Randomized Evaluation of COVID-19 Therapy (RECOVERY) study] had a lower mortality risk [hazard ratio (HR) 0.441, 95% confidence interval (CI) 0.232-0.840] in comparison with patients with lower doses (HR 1.803, 95% CI 1.080-3.012). Patients with methylprednisolone or several steroids tended to have higher cumulative doses (equivalent to >675 mg of prednisolone).

CONCLUSION

The use of steroids in severe COVID-19 reduces mortality only at the dose proposed in the RECOVERY study in the younger population. No benefit of the use of steroids was observed in patients with older age or higher number of comorbidities.

Transplant trends in Mexico during the COVID-19 pandemic: Disparities within healthcare sectors

Healthcare systems worldwide were challenged during the COVID-19 pandemic. In Mexico, the public hospitals that perform most transplants were adapted to provide care for COVID-19 patients. Using a nationwide database, we describe the first report of the impact of COVID-19 and related transplantation healthcare policies in a middle-income country by comparing statistics before and during the pandemic (pre-COVID: March 2019-February 2020 vs. COVID era: March 2020-February 2021) and by type of institution (public vs. private). The global reduction in transplantation was higher in public institutions compared with private institutions, 89% versus 62%, respectively, p < .001. When analyzing by organ, kidney transplantation decreased by 89% at public versus 57% at private, p < .001; cornea by 88% at public versus 64% at private, p < .001; liver by 88% at public versus 35% at private, p < .001; and heart by 88% in public versus 67% at private institutions, p = .4. The COVID-19 pandemic along with the implemented health policies were associated with a decrease in donations, waiting list additions, and a decrease in transplantation, particularly at public institutions, which care for the most vulnerable.

Punt Politics as Failure of Health System Stewardship: Evidence from the COVID-19 Pandemic Response in Brazil and Mexico

We present a new concept, Punt Politics, and apply it to the COVID-19 non-pharmaceutical interventions (NPI) in two epicenters of the pandemic: Mexico and Brazil. Punt Politics refers to national leaders in federal systems deferring or deflecting responsibility for health systems decision-making to sub-national entities without evidence or coordination. The fragmentation of authority and overlapping functions in federal, decentralized political systems make them more susceptible to coordination problems than centralized, unitary systems. We apply the concept to pandemics, which require national health system stewardship, using sub-national NPI data that we developed and curated through the Observatory for the Containment of COVID-19 in the Americas to illustrate Punt Politics in Mexico and Brazil. Both countries suffer from protracted, high levels of COVID-19 mortality and inadequate pandemic responses, including little testing and disregard for scientific evidence. We illustrate how populist leadership drove Punt Politics and how partisan politics contributed to disabling an evidence-based response in Mexico and Brazil. These cases illustrate the combination of decentralization and populist leadership that is most conducive to punting responsibility. We discuss how Punt Politics reduces health system functionality, providing lessons for other countries and future pandemic responses, including vaccine rollout.

Another Vision of the Situation of the COVID-19 Pandemic in Mexico During 2020

The number of coronavirus disease 2019 (COVID-19) cases and deaths registered in Mexico during 2020 could be underestimated, due to the sentinel surveillance adopted in this country. Some consequences of following this type of epidemiological surveillance were the high case fatality rate and the high positivity rate for COVID-19 shown in Mexico in 2020. During this year, the Mexican Ministry of Health only considered cases from the public health system, which followed this sentinel surveillance, but did not consider those cases from the private health system. To better understand this pandemic, it is important to include all the results obtained by all the institutions capable of testing for COVID-19; thus, the Mexican Government could then make good decisions to protect the population from this disease.

COVID-19 Trend Analysis in Mexican States and Cities

This paper presents a trend analysis of the COVID-19 pandemics in Mexico. The studies were run in a subnational basis because they are more useful that way, providing important information about the pandemic to local authorities. Unlike classic approaches in the literature, the trend analysis presented here is not based on the variations in the number of infections along time, but rather on the predicted value of the final number of infections, which is updated every day employing new data. Results for four states and four cities, selected among the most populated in Mexico, are presented. The model was able to suitably fit the local data for the selected regions under evaluation. Moreover, the trend analysis enabled one to assess the accuracy of the forecasts.

Transmission dynamics and forecasts of the COVID-19 pandemic in Mexico, March-December 2020

Mexico has experienced one of the highest COVID-19 mortality rates in the world. A delayed implementation of social distancing interventions in late March 2020 and a phased reopening of the country in June 2020 has facilitated sustained disease transmission in the region. In this study we systematically generate and compare 30-day ahead forecasts using previously validated growth models based on mortality trends from the Institute for Health Metrics and Evaluation for Mexico and Mexico City in near real-time. Moreover, we estimate reproduction numbers for SARS-CoV-2 based on the methods that rely on genomic data as well as case incidence data. Subsequently, functional data analysis techniques are utilized to analyze the shapes of COVID-19 growth rate curves at the state level to characterize the spatiotemporal transmission patterns of SARS-CoV-2. The early estimates of the reproduction number for Mexico were estimated between Rt ~1.1-1.3 from the genomic and case incidence data. Moreover, the mean estimate of Rt has fluctuated around ~1.0 from late July till end of September 2020. The spatial analysis characterizes the state-level dynamics of COVID-19 into four groups with distinct epidemic trajectories based on epidemic growth rates. Our results show that the sequential mortality forecasts from the GLM and Richards model predict a downward trend in the number of deaths for all thirteen forecast periods for Mexico and Mexico City. However, the sub-epidemic and IHME models perform better predicting a more realistic stable trajectory of COVID-19 mortality trends for the last three forecast periods (09/21-10/21, 09/28-10/27, 09/28-10/27) for Mexico and Mexico City. Our findings indicate that phenomenological models are useful tools for short-term epidemic forecasting albeit forecasts need to be interpreted with caution given the dynamic implementation and lifting of social distancing measures.

Clinical and bioethical implications of health care interruption during the COVID-19 pandemic: A cross-sectional study in outpatients with rheumatic diseases

BACKGROUND

To determine the impact of health care interruption (HCI), on clinical status of the patients reincorporated to an outpatient clinic for rheumatic diseases (OCDIR), from a tertiary care level center who was temporally switched to a dedicated COVID-19 hospital, and to provide a bioethical analysis.

METHODS

From March to June 2020, the OCDIR was closed; since June, it is limited to evaluate 25% of the ongoing outpatients. This cross-sectional study surveyed 670 consecutive rheumatic outpatients between June 24th and October 31th, concomitant to the assessment of the rheumatic disease clinical status by the attendant rheumatologist, according to disease activity level, clinical deterioration and adequate/inadequate control. Multiple logistic regression analysis identified factors associated to HCI and to clinical deterioration.

RESULTS

Patients were middle-aged females (86.7%), with median disease duration of 10 years, comorbidity (38.5%) and 138 patients (20.6%) had discontinued treatment. Primary diagnoses were SLE and RA, in 285 (42.5%) and 223 (33.3%) patients, respectively. There were 344 patients (51.3%) with HCI. Non-RA diagnosis (OR: 2.21, 95%CI: 1.5-3.13), comorbidity (OR: 1.7, 95%CI: 1.22-2.37), patient's need for rheumatic care during HCI (OR: 3.2, 95%CI: 2.06-4.97) and adequate control of the rheumatic disease (OR: 0.64, 95%CI: 0.45-0.9) were independently associated to HCI. There were 160 patients (23.8%) with clinical deterioration and associated factors were disease duration, substantial disease activity previous HCI, patients need for rheumatic care and treatment discontinuation.

CONCLUSIONS

HCI during COVID-19 pandemic impacted course of rheumatic diseases and need to be considered in the bioethical analysis of virus containment measures.

Serum IL-6: A potential biomarker of mortality among SARS-CoV-2 infected patients in Mexico

Background

The first case of SARS-CoV-2 in Mexico was reported in February 2020, since then, high rates of mortality due to COVID-19 have been found. Cytokine storm is linked to the severity and decreasing the survival among infected patients by COVID-19. The serum levels of Interleukin 6 (IL-6) have been correlated to mortality in COVID-19 cases and could be used as indicator of mortality in COVID-19 cases. The aim of this study was to determine levels of IL-6 and assess its usefulness as indicator of mortality among COVID-19 patients from Mexico.

Methods

A cohort study among 38 adults (28 men, 10 women) was carried out in the Regional High Specialty Hospital of the Yucatan Peninsula in Merida, Yucatan, Mexico. Demographic and clinical biochemistry data were collected. The serum levels of IL-6 were measured in each patient by specific immunoassays.

Results

High frequency of mortality (36.84%) was found in the sample. The average age of individuals that non-survive was significantly higher (59.71 ± 13.83 years) than the survival group (43.29 ± 11.80 years). Serum levels of IL-6 were significantly higher in patients that did not survive. A correlation between IL-6 levels with lymphocyte count, LDH, CRP and procaciltonin was found. The optimal cutoff value of IL-6 was 30.95 pg/mL with high sensitivity and specificity.

Conclusion

Our findings demonstrate that level of IL-6 is an indicator of mortality among hospitalized COVID-19 patients in Mexico.