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González-Beltrán D, Donat M, Politi J, Ronda E, Barrio G, Belza MJ, Regidor E. Changes in all-cause and cause-specific mortality by occupational skill during COVID-19 epidemic in Spain. J Epidemiol Community Health 2024:jech-2024-222065. [PMID: 38977297 DOI: 10.1136/jech-2024-222065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 06/25/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND There is little information on the differential impact of the COVID-19 pandemic on mortality by occupation. The objective was to examine changes in mortality during the COVID-19 period compared with the prepandemic period in different occupational groups in Spain. METHODS Average mortality in the entire period 2020-2021, and each of its semesters, was compared, respectively, with the average mortality in the entire period 2017-2019, and the corresponding semester (first or second) of this last period, across occupational skill levels. For this, age-standardised death rates and age-adjusted mortality rate ratios (MRRs) obtained through Poisson regression were used. Data were obtained from the National Institute of Statistics and the Labour Force Survey. RESULTS The excess all-cause mortality during the 2020-2021 pandemic period by the MRR was higher in low-skilled (1.18, 95% CI 1.16 to 1.20) and medium-skilled workers (1.14; 95% CI 1.13 to 1.15) than high-skilled workers (1.04; 95% CI 1.02 to 1.05). However, the greatest excess mortality was observed in low-skilled workers in 2020 and in medium-skilled workers in 2021. Focusing on causes of death other than COVID-19, low-skilled workers showed the highest MRR from cardiovascular diseases (1.31; 95% CI 1.26 to 1.36) and high-skilled workers the lowest (1.02; 95% CI 0.98 to 1.02). However, this pattern was reversed for mortality from external causes, with low-skilled workers showing the lowest MRR (1.04; 95% CI 0.97 to 1.09) and high-skilled workers the highest (1.08; 95% CI 1.03 to 1.13). CONCLUSION Globally, in Spain, during the 2020-2021 COVID-19 epidemic period, low-skilled workers experienced a greater excess all-cause mortality than other occupational groups, but this was not the case during the entire epidemic period or for all causes of death.
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Affiliation(s)
- Damián González-Beltrán
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Marta Donat
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Julieta Politi
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
| | - Elena Ronda
- Preventive Medicine and Public Health Area, Universidad de Alicante, Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gregorio Barrio
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María José Belza
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Comunidad de Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Enrique Regidor
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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Gmanyami JM, Quentin W, Lambert O, Jarynowski A, Belik V, Amuasi JH. Excess mortality during the COVID-19 pandemic in low-and lower-middle-income countries: a systematic review and meta-analysis. BMC Public Health 2024; 24:1643. [PMID: 38902661 PMCID: PMC11188207 DOI: 10.1186/s12889-024-19154-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/14/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Although the COVID-19 pandemic claimed a great deal of lives, it is still unclear how it affected mortality in low- and lower-middle-income countries (LLMICs). This review summarized the available literature on excess mortality during the COVID-19 pandemic in LLMICs, including methods, sources of data, and potential contributing factors that might have influenced excess mortality. METHODS We conducted a systematic review and meta-analysis on excess mortality during the COVID-19 pandemic in LLMICs in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines We searched PubMed, Embase, Web of Science, Cochrane Library, Google Scholar, and Scopus. We included studies published from 2019 onwards with a non-COVID-19 period of at least one year as a comparator. The meta-analysis included studies reporting data on population size, as well as observed and expected deaths. We used the Mantel-Haenszel method to estimate the pooled risk ratio with 95% confidence intervals. The protocol was registered in PROSPERO (ID: CRD42022378267). RESULTS The review covered 29 countries, with 10 countries included in the meta-analysis. The pooled meta-analysis included 1,405,128,717 individuals, for which 2,152,474 deaths were expected, and 3,555,880 deaths were reported. Calculated excess mortality was 100.3 deaths per 100,000 population per year, with an excess risk of death of 1.65 (95% CI: 1.649, 1.655, p < 0.001). The data sources used in the studies included civil registration systems, surveys, public cemeteries, funeral counts, obituary notifications, burial site imaging, and demographic surveillance systems. The primary techniques used to estimate excess mortality were statistical forecast modelling and geospatial analysis. One out of the 24 studies found higher excess mortality in urban settings. CONCLUSION Our findings demonstrate that excess mortality in LLMICs during the pandemic was substantial. However, estimates of excess mortality are uncertain due to relatively poor data. Understanding the drivers of excess mortality, will require more research using various techniques and data sources.
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Affiliation(s)
- Jonathan Mawutor Gmanyami
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- German West-African Centre for Global Health and Pandemic Prevention, Berlin, Germany.
- Global Health and Infectious Diseases Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana.
| | - Wilm Quentin
- German West-African Centre for Global Health and Pandemic Prevention, Berlin, Germany
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
- Chair of Planetary & Public Health, University of Bayreuth, Bayreuth, Germany
| | - Oscar Lambert
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Andrzej Jarynowski
- Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Vitaly Belik
- Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - John Humphrey Amuasi
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- German West-African Centre for Global Health and Pandemic Prevention, Berlin, Germany
- Global Health and Infectious Diseases Research Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
- Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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Antonio-Villa NE, Bello-Chavolla OY, Fermín-Martínez CA, Ramírez-García D, Vargas-Vázquez A, Basile-Alvarez MR, Núñez-Luna A, Sánchez-Castro P, Fernández-Chirino L, Díaz-Sánchez JP, Dávila-López G, Posadas-Sánchez R, Vargas-Alarcón G, Caballero AE, Florez JC, Seiglie JA. Diabetes subgroups and sociodemographic inequalities in Mexico: a cross-sectional analysis of nationally representative surveys from 2016 to 2022. LANCET REGIONAL HEALTH. AMERICAS 2024; 33:100732. [PMID: 38616917 PMCID: PMC11015526 DOI: 10.1016/j.lana.2024.100732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/16/2024]
Abstract
Background Differences in the prevalence of four diabetes subgroups have been reported in Mexico compared to other populations, but factors that may contribute to these differences are poorly understood. Here, we estimate the prevalence of diabetes subgroups in Mexico and evaluate their correlates with indicators of social disadvantage using data from national representative surveys. Methods We analyzed serial, cross-sectional Mexican National Health and Nutrition Surveys spanning 2016, 2018, 2020, 2021, and 2022, including 23,354 adults (>20 years). Diabetes subgroups (obesity-related [MOD], severe insulin-deficient [SIDD], severe insulin-resistant [SIRD], and age-related [MARD]) were classified using self-normalizing neural networks based on a previously validated algorithm. We used the density-independent social lag index (DISLI) as a proxy of state-level social disadvantage. Findings We identified 4204 adults (median age: 57, IQR: 47-66, women: 64%) living with diabetes, yielding a pooled prevalence of 16.04% [95% CI: 14.92-17.17]. When stratified by diabetes subgroup, prevalence was 6.62% (5.69-7.55) for SIDD, 5.25% (4.52-5.97) for MOD, 2.39% (1.95-2.83) for MARD, and 1.27% (1.00-1.54) for SIRD. SIDD and MOD clustered in Southern Mexico, whereas MARD and SIRD clustered in Northern Mexico and Mexico City. Each standard deviation increase in DISLI was associated with higher odds of SIDD (OR: 1.12, 95% CI: 1.06-1.12) and lower odds of MOD (OR: 0.93, 0.88-0.99). Speaking an indigenous language was associated with higher odds of SIDD (OR: 1.35, 1.16-1.57) and lower odds of MARD (OR 0.58, 0.45-0.74). Interpretation Diabetes prevalence in Mexico is rising in the context of regional and sociodemographic inequalities across distinct diabetes subgroups. SIDD is a subgroup of concern that may be associated with inadequate diabetes management, mainly in marginalized states. Funding This research was supported by Instituto Nacional de Geriatría in Mexico.
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Affiliation(s)
| | | | - Carlos A. Fermín-Martínez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Daniel Ramírez-García
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Arsenio Vargas-Vázquez
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Martín Roberto Basile-Alvarez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Alejandra Núñez-Luna
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Paulina Sánchez-Castro
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Juan Pablo Díaz-Sánchez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Gael Dávila-López
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Rosalinda Posadas-Sánchez
- Departamento de Endocrinología, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - Gilberto Vargas-Alarcón
- Dirección de Investigación, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
| | - A. Enrique Caballero
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jose C. Florez
- Diabetes Unit and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Programs in Metabolism and Medical & Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jacqueline A. Seiglie
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
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Bello-Chavolla OY, Fermín-Martínez CA, Ramírez-García D, Vargas-Vázquez A, Fernández-Chirino L, Basile-Alvarez MR, Sánchez-Castro P, Núñez-Luna A, Antonio-Villa NE. Prevalence and determinants of post-acute sequelae after SARS-CoV-2 infection (Long COVID) among adults in Mexico during 2022: a retrospective analysis of nationally representative data. LANCET REGIONAL HEALTH. AMERICAS 2024; 30:100688. [PMID: 38327277 PMCID: PMC10847769 DOI: 10.1016/j.lana.2024.100688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/26/2023] [Accepted: 01/21/2024] [Indexed: 02/09/2024]
Abstract
Background Post-acute sequelae after SARS-CoV-2 infection (PASC) remains a concerning long-term complication of COVID-19. Here, we aimed to characterize the epidemiology of PASC in Mexico during 2022 and identify potential associations of covariates with PASC prevalence using nationally representative data. Methods We analyzed data from the 2022 Mexican National Health and Nutrition Survey (ENSANUT) from 24,434 participants, representing 85,521,661 adults ≥20 years. PASC was defined using both the National Institute for Health and Care Excellence (NICE) definition and a PASC score ≥12. Estimates of PASC prevalence were stratified by age, sex, rural vs. urban setting, social lag quartiles, number of reinfections, vaccination status and periods of predominance of SARS-CoV-2 circulating variants. Determinants of PASC were assessed using log-binomial regression models adjusted by survey weights. Findings Persistent symptoms after SARS-CoV-2 infection were reported by 12.44% (95% CI 11.89-12.99) of adults ≥20 years in Mexico in 2022. The most common persistent symptoms were fatigue, musculoskeletal pain, headache, cough, loss of smell or taste, fever, post-exertional malaise, brain fog, anxiety, and chest pain. PASC was present in 21.21% (95% CI 19.74-22.68) of subjects with previously diagnosed COVID-19. Over 28.6% of patients with PASC reported symptoms persistence ≥6 months and 14.05% reported incapacitating symptoms. Higher PASC prevalence was associated with SARS-CoV-2 reinfections, depressive symptoms and living in states with high social lag. PASC prevalence, particularly its more severe forms, decreased with COVID-19 vaccination and for infections during periods of Omicron variant predominance. Interpretation PASC remains a significant public health burden in Mexico as the COVID-19 pandemic transitions into endemic. Promoting SARS-CoV-2 reinfection prevention and booster vaccination may be useful in reducing PASC burden. Funding This research was supported by Instituto Nacional de Geriatría in Mexico.
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Affiliation(s)
| | - Carlos A. Fermín-Martínez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Daniel Ramírez-García
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | | | - Martín Roberto Basile-Alvarez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Paulina Sánchez-Castro
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Alejandra Núñez-Luna
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Houweling L, Maitland-Van der Zee AH, Holtjer JCS, Bazdar S, Vermeulen RCH, Downward GS, Bloemsma LD. The effect of the urban exposome on COVID-19 health outcomes: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2024; 240:117351. [PMID: 37852458 DOI: 10.1016/j.envres.2023.117351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND The global severity of SARS-CoV-2 illness has been associated with various urban characteristics, including exposure to ambient air pollutants. This systematic review and meta-analysis aims to synthesize findings from ecological and non-ecological studies to investigate the impact of multiple urban-related features on a variety of COVID-19 health outcomes. METHODS On December 5, 2022, PubMed was searched to identify all types of observational studies that examined one or more urban exposome characteristics in relation to various COVID-19 health outcomes such as infection severity, the need for hospitalization, ICU admission, COVID pneumonia, and mortality. RESULTS A total of 38 non-ecological and 241 ecological studies were included in this review. Non-ecological studies highlighted the significant effects of population density, urbanization, and exposure to ambient air pollutants, particularly PM2.5. The meta-analyses revealed that a 1 μg/m3 increase in PM2.5 was associated with a higher likelihood of COVID-19 hospitalization (pooled OR 1.08 (95% CI:1.02-1.14)) and death (pooled OR 1.06 (95% CI:1.03-1.09)). Ecological studies, in addition to confirming the findings of non-ecological studies, also indicated that higher exposure to nitrogen dioxide (NO2), ozone (O3), sulphur dioxide (SO2), and carbon monoxide (CO), as well as lower ambient temperature, humidity, ultraviolet (UV) radiation, and less green and blue space exposure, were associated with increased COVID-19 morbidity and mortality. CONCLUSION This systematic review has identified several key vulnerability features related to urban areas in the context of the recent COVID-19 pandemic. The findings underscore the importance of improving policies related to urban exposures and implementing measures to protect individuals from these harmful environmental stressors.
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Affiliation(s)
- Laura Houweling
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; Dept. of Pulmonary Medicine, Amsterdam UMC, Amsterdam, the Netherlands.
| | - Anke-Hilse Maitland-Van der Zee
- Dept. of Pulmonary Medicine, Amsterdam UMC, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands; Amsterdam Public Health, Amsterdam, the Netherlands
| | - Judith C S Holtjer
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Somayeh Bazdar
- Dept. of Pulmonary Medicine, Amsterdam UMC, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands; Amsterdam Public Health, Amsterdam, the Netherlands
| | - Roel C H Vermeulen
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - George S Downward
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lizan D Bloemsma
- Dept. of Pulmonary Medicine, Amsterdam UMC, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands; Amsterdam Public Health, Amsterdam, the Netherlands
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Fermín-Martínez CA, Paz-Cabrera CD, Basile-Alvarez MR, Castro PS, Núñez-Luna A, Perezalonso-Espinosa J, Ramírez-García D, Antonio-Villa NE, Vargas-Vázquez A, Fernández-Chirino L, Carrillo-Herrera KB, Cabrera-Quintana LA, Rojas-Martínez R, Seiglie JA, Bello-Chavolla OY. Prevalence of prediabetes in Mexico: a retrospective analysis of nationally representative surveys spanning 2016-2022. LANCET REGIONAL HEALTH. AMERICAS 2023; 28:100640. [PMID: 38076414 PMCID: PMC10701418 DOI: 10.1016/j.lana.2023.100640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 12/30/2023]
Abstract
Background Characterizing prediabetes phenotypes may be useful in guiding diabetes prevention efforts; however, heterogeneous criteria to define prediabetes have led to inconsistent prevalence estimates, particularly in low- and middle-income countries. Here, we estimated trends in prediabetes prevalence in Mexico across different prediabetes definitions and their association with prevalent cardiometabolic conditions. Methods We conducted a serial cross-sectional analysis of National Health and Nutrition Surveys in Mexico (2016-2022), totalling 22 081 Mexican adults. After excluding individuals with diagnosed or undiagnosed diabetes, we defined prediabetes using ADA (impaired fasting glucose [IFG] 100-125 mg/dL and/or HbA1c 5.7-6.4%), WHO (IFG 110-125 mg/dL), and IEC criteria (HbA1c 6.0-6.4%). Prevalence trends of prediabetes over time were evaluated using weighted Poisson regression and its association with prevalent cardiometabolic conditions with weighted logistic regression. Findings The prevalence of prediabetes (either IFG or high HbA1c [ADA]) in Mexico was 20.9% in 2022. Despite an overall downward trend in prediabetes (RR 0.973, 95% CI 0.957-0.988), this was primarily driven by decreases in prediabetes by ADA-IFG (RR 0.898, 95% CI 0.880-0.917) and WHO-IFG criteria (RR 0.919, 95% CI 0.886-0.953), while prediabetes by ADA-HbA1c (RR 1.055, 95% CI 1.033-1.077) and IEC-HbA1C criteria (RR 1.085, 95% CI 1.045-1.126) increased over time. Prediabetes prevalence increased over time in adults >40 years, with central obesity, self-identified as indigenous or living in urban areas. For all definitions, prediabetes was associated with an increased risk of cardiometabolic conditions. Interpretation Prediabetes rates in Mexico from 2016 to 2022 varied based on defining criteria but consistently increased for HbA1c-based definitions and high-risk subgroups. Funding This research was supported by Instituto Nacional de Geriatría in Mexico. JAS was supported by NIH/NIDDK Grant# K23DK135798.
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Affiliation(s)
- Carlos A. Fermín-Martínez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - César Daniel Paz-Cabrera
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Especialidad en Medicina Preventiva, Instituto Nacional de Salud Pública, Mexico City, Mexico
| | - Martín Roberto Basile-Alvarez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Paulina Sánchez Castro
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Alejandra Núñez-Luna
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Daniel Ramírez-García
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Arsenio Vargas-Vázquez
- Especialidad en Medicina Preventiva, Instituto Nacional de Salud Pública, Mexico City, Mexico
| | | | | | | | | | - Jacqueline A. Seiglie
- Diabetes Unit, Massachusetts General Hospital, Harvard Medical School, MA, USA
- Department of Medicine, Harvard Medical School, MA, USA
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Antonio-Villa NE, Bello-Chavolla OY, Fermín-Martínez CA, Fernández-Chirino L, Ramírez-García D. The evolving landscape of SARS-CoV-2 vaccination in Mexico: real-world evidence in Mexican pensioners. LANCET REGIONAL HEALTH. AMERICAS 2023; 27:100624. [PMID: 38106970 PMCID: PMC10725015 DOI: 10.1016/j.lana.2023.100624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 12/19/2023]
Affiliation(s)
| | | | - Carlos A. Fermín-Martínez
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Luisa Fernández-Chirino
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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López-Cuevas JA, Martínez-García M, Hernández-Lemus E, de Anda-Jáuregui G. Exploring disparities and novel insights into metabolic and cardiovascular comorbidities among COVID-19 patients in Mexico. Front Public Health 2023; 11:1270404. [PMID: 37927854 PMCID: PMC10623435 DOI: 10.3389/fpubh.2023.1270404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/27/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction The COVID-19 pandemic, especially its early stages, sparked extensive discussions regarding the potential impact of metabolic and cardiovascular comorbidities on the severity and fatality of SARS-CoV-2 infection, yielding inconclusive outcomes. In this study, we delve into the prevalence of metabolic and cardiovascular comorbidities within COVID-19 patients in Mexico. Methods Employing a retrospective observational study design, we collected data from official databases encompassing COVID-19 patients admitted to both public and private hospitals in Mexico City. Results Our investigation unveiled a noteworthy incongruity in the prevalence of metabolic and cardiovascular comorbidities among COVID-19 patients, with a particular emphasis on obesity, hypertension, and diabetes. This incongruity manifests as location-dependent phenomena, where the prevalence of these comorbidities among COVID-19 patients significantly deviates from the reported values for the general population in each specific location. Discussion These findings underscore the critical importance of screening for metabolic and cardiovascular comorbidities in COVID-19 patients and advocate for the necessity of tailored interventions for this specific population. Furthermore, our study offers insights into the intricate interplay between COVID-19 and metabolic and cardiovascular comorbidities, serving as a valuable foundation for future research endeavors and informing clinical practice.
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Affiliation(s)
- Jonathan Ariel López-Cuevas
- Computational Genomics Division, National Institute of Genomic Medicine, Mexico City, Mexico
- Immunology Department, National Institute of Cardiology Ignacio Chávez, Mexico City, Mexico
| | - Mireya Martínez-García
- Immunology Department, National Institute of Cardiology Ignacio Chávez, Mexico City, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, National Institute of Genomic Medicine, Mexico City, Mexico
- Center for Complexity Sciences, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Guillermo de Anda-Jáuregui
- Computational Genomics Division, National Institute of Genomic Medicine, Mexico City, Mexico
- Center for Complexity Sciences, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Investigadores e Investigadoras for Mexico (formerly Cátedras Conacyt), National Council on Humanities, Science and Technology, Mexico City, Mexico
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Regules R, Pinchoff J, Gomez-Ugarte AC, Abularrage TF, Vieitez I, Ngo TD. Climate-related experiences and harms in the wake of the COVID-19 pandemic: results from a survey of 152,088 Mexican youth. Sci Rep 2023; 13:16549. [PMID: 37783750 PMCID: PMC10545750 DOI: 10.1038/s41598-023-43305-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023] Open
Abstract
The dual crises of COVID-19 and climate change are impacting the lives of adolescents and young people as they transition to adulthood in an uncertain world, yet they are often excluded from research and political discourse. We surveyed young people about their needs and experiences, critical to engaging them and designing effective programs and policies to address these intersecting harms. The 2022 round of a national online survey through the Violence Outcomes in COVID-19 Epoch (VoCes) Study surveyed 152,088 Mexican youth (15-24 years). Logistic regressions were implemented to identify characteristics associated with four climate responses (economic, work-related, receiving government support, or social network support). Overall, 8.1% of participants experienced a recent climate hazard, with major impacts including housing damage from floods, and crop/livestock losses from drought. Participants who experienced a climate hazard were more likely to have experienced a pandemic-related harm, suggesting a dual impact. Poor youth were more likely to report economic losses from both the pandemic and a climate event but least likely to receive government support. Economic effects from the pandemic are exacerbating climate-related harms, unequally threatening the poorest youth. Engaging young people in decision-making and supporting the most vulnerable youth is critical for the next generation to thrive.
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Affiliation(s)
| | - Jessie Pinchoff
- Population Council, One Dag Hammarskjold Plaza #3, New York, NY, 10017, USA.
| | | | - Tara F Abularrage
- Population Council, One Dag Hammarskjold Plaza #3, New York, NY, 10017, USA
| | | | - Thoai D Ngo
- Population Council, One Dag Hammarskjold Plaza #3, New York, NY, 10017, USA
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10
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Bello-Chavolla OY, Antonio-Villa NE, Valdés-Ferrer SI, Fermín-Martínez CA, Fernández-Chirino L, Vargas-Vázquez A, Ramírez-García D, Mancilla-Galindo J, Kammar-García A, Ávila-Funes JA, Zúñiga-Gil CH, García-Grimshaw M, Ceballos-Liceaga SE, Carbajal-Sandoval G, Montes-González JA, Zaragoza-Jiménez CA, García-Rodríguez G, Cortés-Alcalá R, Reyes-Terán G, López-Gatell H, Gutiérrez-Robledo LM. Effectiveness of a nationwide COVID-19 vaccination program in Mexico against symptomatic COVID-19, hospitalizations, and death: a retrospective analysis of national surveillance data. Int J Infect Dis 2023; 129:188-196. [PMID: 36775188 PMCID: PMC9918316 DOI: 10.1016/j.ijid.2023.01.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 01/05/2023] [Accepted: 01/27/2023] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVES Vaccination has been effective in ameliorating the impact of COVID-19. Here, we report vaccine effectiveness (VE) of the nationally available COVID-19 vaccines in Mexico. METHODS Retrospective analysis of a COVID-19 surveillance system to assess the VE of the BNT162b2, messenger RNA (mRNA)-12732, Gam-COVID-Vac, Ad5-nCoV, Ad26.COV2.S, ChAdOx1, and CoronaVac vaccines against SARS-CoV-2 infection, COVID-19 hospitalization, and death in Mexico. The VE was estimated using time-varying Cox proportional hazard models in vaccinated and unvaccinated adults, adjusted for age, sex, and comorbidities. VE was also estimated for adults with diabetes, aged ≥60 years, and comparing the predominance of SARS-CoV-2 variants B.1.1.519 and B.1.617.2. RESULTS We assessed 793,487 vaccinated and 4,792,338 unvaccinated adults between December 24, 2020 and September 27, 2021. The VE against SARS-CoV-2 infection was the highest for fully vaccinated individuals with mRNA-12732 (91.5%, 95% confidence interval [CI] 90.3-92.4) and Ad26.COV2.S (82.2%, 95% CI 81.4-82.9); for COVID-19 hospitalization, BNT162b2 (84.3%, 95% CI 83.6-84.9) and Gam-COVID-Vac (81.4% 95% CI 79.5-83.1), and for mortality, BNT162b2 (89.8%, 95% CI 89.2-90.2) and mRNA-12732 (93.5%, 95% CI 86.0-97.0). The VE decreased for all vaccines in adults aged ≥60 years, people with diabetes, and periods of Delta variant predominance. CONCLUSION All the vaccines implemented in Mexico were effective against SARS-CoV-2 infection, COVID-19 hospitalization, and death. Mass vaccination with multiple vaccines is useful to maximize vaccination coverage.
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Affiliation(s)
| | - Neftali Eduardo Antonio-Villa
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico; MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Sergio Iván Valdés-Ferrer
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Carlos A Fermín-Martínez
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico; MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Luisa Fernández-Chirino
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico; Facultad de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Arsenio Vargas-Vázquez
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Daniel Ramírez-García
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico; Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Ashuin Kammar-García
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico
| | | | | | - Miguel García-Grimshaw
- Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | | | | | | | - Ricardo Cortés-Alcalá
- Dirección General de Promoción de la Salud, Secretaría de Salud, Mexico City, Mexico
| | - Gustavo Reyes-Terán
- Comisión Coordinadora de Institutos Nacionales de Salud y Hospitales de Alta Especialidad, Mexico City, Mexico
| | - Hugo López-Gatell
- Subsecretaría de Prevención y Promoción de la Salud, Secretaría de Salud Direccion General de Epidemiologia, SecretarIa de Salud, Mexico City, Mexico
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11
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Alang S, Blackstock O. Health Justice: A Framework for Mitigating the Impacts of HIV and COVID-19 on Disproportionately Affected Communities. Am J Public Health 2023; 113:194-201. [PMID: 36521095 PMCID: PMC9850620 DOI: 10.2105/ajph.2022.307139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 12/23/2022]
Abstract
Health crises have a disproportionate impact on communities that are marginalized by systems of oppression such as racism and capitalism. Benefits of advances such as in the prevention and treatment of HIV disease are unequally distributed. Intersecting factors including poverty, homophobia, homelessness, racism, and mass incarceration expose marginalized populations to greater risks while limiting access to resources that buffer these risks. Similar patterns have emerged with COVID-19. We identify comparable pitfalls in our responses to HIV and COVID-19. We introduce health justice as a framework for mitigating the long-term impact of the HIV epidemic and COVID-19 pandemic. The health justice framework considers the central role of power in the health and liberation of communities hit hardest by legacies of marginalization. We provide 5 recommendations grounded in health justice: (1) redistribute resources, (2) enforce mandates that redistribute power, (3) enact legislation that guarantees support for people with long-haul COVID-19, (4) center experiences of the most impacted communities in policy development, and (5) evaluate multidimensional effects of policies across systems. Successful implementation of these recommendations requires community organizing and collective action. (Am J Public Health. 2023;113(2): 194-201. https://doi.org/10.2105/AJPH.2022.307139).
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Affiliation(s)
- Sirry Alang
- Sirry Alang is with the Department of Health and Human Development at the University of Pittsburgh, Pittsburgh, PA. Oni Blackstock is with Health Justice, New York, NY
| | - Oni Blackstock
- Sirry Alang is with the Department of Health and Human Development at the University of Pittsburgh, Pittsburgh, PA. Oni Blackstock is with Health Justice, New York, NY
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12
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Zińczuk A, Rorat M, Jurek T. COVID-19-related excess mortality - an overview of the current evidence. ARCHIVES OF FORENSIC MEDICINE AND CRIMINOLOGY 2023; 73:33-44. [PMID: 38186033 DOI: 10.4467/16891716amsik.22.004.18214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/11/2023] [Indexed: 01/09/2024] Open
Abstract
Analysis of excess deaths, defined as the difference in the total number of deaths in an emergency compared to the number of deaths expected under normal conditions, allows a more reliable assessment of the impact on health systems caused by the global threat of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2). So far, data for the two years of the pandemic (2020-2021) indicates the occurrence of 14.9 million excess deaths according to WHO (World Health Organization) estimates. The purpose of the analysis conducted was to define the concept and identify the causes of excess mortality during the COVID-19 pandemic. Inconsistent and unreliable death registration systems; overburdened health systems in low- and middle-income countries; reduced access to medical services for patients with health problems other than COVID-19; the introduction of social distancing and lockdown rules, which translated into increased deaths from psychiatric illnesses and addictions; political considerations and media messages that interfered with vaccination acceptance and adherence; and the additional impact of other natural disasters (hurricanes, floods, drought) were identified as the most important reasons for excess deaths occurrence. The correct identification of country-specific factors and the correct response and countermeasures taken appear crucial in terms of limiting the negative impact of the current pandemic, but also of future threats of a similar nature, in order to reduce excess deaths.
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Affiliation(s)
| | - Maria Rorat
- Department of Forensic Medicine, Wroclaw Medical University, Poland
| | - Tomasz Jurek
- Department of Forensic Medicine, Wroclaw Medical University, Poland
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13
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Núñez I, Soto-Mota A. Impact of healthcare strain on access to mechanical ventilation and mortality of hospitalized COVID-19 patients: a retrospective cohort study. Trans R Soc Trop Med Hyg 2022; 117:383-390. [PMID: 36563101 DOI: 10.1093/trstmh/trac123] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/08/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Healthcare saturation has been a prominent worry during the COVID-19 pandemic. Increase of hospital beds with mechanical ventilators has been central in Mexico's approach, but it is not known whether this actually improves access to care and the resulting quality of it. This study aimed to determine the impact of healthcare strain and other pre-specified variables on dying from coronavirus disease 2019 (COVID-19) without receiving invasive mechanical ventilation (IMV). METHODS A retrospective cohort study was conducted using open data from Mexico City between 8 May 2020 and 5 January 2021. We performed Cox proportional hazards models to identify the strength of the association between proposed variables and the outcomes. RESULTS Of 33 797 hospitalized patients with suspected or confirmed COVID-19, 19 820 (58.6%) did not require IMV and survived, 5414 (16.1%) required IMV and were intubated and 8563 (25.3%) required IMV but died without receiving it. A greater occupation of IMV-capable beds increased the hazard of death without receiving IMV (hazard ratio [HR] 1.56, comparing 90% with 50% occupation). Private healthcare was the most protective factor for death without IMV (HR 0.14). CONCLUSIONS Higher hospital bed saturation increased the hazard of dying without being intubated and worsened the outcomes among mechanically ventilated patients. Older age also increased the hazard of the outcomes, while private healthcare dramatically decreased them.
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Affiliation(s)
- Isaac Núñez
- Department of Medical Education, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga #15, Belisario Domínguez Sección XVI, Tlalpan, Mexico City, Mexico14080
| | - Adrian Soto-Mota
- Metabolic Diseases Research Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga #15, Belisario Domínguez Sección XVI, Tlalpan, Mexico City, Mexico14080
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14
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Bello-Chavolla OY, Antonio-Villa NE, Fermín-Martínez CA, Fernández-Chirino L, Vargas-Vázquez A, Ramírez-García D, Basile-Alvarez MR, Hoyos-Lázaro AE, Carrillo-Larco RM, Wexler DJ, Manne-Goehler J, Seiglie JA. Diabetes-Related Excess Mortality in Mexico: A Comparative Analysis of National Death Registries Between 2017-2019 and 2020. Diabetes Care 2022; 45:2957-2966. [PMID: 36286591 PMCID: PMC7613876 DOI: 10.2337/dc22-0616] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 09/27/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To estimate diabetes-related mortality in Mexico in 2020 compared with 2017-2019 after the onset of the coronavirus disease 2019 (COVID-19) pandemic. RESEARCH DESIGN AND METHODS This retrospective, state-level study used national death registries of Mexican adults aged ≥20 years for the 2017-2020 period. Diabetes-related death was defined using ICD-10 codes listing diabetes as the primary cause of death, excluding certificates with COVID-19 as the primary cause of death. Spatial and negative binomial regression models were used to characterize the geographic distribution and sociodemographic and epidemiologic correlates of diabetes-related excess mortality, estimated as increases in diabetes-related mortality in 2020 compared with average 2017-2019 rates. RESULTS We identified 148,437 diabetes-related deaths in 2020 (177 per 100,000 inhabitants) vs. an average of 101,496 deaths in 2017-2019 (125 per 100,000 inhabitants). In-hospital diabetes-related deaths decreased by 17.8% in 2020 versus 2017-2019, whereas out-of-hospital deaths increased by 89.4%. Most deaths were attributable to type 2 diabetes (130 per 100,000 inhabitants). Compared with 2018-2019 data, hyperglycemic hyperosmolar state and diabetic ketoacidosis were the two contributing causes with the highest increase in mortality (128% and 116% increase, respectively). Diabetes-related excess mortality clustered in southern Mexico and was highest in states with higher social lag, rates of COVID-19 hospitalization, and prevalence of HbA1c ≥7.5%. CONCLUSIONS Diabetes-related deaths increased among Mexican adults by 41.6% in 2020 after the onset of the COVID-19 pandemic, occurred disproportionately outside the hospital, and were largely attributable to type 2 diabetes and hyperglycemic emergencies. Disruptions in diabetes care and strained hospital capacity may have contributed to diabetes-related excess mortality in Mexico during 2020.
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Affiliation(s)
| | - Neftali Eduardo Antonio-Villa
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Carlos A. Fermín-Martínez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Luisa Fernández-Chirino
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Arsenio Vargas-Vázquez
- MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Daniel Ramírez-García
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Martín Roberto Basile-Alvarez
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ana Elena Hoyos-Lázaro
- Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Rodrigo M. Carrillo-Larco
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Deborah J. Wexler
- Diabetes Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Jennifer Manne-Goehler
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jacqueline A. Seiglie
- Diabetes Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
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15
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Téllez-González MA, Pineda-Juárez JA, Suárez-Cuenca JA, Escamilla-Tilch M, Santillán-Cortez D, García S, Alcaraz-Estrada SL, Pérez-Razo JC, Delgado-Quintana CA, Vargas-Hernández J, Muñoz-López S, Escarela-Serrano M, Santosbeña-Lagunes M, Alanís-Vega A, Vázquez-Alvarado RP, Merino-Rajme JA, Mondragón-Terán P. Epidemiological Profile and Social Welfare Index as Factors Associated with COVID-19 Hospitalization and Severity in Mexico City: A Retrospective Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14803. [PMID: 36429525 PMCID: PMC9690264 DOI: 10.3390/ijerph192214803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/21/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
Epidemiological data indicate that Mexico holds the 19th place in cumulative cases (5506.53 per 100,000 inhabitants) of COVID-19 and the 5th place in cumulative deaths (256.14 per 100,000 inhabitants) globally and holds the 4th and 3rd place in cumulative cases and deaths in the Americas region, respectively, with Mexico City being the most affected area. Several modifiable and non-modifiable risk factors have been linked to a poor clinical outcome in COVID-19 infection; however, whether socioeconomic and welfare factors are associated with clinical outcome has been scanty addressed. This study tried to investigate the association of Social Welfare Index (SWI) with hospitalization and severity due to COVID-19. A retrospective analysis was conducted at the Centro Médico Nacional "20 de Noviembre"-ISSSTE, based in Mexico City, Mexico. A total of 3963 patients with confirmed or suspected COVID-19, registered from March to July 2020, were included, retrieved information from the Virology Analysis and Reference Unit Database. Demographic, symptoms and clinical data were analyzed, as well as the SWI, a multidimensional parameter based on living and household conditions. An adjusted binary logistic regression model was performed in order to compare the outcomes of hospitalization, mechanical ventilation requirement (MVR) and mortality between SWI categories: Very high (VHi), high (Hi), medium (M) and low (L). The main findings show that lower SWI were independently associated with higher probability for hospital entry: VHi vs. Hi vs. M vs. L-SWI (0 vs. +0.24 [OR = 1.24, CI95% 1.01-1.53] vs. +0.90 [OR = 1.90, CI95% 1.56-2.32] vs. 0.73 [OR = 1.73, CI95% 1.36-2.19], respectively); Mechanical Ventilation Requirement: VHi vs. M vs. L-SWI (0 vs. +0.45 [OR = 1.45, CI95% 1.11-1.87] vs. +0.35 [OR = 1.35, CI95% 1.00-1.82]) and mortality: VHi vs. Hi vs. M (0 vs. +0.54 [OR = 1.54, CI95% 1.22-1.94] vs. +0.41 [OR = 1.41, CI95% 1.13-1.76]). We concluded that SWI was independently associated with the poor clinical outcomes in COVID-19, beyond demographic, epidemiological and clinical characteristics.
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Affiliation(s)
| | | | | | - Mónica Escamilla-Tilch
- Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico
| | - Daniel Santillán-Cortez
- Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico
| | - Silvia García
- Centro Médico Nacional “20 de Noviembre”, Clinical Research Service, Mexico City 03229, Mexico
| | | | - Juan Carlos Pérez-Razo
- Centro Médico Nacional “20 de Noviembre”, Genomics Research Division, Mexico City 03229, Mexico
| | | | | | - Sandra Muñoz-López
- Centro Médico Nacional “20 de Noviembre”, COVID-19 Group, Mexico City 03229, Mexico
| | | | | | | | | | | | - Paul Mondragón-Terán
- Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico
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Global Excess Mortality during COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10101702. [PMID: 36298567 PMCID: PMC9607451 DOI: 10.3390/vaccines10101702] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/29/2022] [Accepted: 10/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Currently, reported COVID-19 deaths are inadequate to assess the impact of the pandemic on global excess mortality. All-cause excess mortality is a WHO-recommended index for assessing the death burden of COVID-19. However, the global excess mortality assessed by this index remains unclear. We aimed to assess the global excess mortality during the COVID-19 pandemic. Methods: We searched PubMed, EMBASE, and Web of Science for studies published in English between 1 January 2020, and 21 May 2022. Cross-sectional and cohort studies that reported data about excess mortality during the pandemic were included. Two researchers independently searched the published studies, extracted data, and assessed quality. The Mantel–Haenszel random-effects method was adopted to estimate pooled risk difference (RD) and their 95% confidence intervals (CIs). Results: A total of 79 countries from twenty studies were included. During the COVID-19 pandemic, of 2,228,109,318 individuals, 17,974,051 all-cause deaths were reported, and 15,498,145 deaths were expected. The pooled global excess mortality was 104.84 (95% CI 85.56–124.13) per 100,000. South America had the highest pooled excess mortality [134.02 (95% CI: 68.24–199.80) per 100,000], while Oceania had the lowest [−32.15 (95% CI: −60.53–−3.77) per 100,000]. Developing countries had higher excess mortality [135.80 (95% CI: 107.83–163.76) per 100,000] than developed countries [68.08 (95% CI: 42.61–93.55) per 100,000]. Lower middle-income countries [133.45 (95% CI: 75.10–191.81) per 100,000] and upper-middle-income countries [149.88 (110.35–189.38) per 100,000] had higher excess mortality than high-income countries [75.54 (95% CI: 53.44–97.64) per 100,000]. Males had higher excess mortality [130.10 (95% CI: 94.15–166.05) per 100,000] than females [102.16 (95% CI: 85.76–118.56) per 100,000]. The population aged ≥ 60 years had the highest excess mortality [781.74 (95% CI: 626.24–937.24) per 100,000]. Conclusions: The pooled global excess mortality was 104.84 deaths per 100,000, and the number of reported all-cause deaths was higher than expected deaths during the global COVID-19 pandemic. In South America, developing and middle-income countries, male populations, and individuals aged ≥ 60 years had a heavier excess mortality burden.
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Barboza G, Angulski K, Hines L, Brown P. Variability in Opioid-Related Drug Overdoses, Social Distancing, and Area-Level Deprivation during the COVID-19 Pandemic: a Bayesian Spatiotemporal Analysis. J Urban Health 2022; 99:873-886. [PMID: 36068454 PMCID: PMC9447988 DOI: 10.1007/s11524-022-00675-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
Monitoring the spatial and temporal course of opioid-related drug overdose mortality is a key public health determinant. Despite previous studies exploring the evolution of drug-related fatalities following the stay-at-home mandates during the COVID-19 pandemic, little is known about the spatiotemporal dynamics that mitigation efforts had on overdose deaths. The purpose of this study was to describe the spatial and temporal dynamics of overdose death relative risk using a 4-week interval over a span of 5 months following the implementation of the COVID-19 lockdown in the city of Chicago, IL. A Bayesian space-time model was used to produce posterior risk estimates and exceedance probabilities of opioid-related overdose deaths controlling for measures of area-level deprivation and stay-at-home mandates. We found that area-level temporal risk and inequalities in drug overdose mortality increased significantly in the initial months of the pandemic. We further found that a change in the area-level deprivation from the first to the fourth quintile increased the relative risk of a drug overdose risk by 44.5%. The social distancing index measuring the proportion of persons who stayed at home in each census block group was not associated with drug overdose mortality. We conclude by highlighting the importance of contextualizing the spatial and temporal risk in overdose mortality for implementing effective and safe harm reduction strategies during a global pandemic.
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Affiliation(s)
- Gia Barboza
- College of Public Health and the College of Social Work, The Ohio State University, Columbus, OH, USA.
| | - Kate Angulski
- University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Lisa Hines
- University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Philip Brown
- University of Colorado Colorado Springs, Colorado Springs, CO, USA
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18
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Antonio-Villa NE, Bello-Chavolla OY, Fermín-Martínez CA, Aburto JM, Fernández-Chirino L, Ramírez-García D, Pisanty-Alatorre J, González-Díaz A, Vargas-Vázquez A, Barquera S, Gutiérrez-Robledo LM, Seiglie JA. Socio-demographic inequalities and excess non-COVID-19 mortality during the COVID-19 pandemic: a data-driven analysis of 1 069 174 death certificates in Mexico. Int J Epidemiol 2022; 51:1711-1721. [PMID: 36174226 PMCID: PMC9619535 DOI: 10.1093/ije/dyac184] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/08/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND In 2020, Mexico experienced one of the highest rates of excess mortality globally. However, the extent of non-COVID deaths on excess mortality, its regional distribution and the association between socio-demographic inequalities have not been characterized. METHODS We conducted a retrospective municipal and individual-level study using 1 069 174 death certificates to analyse COVID-19 and non-COVID-19 deaths classified by ICD-10 codes. Excess mortality was estimated as the increase in cause-specific mortality in 2020 compared with the average of 2015-2019, disaggregated by primary cause of death, death setting (in-hospital and out-of-hospital) and geographical location. Correlates of individual and municipal non-COVID-19 mortality were assessed using mixed effects logistic regression and negative binomial regression models, respectively. RESULTS We identified a 51% higher mortality rate (276.11 deaths per 100 000 inhabitants) compared with the 2015-2019 average period, largely attributable to COVID-19. Non-COVID-19 causes comprised one-fifth of excess deaths, with acute myocardial infarction and type 2 diabetes as the two leading non-COVID-19 causes of excess mortality. COVID-19 deaths occurred primarily in-hospital, whereas excess non-COVID-19 deaths occurred in out-of-hospital settings. Municipal-level predictors of non-COVID-19 excess mortality included levels of social security coverage, higher rates of COVID-19 hospitalization and social marginalization. At the individual level, lower educational attainment, blue-collar employment and lack of medical care assistance prior to death were associated with non-COVID-19 deaths. CONCLUSION Non-COVID-19 causes of death, largely chronic cardiometabolic conditions, comprised up to one-fifth of excess deaths in Mexico during 2020. Non-COVID-19 excess deaths occurred disproportionately out-of-hospital and were associated with both individual- and municipal-level socio-demographic inequalities.
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Affiliation(s)
- Neftali Eduardo Antonio-Villa
- Corresponding author. Division de Investigación, Instituto Nacional de Geriatría, Anillo Perif. 2767, San Jerónimo Lídice, La Magdalena Contreras, 10200 Mexico City, Mexico. E-mail:
| | | | - Carlos A Fermín-Martínez
- Division de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico,MD/PhD (PECEM) Program, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - José Manuel Aburto
- Leverhulme Centre for Demographic Science, Department of Sociology, University of Oxford, Oxford, United Kindom,Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Luisa Fernández-Chirino
- Division de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico,Faculty of Chemistry, National Autonomous University of Mexico, Mexico City, Mexico
| | | | - Julio Pisanty-Alatorre
- Instituto Mexicano del Seguro Social, Mexico City, Mexico,Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Armando González-Díaz
- Facultad de Ciencias Politicas Sociales y Sociales, National Autonomous University of Mexico, Mexico City, Mexico
| | - Arsenio Vargas-Vázquez
- Division de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico,MD/PhD (PECEM) Program, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Simón Barquera
- Health and Nutrition Research Center, National Institute of Public Health, Cuernavaca, Mexico
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Cui P, Dong Z, Yao X, Cao Y, Sun Y, Feng L. What Makes Urban Communities More Resilient to COVID-19? A Systematic Review of Current Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710532. [PMID: 36078249 PMCID: PMC9517785 DOI: 10.3390/ijerph191710532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 05/21/2023]
Abstract
It has been more than two years since the outbreak of the COVID-19 epidemic at the end of 2019. Many scholars have introduced the "resilience" concept into COVID-19 prevention and control to make up for the deficiencies in traditional community governance. This study analyzed the progress in research on social resilience, which is an important component of community resilience, focusing on the current literature on the impact of social resilience on COVID-19, and proposed a generalized dimension to integrated previous relevant literature. Then, VOSviewer was used to visualize and analyze the current progress of research on social resilience. The PRISMA method was used to collate studies on social resilience to the pandemic. The result showed that many current policies are effective in controlling COVID-19, but some key factors, such as vulnerable groups, social assistance, and socioeconomics, affect proper social functioning. Some scholars have proposed effective solutions to improve social resilience, such as establishing an assessment framework, identifying priority inoculation groups, and improving access to technology and cultural communication. Social resilience to COVID-19 can be enhanced by both external interventions and internal regulation. Social resilience requires these two aspects to be coordinated to strengthen community and urban pandemic resilience.
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Méndez-Lizárraga CA, Castañeda-Cediel ML, Delgado-Sánchez G, Ferreira-Guerrero EE, Ferreyra-Reyes L, Canizales-Quintero S, Mongua-Rodríguez N, Tellez-Vázquez N, Jiménez-Corona ME, Bradford Vosburg K, Bello-Chavolla OY, García-García L. Evaluating the impact of mobility in COVID-19 incidence and mortality: A case study from four states of Mexico. Front Public Health 2022; 10:877800. [PMID: 35991046 PMCID: PMC9387383 DOI: 10.3389/fpubh.2022.877800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe 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.MethodsCOVID-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.ResultsAfter 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.ConclusionMobility 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.
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Affiliation(s)
| | - MLucía Castañeda-Cediel
- Posgrado en Geografía, Facultad de Filosofía y Letras, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Guadalupe Delgado-Sánchez
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - Leticia Ferreyra-Reyes
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Sergio Canizales-Quintero
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Norma Mongua-Rodríguez
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Norma Tellez-Vázquez
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - Kathryn Bradford Vosburg
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States
| | | | - Lourdes García-García
- Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
- *Correspondence: Lourdes García-García
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21
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Application of Data Science for Cluster Analysis of COVID-19 Mortality According to Sociodemographic Factors at Municipal Level in Mexico. MATHEMATICS 2022. [DOI: 10.3390/math10132167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Mexico is among the five countries with the largest number of reported deaths from COVID-19 disease, and the mortality rates associated to infections are heterogeneous in the country due to structural factors concerning population. This study aims at the analysis of clusters related to mortality rate from COVID-19 at the municipal level in Mexico from the perspective of Data Science. In this sense, a new application is presented that uses a machine learning hybrid algorithm for generating clusters of municipalities with similar values of sociodemographic indicators and mortality rates. To provide a systematic framework, we applied an extension of the International Business Machines Corporation (IBM) methodology called Batch Foundation Methodology for Data Science (FMDS). For the study, 1,086,743 death certificates corresponding to the year 2020 were used, among other official data. As a result of the analysis, two key indicators related to mortality from COVID-19 at the municipal level were identified: one is population density and the other is percentage of population in poverty. Based on these indicators, 16 municipality clusters were determined. Among the main results of this research, it was found that clusters with high values of mortality rate had high values of population density and low poverty levels. In contrast, clusters with low density values and high poverty levels had low mortality rates. Finally, we think that the patterns found, expressed as municipality clusters with similar characteristics, can be useful for decision making by health authorities regarding disease prevention and control for reinforcing public health measures and optimizing resource distribution for reducing hospitalizations and mortality.
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22
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Filosa JN, Botello-Mares A, Goodman-Meza D. COVID-19 needs no passport: the interrelationship of the COVID-19 pandemic along the U.S.-Mexico border. BMC Public Health 2022; 22:1081. [PMID: 35641957 PMCID: PMC9153860 DOI: 10.1186/s12889-022-13513-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/25/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To investigate the impact of the COVID-19 pandemic along the U.S.-Mexico border region and evaluate the relationship of COVID-19 related mortality, socioeconomic status, and vaccination. METHODS We used indirect standardization to age-adjust mortality rates and calculate standardized mortality ratios [SMR] in both countries. To examine the impact of socioeconomic factors, we calculated the Human Development Index (HDI) by county/municipality. We performed linear regression to understand the relationship between mortality, vaccination, and HDI. We used choropleth maps to visualize the trends seen in the region. RESULTS Between January 22nd, 2020 and December 1st, 2021, surges of cases and deaths were similar in dyad cities along the U.S.-Mexico border visualizing the interconnectedness of the region. Mortality was higher in U.S. counties along the border compared to the national average (SMR 1.17, 95% CI 1.15-1.19). In Mexico, border counties had a slightly lower mortality to the national average (SMR 0.94, 95% CI 0.93-0.95). In U.S. border states, SMR was shown to negatively correlate with human development index (HDI), a socioeconomic proxy, resulting in a higher SMR in the border region compared to the rest of the counties. Conversely in Mexican border states, there was no association between SMR and HDI. Related to vaccination, U.S. counties along the border were vaccinated at a greater percentage than non-border counties and vaccination was negatively correlated with HDI. In Mexico, states along the border had a higher ratio of vaccinations per person than non-border states. CONCLUSIONS The U.S.-Mexico border is a divide of incredible importance not only to immigration but as a region with unique social, economic, environmental, and epidemiological factors that impact disease transmission. We investigated how the COVID-19 pandemic followed trends of previously studied diseases in the corridor such as tuberculosis, HIV, and influenza H1N1. These data state how targeted intervention along the U.S.-Mexico border region is a necessity when confronting COVID-19 and have implications for future control of infectious diseases in the region.
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Affiliation(s)
- John N Filosa
- David Geffen School of Medicine, University of California, Los Angeles (UCLA), 10833 Le Conte Ave, Los Angeles, CA, 90095-1688, USA
| | - Adrian Botello-Mares
- Department of Population Studies, Colegio de la Frontera Norte, Sonora, Nogales, Mexico
| | - David Goodman-Meza
- David Geffen School of Medicine, University of California, Los Angeles (UCLA), 10833 Le Conte Ave, Los Angeles, CA, 90095-1688, USA.
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles (UCLA), CA, Los Angeles, USA.
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23
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Olaiz-Fernández G, Vicuña de Anda FJ, Diaz-Ramirez JB, Fajardo Dolci GE, Bautista-Carbajal P, Angel-Ambrocio AH, García-León ML, Gómez Peña E, Camacho Morales JA, Wong-Chew RM. Effect of Omicron on the prevalence of COVID-19 in international travelers at the Mexico city international airport. December 16th, 2021 to January 31st, 2022. Travel Med Infect Dis 2022; 49:102361. [PMID: 35640809 PMCID: PMC9148423 DOI: 10.1016/j.tmaid.2022.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/27/2022] [Accepted: 05/22/2022] [Indexed: 11/29/2022]
Abstract
Introduction SARS-CoV-2 continues to have a high rate of contagion worldwide. The new variant of concern, Omicron, has mutations that decrease the effectiveness of vaccines and evade antibodies from previous infections resulting in a fourth wave of the pandemic. It was identified in Mexico in December 2021. Methods The Traveler's Preventive Care Clinic from the Faculty of Medicine UNAM at Mexico City International Airport has performed rapid antigen and PCR SARS CoV2 tests since January 2021 to comply with the new travel requirements. Demographic and clinical characteristics were collected from each passenger and the fourth wave of the pandemic in Mexico mainly caused by Omicron was analyzed in the travelers. Results A total of 5176 travelers attended the clinic between the second half of December 2021 and January 2022. Ten percent of all the tests performed were positive (13% of PCR and 9.3% of antigens, p = 0.001). Most of the SARS CoV2 positive cases were asymptomatic (78%), with a ratio of 3.5:1 over the symptomatic. By age groups, this ratio was higher for those under 20 years old (8.7:1). Discussion This study shows the rapid escalation of positivity that occurred in Mexico, detected in travelers, from the second half of December 2020 and throughout the month of January 2021. The incidence of COVID-19 was extremely high in travelers who were mostly asymptomatic for the period under study.
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Affiliation(s)
- Gustavo Olaiz-Fernández
- Center for Research in Policies, Population and Health, Faculty of MedicineUniversidad Nacional Autónoma de México (UNAM), Edificio CIPPS, Piso 2, Cto, Centro Cultural Universitario S/N, C.U. Coyoacán, 04510, Ciudad de México, Mexico
| | - Félix Jesús Vicuña de Anda
- Center for Research in Policies, Population and Health, Faculty of MedicineUniversidad Nacional Autónoma de México (UNAM), Edificio CIPPS, Piso 2, Cto, Centro Cultural Universitario S/N, C.U. Coyoacán, 04510, Ciudad de México, Mexico
| | - Jorge-Baruch Diaz-Ramirez
- Traveler's Preventive Care Clinic, Facultad de MedicinaUNAM, Aeropuerto Internacional de la Ciudad de México "Benito Juarez", Terminal 2, Venustiano Carranza, 15626, Ciudad de México, Mexico
| | | | - Patricia Bautista-Carbajal
- División de Investigación, Laboratorio de Investigación en enfermedades infecciosas, Facultad de MedicinaUNAM, Cto. Escolar S/N, Copilco el Alto, Coyoacán, 04510, Ciudad de México, Mexico
| | - Antonio Humberto Angel-Ambrocio
- División de Investigación, Laboratorio de Investigación en enfermedades infecciosas, Facultad de MedicinaUNAM, Cto. Escolar S/N, Copilco el Alto, Coyoacán, 04510, Ciudad de México, Mexico
| | - Miguel Leonardo García-León
- División de Investigación, Laboratorio de Investigación en enfermedades infecciosas, Facultad de MedicinaUNAM, Cto. Escolar S/N, Copilco el Alto, Coyoacán, 04510, Ciudad de México, Mexico
| | - Elena Gómez Peña
- Center for Research in Policies, Population and Health, Faculty of MedicineUniversidad Nacional Autónoma de México (UNAM), Edificio CIPPS, Piso 2, Cto, Centro Cultural Universitario S/N, C.U. Coyoacán, 04510, Ciudad de México, Mexico
| | - Jorge Alejandro Camacho Morales
- Department of Biomedical Informatics, Faculty of MedicineUNAM, Cto. Escolar S/N, Copilco el Alto, Coyoacán, 04510, Ciudad de México, Mexico
| | - Rosa Maria Wong-Chew
- División de Investigación, Laboratorio de Investigación en enfermedades infecciosas, Facultad de MedicinaUNAM, Cto. Escolar S/N, Copilco el Alto, Coyoacán, 04510, Ciudad de México, Mexico.
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Ramìrez-Aldana R, Gomez-Verjan JC, Bello-Chavolla OY, Naranjo L. A spatio-temporal study of state-wide case-fatality risks during the first wave of the COVID-19 pandemic in Mexico. GEOSPATIAL HEALTH 2022; 17. [PMID: 35352540 DOI: 10.4081/gh.2022.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
spatio-temporal analysis of the first wave of the coronavirus (COVID-19) pandemic in Mexico (April to September 2020) was performed by state. Descriptive analyses through diagrams, mapping, animations and time series representations were carried out. Greater risks were observed at certain times in specific regions. Various trends and clusters were observed and analysed by fitting linear mixed models and time series clustering. The association of co-morbidities and other variables were studied by fitting a spatial panel data linear model (SPLM). On average, the greatest risks were observed in Baja California Norte, Chiapas and Sonora, while some other densely populated states, e.g., Mexico City, had lower values. The trends varied by state and a four-order polynomial, including fixed and random effects, was necessary to model them. The most common risk development was observed in states belonging to two clusters and consisted of an initial increase followed by a decrease. Some states presented cluster configurations with a retarded risk increase before the decrease, while the risk increased throughout the time of study in others. A cyclic behaviour with a second increasing trend was also observed in some states. The SPLM approach revealed a positive significant association with respect to case fatality risk between certain groups, such as males and individuals aged 50 years and more, and the prevalence of chronic kidney disease, cardiovascular disease, asthma and hypertension. The analysis may provide valuable insight into COVID-19 dynamics applicable in future outbreaks, as well as identify determinants signifying certain trends at the state level. The combination of spatial and temporal information may provide a better understanding of the fatalities due to COVID-19.
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Affiliation(s)
| | | | | | - Lizbeth Naranjo
- 2Department of Mathematics, Faculty of Sciences, National Autonomous University of Mexico, Mexico City.
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Ríos V, Denova-Gutiérrez E, Barquera S. Association between living in municipalities with high crowding conditions and poverty and mortality from COVID-19 in Mexico. PLoS One 2022; 17:e0264137. [PMID: 35192660 PMCID: PMC8863291 DOI: 10.1371/journal.pone.0264137] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/03/2022] [Indexed: 12/15/2022] Open
Abstract
Background The World Health Organization stated a pandemic by severe acute respiratory syndrome coronavirus SARS-Cov2 (COVID-19) on March, 2020 with devastating implications for populations, healthcare systems, and economies globally. Objective The present study explores the association between patients living in municipalities with crowding conditions and poverty and mortality from COVID-19 in Mexico; specifically evaluating the socioeconomic characteristics of the municipality in which the patients reside and some individual characteristics. Methods In the present study, we examined public information collected from the National Epidemiological Surveillance System informing all persons tested for SARS-CoV-2 and published by the Ministry of Health. The present analysis was restricted to those with the date of registration to October 12, 2021. The association between the main exposures (overcrowded conditions and poverty) and the outcomes of interest (death by COVID-19) was explored using Cox proportional hazard regression models, including frailty penalties to accommodate multilevel data and random effects for the municipality of case occurrence. Results A total of 9619917 subjects were included in the Epidemiological Surveillance System for viral respiratory disease platform. Of those for which results were available, 6141403 were negative for COVID-19 and 3478514 were positive for COVID-19; with a total of 273216 deaths in those who tested positive. Among those positive to COVID-19 mean age was 46.9. Patients living in municipalities with high rates of crowding conditions increased the risk of dying from COVID-19 by 8% (95% CI: 1.03, 1.14). Individuals living in municipalities with indigenous background was associated with an increased risk of dying from COVID-19 (HR = 1.10; 95% CI: 1.04, 1.17). Individuals living in municipalities with illiteracy (HR = 1.09; 95% CI: 1.03, 1.11), poverty (HR = 1.17; 95% CI: 1.14, 1.19), food insecurity (HR = 1.094; 95% CI 1.02, 1.06), limited access to social security (HR = 1.10; 95% CI: 1.08, 1.13) and health services (HR = 1.06; 95% CI: 1.04, 1.08) had a higher risk of mortality from COVID-19. Conclusion Our data suggest that patients living in municipalities with higher rates of crowding conditions and higher rates of poverty had elevated risk of mortality from COVID-19. In Mexico, the COVID-19 pandemic is a systemic crisis linked to human development since we have seen that it affects less developed and more vulnerable municipalities. Policies to reduce vulnerabilities and develop strategies to deal with health crises like the current one needs to be considered.
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Affiliation(s)
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Simón Barquera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- * E-mail:
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Arceo-Gomez EO, Campos-Vazquez RM, Esquivel G, Alcaraz E, Martinez LA, Lopez NG. The income gradient in COVID-19 mortality and hospitalisation: An observational study with social security administrative records in Mexico. LANCET REGIONAL HEALTH. AMERICAS 2021; 6:100115. [PMID: 34778865 PMCID: PMC8578731 DOI: 10.1016/j.lana.2021.100115] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The COVID-19 pandemic revealed large structural inequalities that led to disparities in health outcomes related to socioeconomic status. So far, most of the evidence is based on aggregated data or simulations with individual data, which point to various possible mechanisms behind the association. To date, there have been no studies regarding an income gradient in COVID-19 mortality based on individual-level data and adjusting for comorbidities or access to healthcare. METHODS In this paper, we use linked employee-patient data for patients tested for COVID-19 at the Mexican Institute of Social Security. We estimate the association of the probability of dying with income centiles, using a probit estimation and adjusting for COVID-19 diagnosis, sociodemographic variables, and comorbidities. FINDINGS After controlling for all these variables, we find that persons in the lowest income decile still had a probability of dying from COVID-19 five times greater than those at the top decile. INTERPRETATION Our results imply that the association between income and COVID outcomes is not explained by the prevalence of comorbidities or by a lack of access to healthcare among the low-income population. FUNDING This study was not supported by any external funding source.
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Affiliation(s)
| | - Raymundo M. Campos-Vazquez
- Centro de Estudios Económicos, El Colegio de México, Carretera Picacho Ajusco 20, Col. Ampliación Fuentes del Pedregal, Mexico City 14110, Mexico,Corresponding author.
| | | | - Eduardo Alcaraz
- Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Luis A. Martinez
- Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
| | - Norma G. Lopez
- Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
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COVID-19 patients with increasing age experience differential time to initial medical care and severity of symptoms. Epidemiol Infect 2021; 149:e230. [PMID: 34674789 PMCID: PMC8576123 DOI: 10.1017/s095026882100234x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
We conducted a retrospective observational study in patients with laboratory-confirmed coronavirus disease (COVID-19) who received medical care in 688 COVID-19 ambulatory units and hospitals in Mexico City between 24 February 2020 and 24 December 2020, to study if the elderly seek medical care later than younger patients and their severity of symptoms at initial medical evaluation. Patients were categorised into eight groups (<20, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79 and ≥80 years). Symptoms at initial evaluation were classified according to a previously validated classification into respiratory and non-respiratory symptoms. Comparisons between time from symptom onset to medical care for every age category were performed through variance analyses. Logistic regression models were applied to determine the risk of presenting symptoms of severity according to age, and mortality risk according to delays in medical care. In total, 286 020 patients were included (mean age: 42.8, s.d.: 16.8 years; 50.4% were women). Mean time from symptom onset to medical care was 4.04 (s.d.: 3.6) days and increased with older age categories (P < 0.0001). Mortality risk increased by 6.4% for each day of delay in medical care from symptom onset. The risk of presenting with the symptoms of severity was greater with increasing age categories. In conclusion, COVID-19 patients with increasing ages tend to seek medical care later, with higher rates of symptoms of severity at initial presentation in both ambulatory units and hospitals.
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Rivas‐Ramírez ÁR, Tendilla‐Beltrán H, Gómez‐Mendoza LE, Loaiza G, Flores G. Patients with schizophrenia have decreased COVID-19 prevalence among hospitalised patients with psychiatric and neurological diseases: A retrospective analysis in Mexican population. Int J Clin Pract 2021; 75:e14528. [PMID: 34125988 PMCID: PMC8420595 DOI: 10.1111/ijcp.14528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/13/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Increased coronavirus disease 2019 (COVID-19) incidence and mortality in hospitalised patients with psychiatric and neurologic disorders have been reported. METHODS The clinical records of 198 patients with psychiatric and neurological disorders hospitalised in the Dr Rafael Serrano Psychiatric Hospital in Puebla during the peak of the first wave of the COVID-19 pandemic in Mexico were analysed for psychiatric or neurologic diagnosis, gender, age, medical diagnosis, and COVID-19 prevalence. For patients with COVID-19, the effects of gender, and medical diagnosis were explored. RESULTS There was an increased COVID-19 prevalence in the studied population (43.94%), compared with the national Mexican (~0.21% to 0.63%) and worldwide average in the general population (~0.13% to 4.28%). However, the mortality rate (5.75%) was lower than that reported in Mexico (11.28%-13.55%), which was higher than the worldwide average (2.95%-4.98%). We detected increased COVID-19 prevalence in patients with comorbidities (odds ratios [OR] 0.4; 95% CI: 0.2-1, P = .0447). Moreover, patients with schizophrenia spectrum disorders have a decreased predisposition to COVID-19 (OR 0.4, 95% CI: 0.2-0.8; P = .0250), as opposed to patients with intellectual disability that are predisposed to COVID-19 (OR 2.2, 95% CI: 0.2-0.8; P = .0434), in comparison with the rest of the hospital population. CONCLUSION The prevalence of COVID-19 in hospitalised patients with psychiatric disorders is increased compared with that of the general population; however, a lower mortality rate was detected. Also, an increased risk of COVID-19 was detected in patients with comorbidities. Interestingly, the observed variation in COVID-19 prevalence in patients with schizophrenia and intellectual disability was not associated with age or other specific medical diagnoses.
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Affiliation(s)
| | - Hiram Tendilla‐Beltrán
- Laboratorio de NeuropsiquiatríaInstituto de FisiologíaBenemérita Universidad Autónoma de Puebla (BUAP)PueblaMexico
| | | | | | - Gonzalo Flores
- Laboratorio de NeuropsiquiatríaInstituto de FisiologíaBenemérita Universidad Autónoma de Puebla (BUAP)PueblaMexico
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Bello-Chavolla OY, Antonio-Villa NE, Fernández-Chirino L, Guerra EC, Fermín-Martínez CA, Márquez-Salinas A, Vargas-Vázquez A, Bahena-López JP. Diagnostic performance and clinical implications of rapid SARS-CoV-2 antigen testing in Mexico using real-world nationwide COVID-19 registry data. PLoS One 2021; 16:e0256447. [PMID: 34464393 PMCID: PMC8407542 DOI: 10.1371/journal.pone.0256447] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/06/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND SARS-CoV-2 testing capacity is important to monitor epidemic dynamics and as a mitigation strategy. Given difficulties of large-scale quantitative reverse transcription polymerase chain reaction (qRT-PCR) implementation, rapid antigen tests (Rapid Ag-T) have been proposed as alternatives in settings like Mexico. Here, we evaluated diagnostic performance of Rapid Ag-T for SARS-CoV-2 infection and its associated clinical implications compared to qRT-PCR testing in Mexico. METHODS We analyzed data from the COVID-19 registry of the Mexican General Directorate of Epidemiology up to April 30th, 2021 (n = 6,632,938) and cases with both qRT-PCR and Rapid Ag-T (n = 216,388). We evaluated diagnostic performance using accuracy measures and assessed time-dependent changes in the Area Under the Receiver Operating Characteristic curve (AUROC). We also explored test discordances as predictors of hospitalization, intubation, severe COVID-19 and mortality. RESULTS Rapid Ag-T is primarily used in Mexico City. Rapid Ag-T have low sensitivity 37.6% (95%CI 36.6-38.7), high specificity 95.5% (95%CI 95.1-95.8) and acceptable positive 86.1% (95%CI 85.0-86.6) and negative predictive values 67.2% (95%CI 66.2-69.2). Rapid Ag-T has optimal diagnostic performance up to days 3 after symptom onset, and its performance is modified by testing location, comorbidity, and age. qRT-PCR (-) / Rapid Ag-T (+) cases had higher risk of adverse COVID-19 outcomes (HR 1.54 95% CI 1.41-1.68) and were older, qRT-PCR (+)/ Rapid Ag-T(-) cases had slightly higher risk or adverse outcomes and ≥7 days from symptom onset (HR 1.53 95% CI 1.48-1.59). Cases detected with rapid Ag-T were younger, without comorbidities, and milder COVID-19 course. CONCLUSIONS Rapid Ag-T could be used as an alternative to qRT-PCR for large scale SARS-CoV-2 testing in Mexico. Interpretation of Rapid Ag-T results should be done with caution to minimize the risk associated with false negative results.
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Affiliation(s)
| | | | | | - Enrique C. Guerra
- MD/PhD (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | | | | | - Arsenio Vargas-Vázquez
- MD/PhD (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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30
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Soto-Perez-de-Celis E, Arrieta O, Bargalló-Rocha E, Campos-Gómez S, Chavarri-Guerra Y, Chávez-Nogueda J, González-Lara F, Pérez-Jacobo F, Martínez-Said H. COVID-19 Vaccine Guidance for Patients with Cancer in Mexico: Report From the Working Group of the Mexican Society of Oncology. Arch Med Res 2021; 53:223-227. [PMID: 34366169 PMCID: PMC8321707 DOI: 10.1016/j.arcmed.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/05/2021] [Accepted: 07/23/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Enrique Soto-Perez-de-Celis
- Departamento de Geriatría. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
| | - Oscar Arrieta
- Unidad de Oncología Torácica. Instituto Nacional de Cancerología, Ciudad de México, México
| | - Enrique Bargalló-Rocha
- Departamento de Tumores Mamarios. Instituto Nacional de Cancerología, Ciudad de México, México
| | - Saúl Campos-Gómez
- Departamento de Oncología. Centro Médico Estatal ISSEMYM, Toluca, México
| | - Yanin Chavarri-Guerra
- Departamento de Hemato-Oncología. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Jessica Chávez-Nogueda
- Servicio de Radioterapia. Hospital de Oncología. Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México
| | - Fernanda González-Lara
- Departamento de Infectología. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México
| | - Fernando Pérez-Jacobo
- Departamento de Hematología y Banco de Sangre. Hospital Central Norte de Petróleos Mexicanos, Ciudad de México, México
| | - Héctor Martínez-Said
- Departamento de Piel y Partes Blandas. Instituto Nacional de Cancerología de México Ciudad de México, México.; Sociedad Mexicana de Oncología, Ciudad de México, México
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