Clinical monitored in subjects metabolically healthy and unhealthy before and during a SARS-CoV-2 infection- A cross-sectional study in Mexican population.

The COVID-19 disease has forced us to consider the physiologic role of obesity and metabolically healthy and unhealthy status in response to SARS-CoV-2 infection. Hematological, coagulation, biochemical, and immunoinflammatory changes have been informed with a disparity in morbidity and mortality. Therefore, we aimed to investigate the influence of metabolic health on clinical features in a cross-sectional study in Mexican subjects with and without SARS-CoV-2 infection in non-severe stages after a rigorous classification of obese and non-obese subjects who were metabolically healthy and unhealthy. Four groups were formed: 1) metabolically healthy with normal BMI (MHN); 2) metabolically unhealthy with normal BMI (MUN); 3) metabolically healthy obese (MHO); 4) metabolically unhealthy obese (MUO). Serum proinflammatory (TNF-α, MCP-1, IL-1ß, and IL-6) and anti-inflammatory (TGF-ß, IL-1Ra, IL-4, and IL-10) cytokines, hematological parameters, coagulation, and acute phase components were evaluated. Our results showed that MHO people live with inflammaging. Meanwhile, MUN and MUO subjects develop metaflammation. Both inflammaging and metaflammation cause imperceptible modifications on hematological parameters, mainly in leukocyte populations and platelets, as well as acute phase and coagulation components. The statistical analysis revealed that many clinical features are dependent on metabolic health. In conclusion, MHO subjects seem to be transitioning from metabolically healthy to unhealthy, which is accelerated in acute processes, such as SARS-CoV-2 infection. Meanwhile, metabolically unhealthy subjects independently of BMI have a deteriorating immunometabolic status associated with a hyperinflammatory state leading to multi-organ dysfunction, treatment complications, and severe COVID-19 disease.

Clinical-epidemiological characterization of confirmed COVID-19 patients in Pinar del Río

RESUMEN Introducción: el estudio de las características de los pacientes con la COVID-19 permite determinar grupos de riesgo en poblaciones específicas y trazar estrategias por las instituciones para enfrentar dicha situación. Objetivo: caracterizar clínico-epidemiológicamente a pacientes confirmados con la COVID-19 en Pinar del Río. Métodos: se realizó un estudio observacional, descriptivo, longitudinal y prospectivo en los 52 casos con diagnóstico confirmado a la COVID-19 entre marzo y mayo de 2020. Los datos fueron recogidos de las historias clínicas y las encuestas epidemiológicas. Se empleó estadística descriptiva. Resultados: predominó el grupo etario entre 40 y 59 años (tasa de 8,2 por cada 10 mil habitantes), con predominio del sexo masculino (tasa de 0,8 por cada 10 mil habitantes). El 94,2 % de los pacientes presentaron fuente de infección precisada al momento del ingreso. Los síntomas más frecuentes fueron la fiebre (51,9 %), tos (40,4 %) y rinorrea (21,1 %). La hipertensión arterial se presentó en el 11,11 % de los pacientes, donde el 35,7 % de los pacientes hipertensos desarrollaron neumopatía aguda inflamatoria. En el 86,5 % de los pacientes se realizó alta clínica a los 14 días y el 96,2 % alta epidemiológica a los 28 días. Conclusiones: la transmisión fue mayormente autóctona, menormente asintomática, donde la fiebre y la tos fueron los principales síntomas. Los pacientes con comorbilidades desarrollaron en mayor cuantía, complicaciones. Se encontró una respuesta positiva al tratamiento con altos porcentajes de alta clínica y epidemiológica a los 14 y 28 días respectivamente. ABSTRACT Introduction: the study of the characteristics of COVID-19 patients allows the determination of risk groups and specific populations and the strategies designed by the institutions to deal with this situation. Objective: to characterize clinical and epidemiologically the confirmed COVID-19 patients in Pinar del Río. Methods: an observational, descriptive, longitudinal and prospective study including the 52 confirmed cases of COVID-19 between March and May 2020 was conducted. Data were collected from clinical records and epidemiological surveys. Descriptive statistics was used. Results: the age group between 40 and 59 years old predominated (rate of 8,2 per 10 thousand inhabitants), with predominance of male sex (rate of 0,8 per 10 thousand inhabitants). The 94,2 % of the patients presented a precise source of infection at the time of admission. The most frequent symptoms were fever (51,9 %), cough (40,4 %) and rhinorrhea (21,1 %). High blood pressure was present in 11,11 % of the patients, where 35,7 % of hypertensive patients developed acute inflammatory pneumopathy;86,5 % of the patients were discharged from hospital after 14 days and 96,2 % were epidemiologically discharged after 28 days. Conclusions: transmission was mostly autochthonous, less asymptomatic, where fever and cough were the main symptoms. Patients with comorbidities developed more complications. A positive response to treatment was found, achieving high percentages of clinical and epidemiological discharge at 14 and 28 days respectively.

The only severely-ill COVID-19 patient reported in Pinar del Río

RESUMEN Introducción: la COVID-19 causada por el SARS-CoV-2 constituye una amenaza para la salud pública mundial;con mayor efecto negativo en pacientes con comorbilidades y deterioro del estado de salud. Caso clínico: paciente femenina, de color de piel blanca, de 59 años de edad con antecedentes patológicos personales de hipertensión arterial, diabetes mellitus tipo II, enfermedad pulmonar obstructiva crónica y exfumadora con confirmación de COVID-19 por PCR-RT, presentó neumopatía aguda inflamatoria como complicación y evolución satisfactoria. Sin fuente de infección precisada, se aislaron todos los contactos, se estudiaron y fueron negativos a la COVID-19. Conclusiones: se concluye con la presentación de este caso que la pandemia actual significa un desafío para la comunidad científica porque no existe un tratamiento específico contra el SARSCoV-2. No obstante, Cuba utiliza en su protocolo diversos medicamentos que han demostrado efectividad en el control de la enfermedad al lograr la evolución clínica satisfactoria de varios casos críticos. ABSTRACT Introduction: SARS-CoV-2 (COVID-19) is a threat to global public health;with the most negative effect on patients with comorbidities and weak health status. Clinical case: a 59-year-old, white skinned, female patient with personal pathological history of high blood pressure, diabetes mellitus type II, chronic obstructive pulmonary disease and ex-smoker with confirmed positive PCR-RT (COVID-19 carrier), presented acute inflammatory pneumopathy as a complication and satisfactory evolution. Without a precise source of infection, all contacts were isolated, they underwent to studies and resulted negative to COVID-19. Conclusions: with this case report it is concluded that this pandemic is a challenge for the scientific community because there is not a specific treatment against SARSCoV-2. Nevertheless, Cuba makes use of its protocols of treatment where diverse medicines are included;which have demonstrated effectiveness in the control of the disease, achieving a satisfactory clinical evolution of several critical patients.

Clinical-epidemiological characterization of confirmed COVID-19 patients in Pinar del Río

RESUMEN Introducción: el estudio de las características de los pacientes con la COVID-19 permite determinar grupos de riesgo en poblaciones específicas y trazar estrategias por las instituciones para enfrentar dicha situación. Objetivo: caracterizar clínico-epidemiológicamente a pacientes confirmados con la COVID-19 en Pinar del Río. Métodos: se realizó un estudio observacional, descriptivo, longitudinal y prospectivo en los 52 casos con diagnóstico confirmado a la COVID-19 entre marzo y mayo de 2020. Los datos fueron recogidos de las historias clínicas y las encuestas epidemiológicas. Se empleó estadística descriptiva. Resultados: predominó el grupo etario entre 40 y 59 años (tasa de 8,2 por cada 10 mil habitantes), con predominio del sexo masculino (tasa de 0,8 por cada 10 mil habitantes). El 94,2 % de los pacientes presentaron fuente de infección precisada al momento del ingreso. Los síntomas más frecuentes fueron la fiebre (51,9 %), tos (40,4 %) y rinorrea (21,1 %). La hipertensión arterial se presentó en el 11,11 % de los pacientes, donde el 35,7 % de los pacientes hipertensos desarrollaron neumopatía aguda inflamatoria. En el 86,5 % de los pacientes se realizó alta clínica a los 14 días y el 96,2 % alta epidemiológica a los 28 días. Conclusiones: la transmisión fue mayormente autóctona, menormente asintomática, donde la fiebre y la tos fueron los principales síntomas. Los pacientes con comorbilidades desarrollaron en mayor cuantía, complicaciones. Se encontró una respuesta positiva al tratamiento con altos porcentajes de alta clínica y epidemiológica a los 14 y 28 días respectivamente. ABSTRACT Introduction: the study of the characteristics of COVID-19 patients allows the determination of risk groups and specific populations and the strategies designed by the institutions to deal with this situation. Objective: to characterize clinical and epidemiologically the confirmed COVID-19 patients in Pinar del Río. Methods: an observational, descriptive, longitudinal and prospective study including the 52 confirmed cases of COVID-19 between March and May 2020 was conducted. Data were collected from clinical records and epidemiological surveys. Descriptive statistics was used. Results: the age group between 40 and 59 years old predominated (rate of 8,2 per 10 thousand inhabitants), with predominance of male sex (rate of 0,8 per 10 thousand inhabitants). The 94,2 % of the patients presented a precise source of infection at the time of admission. The most frequent symptoms were fever (51,9 %), cough (40,4 %) and rhinorrhea (21,1 %). High blood pressure was present in 11,11 % of the patients, where 35,7 % of hypertensive patients developed acute inflammatory pneumopathy;86,5 % of the patients were discharged from hospital after 14 days and 96,2 % were epidemiologically discharged after 28 days. Conclusions: transmission was mostly autochthonous, less asymptomatic, where fever and cough were the main symptoms. Patients with comorbidities developed more complications. A positive response to treatment was found, achieving high percentages of clinical and epidemiological discharge at 14 and 28 days respectively.

The only severely-ill COVID-19 patient reported in Pinar del Río

RESUMEN Introducción: la COVID-19 causada por el SARS-CoV-2 constituye una amenaza para la salud pública mundial;con mayor efecto negativo en pacientes con comorbilidades y deterioro del estado de salud. Caso clínico: paciente femenina, de color de piel blanca, de 59 años de edad con antecedentes patológicos personales de hipertensión arterial, diabetes mellitus tipo II, enfermedad pulmonar obstructiva crónica y exfumadora con confirmación de COVID-19 por PCR-RT, presentó neumopatía aguda inflamatoria como complicación y evolución satisfactoria. Sin fuente de infección precisada, se aislaron todos los contactos, se estudiaron y fueron negativos a la COVID-19. Conclusiones: se concluye con la presentación de este caso que la pandemia actual significa un desafío para la comunidad científica porque no existe un tratamiento específico contra el SARSCoV-2. No obstante, Cuba utiliza en su protocolo diversos medicamentos que han demostrado efectividad en el control de la enfermedad al lograr la evolución clínica satisfactoria de varios casos críticos. ABSTRACT Introduction: SARS-CoV-2 (COVID-19) is a threat to global public health;with the most negative effect on patients with comorbidities and weak health status. Clinical case: a 59-year-old, white skinned, female patient with personal pathological history of high blood pressure, diabetes mellitus type II, chronic obstructive pulmonary disease and ex-smoker with confirmed positive PCR-RT (COVID-19 carrier), presented acute inflammatory pneumopathy as a complication and satisfactory evolution. Without a precise source of infection, all contacts were isolated, they underwent to studies and resulted negative to COVID-19. Conclusions: with this case report it is concluded that this pandemic is a challenge for the scientific community because there is not a specific treatment against SARSCoV-2. Nevertheless, Cuba makes use of its protocols of treatment where diverse medicines are included;which have demonstrated effectiveness in the control of the disease, achieving a satisfactory clinical evolution of several critical patients.