ABSTRACT
That the COVID-19 pandemic is unprecedented in terms of its scale, spread and shocks can be evinced by the myriad of ever-changing responses cities all around the world have rolled out throughout the different waves of outbreaks. Although the threat is similar across the world, it took some time before its reach became global and the waves of outbreak are experienced by cities at different times. While this staggered spread imply that some cities might manage the virus better as they learn from the experiences of cities which had been amongst the earliest to face the virus, the reality is more complicated. In the early stages of the pandemic, the global consensus on the best way to contain the virus swiftly converged in the interlinked strategies of restricting the movement of people and minimizing their social contact. However, the effectiveness of these strategies differ greatly between cities. To that end, this study focuses on COVID-19 responses in two regions (Latin America and Southeast Asia) and examines the evolution of the first wave of COVID-19 outbreaks during 2020 in Singapore, Jakarta (Indonesia), Bogotá (Colombia) and Santiago (Chile). The study is based on a comparative approach and uses a variety of data sources, namely morphology, density, housing concentration, mobility, and governance in the four analyzed cities. The goal is to shed light on the response of city governments in these two different regions in terms of mobility restrictions in order to reduce the cases of new infections. The results show the relevance of urban policies and their territorial approaches, particularly in terms of mobility and public transport networks in the four cities.
ABSTRACT
INTRODUCTION: COVID-19 disease can affect women at any stage of pregnancy, and newborns could become infected with SARS-CoV-2 through vertical or horizontal transmission. OBJECTIVE: To determine clinical and epidemiological characteristics of mothers with COVID-19, associated neonatal outcomes, and to evaluate SARS-CoV-2 vertical transmission. METHODS: We conducted an observational, descriptive, cross-sectional study. We included all mothers with positive serology for SARS-CoV-2 and their newborns at the Hospital Regional Docente de Trujillo from April 18 to September 30, 2020. Variables were collected from the medical records, and descriptive statistics were used for the analysis. RESULTS: A total of 647 mothers and 656 neonates were enrolled. Of all live births, 85.3% and 14.7% were term and preterm neonates, respectively. We found 1.7% (11/656) of newborns with positive RT-PCR for SARS-CoV-2; and that 27.3% (3/11) of these neonates required hospitalization. Neonatal mortality was 4/656 (0.6%), and no case was attributed to COVID-19. Of all mothers affected with COVID-19, 95.7% were asymptomatic, and 4.3% presented clinical symptoms attributed to COVID-19, most of which were mild. The most frequent obstetric complications were preeclampsia-eclampsia, prelabour rupture of membranes, and acute fetal distress. All the mothers were discharged. CONCLUSION: We found 1.7% of newborns with positive RT-PCR test for SARS-CoV-2; and that 20.1% of these neonates were hospitalized. The most frequent morbidity was neonatal sepsis and prematurity. The infection was mild among newborns, showing a 0.6% overall mortality, with no cases attributed to COVID-19. We found that only 5% of mothers presented symptoms, most of which were mild to moderate symptoms. There was no record of maternal mortality in this study group. It is not possible to conclude whether vertical transmission or intrapartum-acquired infection is responsible for neonatal COVID-19 infections.
INTRODUCCIÓN: La enfermedad de COVID-19 puede afectar a gestantes en cualquier trimestre del embarazo. Por su parte, los neonatos podrían infectarse con SARS-CoV-2 por transmisión vertical u horizontal. OBJETIVO: Determinar las características clínicas y epidemiológicas de madres con COVID-19, de sus neonatos y la transmisión vertical del SARS-CoV-2. MÉTODOS: Estudio observacional, descriptivo, transversal. Se incluyeron todas las madres con serología positiva para SARS-CoV-2 y sus neonatos nacidos en el Hospital Regional Docente de Trujillo desde el 18 de abril hasta el 30 de septiembre de 2020. La información para las variables se recogió de las historias clínicas. Para el análisis se usó estadística descriptiva. RESULTADOS: Participaron 647 madres y 656 neonatos. El 85,3% de los neonatos nació de término y el 14,7% fue prematuro. El 1,7% (11/656) tuvieron PCR-RT positivos para SARS-CoV-2, y de ellos el 27,3% (3/11) requirió hospitalizados. La mortalidad fue de 4/656 (0,6%), no atribuida a COVID-19. De las madres afectadas con COVID-19, 95,7% fue asintomática, el 4,3% presentó sintomatología clínica atribuida a COVID-19, siendo en su mayoría casos leves. Las complicaciones obstétricas más frecuentes fueron preeclampsia, eclampsia, rotura prematura de las membranas y sufrimiento fetal agudo. Todas las madres fueron dadas de alta. CONCLUSIÓN: De los neonatos estudiados, el 1,7% presentó prueba PCR-RT para SARS-CoV-2 positiva. El 20,1% fue hospitalizado. La morbilidad más frecuente fue sepsis neonatal y prematuridad. La mortalidad fue de 0,6%, ningún caso atribuido a COVID-19. El cuadro clínico de esta patología fue leve en los neonatos. El 95% de las madres con COVID-19 fueron asintomáticas. De las gestantes que presentaron cuadro clínico, tuvieron sintomatología leve a moderada. No se tuvo registro de mortalidad materna en el grupo de estudio. No se puede concluir si se trata de casos de transmisión vertical del SARS-CoV-2 o estamos frente a casos de posible infección neonatal adquirida intraparto.