Risk of death, hospitalization and intensive care unit admission by SARS-CoV-2 variants in Peru: a retrospective study.

OBJECTIVES: Peru has had the highest death toll from the pandemic worldwide; however, it is not clear what the effects of the different variants on these outcomes are. The study aimed to evaluate the risk of death, hospitalization, and intensive care unit (ICU) admission rates of COVID-19 according to the SARS-CoV-2 variants detected in Peru from March 2020-February 2022. METHODS: Retrospective study using open-access databases were published by the Peruvian Ministry of Health. Databases of genomic sequencing, death, COVID-19 cases, hospitalization and ICU, and vaccination were used. Crude and adjusted Cox proportional hazards regressions with clustered variances were modeled to calculate the hazard ratio (HR) of outcomes by variant. RESULTS: Lambda variant had the highest risk of death (HR 1.92, 95% CI 1.37-2.68), whereas the Delta variant had the lowest risk (HR 0.50, 95% CI 0.31-0.82). Mu variant had the highest risk of hospitalization (HR: 2.39, 95% CI 1.56-3.67), Omicron the lowest (HR 0.45, 95%CI 0.23-0.90), and Gamma had the highest ICU admission rate (HR 1.95, 95%CI 1.40-2.71). CONCLUSION: SARS-CoV-2 variants showed distinctive risks of clinical outcomes, which could have implications for the management of infected persons during the pandemic.

Intrauterine and Extrauterine Environmental PM2.5 Exposure Is Associated with Overweight/Obesity (O/O) in Children Aged 6 to 59 Months from Lima, Peru: A Case-Control Study.

There is evidence that PM2.5 could be obesogenic. Lima is one of the most polluted cities in South America, with an increasing prevalence of childhood obesity. This study aimed to determine the association between PM2.5 exposure of children aged 6 to 59 months and being overweight or obese (O/O) in a significant dataset survey. Cases were defined when weight for height Z-score (WHZ) was >2 standard deviations (SD) from the mean, for each sex. A control was defined when WHZ was between ±2 SD. We used a conditional logistic regression model to calculate the odds ratio (OR) between extrauterine and intrauterine PM2.5 exposure and O/O. Extrauterine PM2.5 exposure was evaluated as a 6-month PM2.5 mean prior to the survey. We found a significant association between O/O and extrauterine (OR: 1.57, 1.51-1.63) and intrauterine (OR: 1.99, 1.88-2.12) PM2.5 exposure for an increment of 10 µg/m3. The ORs increased as the quartile increased in both exposures. We observed a higher association in children aged 6-11 months (OR: 3.07, 2.84-3.31). In conclusion, higher levels of PM2.5 in Lima and Callao were associated with cases of O/O in children from 6 to 59 months, with the association higher for prenatal exposure.

Association between air pollution in Lima and the high incidence of COVID-19: findings from a post hoc analysis.

BACKGROUND: Coronavirus disease 2019 (COVID-19) originated in the People's Republic of China in December 2019. Thereafter, a global logarithmic expansion of cases occurred. Some countries have a higher rate of infections despite the early implementation of quarantine. Air pollution might be related to high susceptibility to the virus and associated case fatality rates (deaths/cases*100). Lima, Peru, has the second highest incidence of COVID-19 in Latin America and also has one the highest levels of air pollution in the region. METHODS: This study investigated the association of levels of PM2.5 exposure in previous years (2010-2016) in 24 districts of Lima with cases, deaths and case fatality rates for COVID-19. Multiple linear regression was used to evaluate this association controlled by age, sex, population density and number of food markets per district. The study period was from March 6 to June 12, 2020. RESULTS: There were 128,700 cases in Lima and 2382 deaths due to COVID-19. The case fatality rate was 1.93%. Previous exposure to PM2.5 (2010-2016) was associated with the number of COVID-19- cases (ß = 0.07; 95% CI: 0.034-0.107) and deaths (ß = 0.0014; 95% CI: 0.0006-0.0.0023) but not with the case fatality rate. CONCLUSIONS: After adjusting for age, sex and number of food markets, the higher rates of COVID-19 in Metropolitan Lima are attributable to the increased PM2.5 exposure in the previous years, among other reasons. Reduction in air pollution from a long-term perspective and social distancing are needed to prevent the spread of virus outbreaks.

Association Between Air Pollution in Lima and the High Incidence of COVID-19: Findings from a Post Hoc Analysis.

BACKGROUND: Corona virus disease (COVID-19) originated in China in December 2019. Thereafter, a global logarithmic expansion of the cases has occurred. Some countries have a higher rate of infections despite of early implementation of quarantine. Air pollution could be related to the high susceptibility to SARS-CoV-2 and the associated case-fatality rates (deaths/cases*100). Lima, Peru has the second highest incidence of COVID-19 in Latin America and it is also one of the cities with highest levels of air pollution in the Region. METHODS: This study investigated the association of the levels of PM2.5 exposure in the previous years (2010-2016) in 24 districts of Lima with the cases, deaths and case-fatality rates of COVID-19. RESULTS: Until June 12, 2020, there were 6,308 deaths and 220,749 SARS-CoV-2 positive cases in Peru. In Lima, the total number of COVID-19 deaths in all metropolitan areas was 2,382. The case-fatality rate at the national level was 2.58% and 1.93% in Lima. Higher PM2.5 levels are associated with higher number of cases and deaths of COVID-19. The case-fatality rate (Deaths/cases*100) did not increase with the increase in PM2.5 levels. A higher number of food markets was associated with higher incidence and mortality of COVID-19 (p < 0.01 for both); these associations persisted when cases (r = 0.49; p < 0.01) and deaths (r = 0.58; p < 0.01) were adjusted by the population density. The association of PM2.5 with cases of COVID-19 was maintained after controlling analysis by age, sex and number of food markers. CONCLUSIONS: the higher rates of COVID-19 in Metropolitan Lima is attributable, among others, to the increased PM2.5 exposure in the previous years after adjusting for age, sex and number of food markets. Reduction of air pollution since a long term perspective, and social distancing are needed to prevent spreads of virus outbreak.

High altitude reduces infection rate of COVID-19 but not case-fatality rate.

Coronavirus disease 19 (COVID-19) is a pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It is suggested that life at high altitude may reduce COVID-19 infections and case-fatality rates (cases/deaths). We study data from Peru COVID-19 pandemics, which first case was recorded on March 6th, 2020. By June 13, 2020 there were 6498 deaths, and 224,132 SARS-CoV-2 positives. Using data from 185 capitals of provinces with altitudes ranging from 3 to 4342 m, we confirm previous reports that infection with COVID-19 at high altitude is reduced. However, case-fatality rate is not dependent of altitude. We have also presented first evidence that female protection towards death by COVID-19 is reduced as altitude of residence increases.