Advances and Challenges in COVID-19 Vaccination in Latin American: A public health perspective

The vaccination against SARS-CoV-2 has been recognized as a priority strategy to safeguard public health. However, disparities in productive, acquisitive and distributional capacity have led to delays in immunization, particularly in low- and middle-income countries. Consequently, global coverage is expected to achieve herd immunity against COVID-19 by 2023 or 2024, although with highly variable coverage percentages among countries. In Latin America, immunization against COVID-19 faces different challenges to achieve herd immunity. To date (February 6, 2022), the countries that had several doses needed to immunize their populations with at least two doses (number of doses between population) were Peru (520.7%), Chile (458.4%), Argentina (298.0%), Brazil (236.6%), Bolivia (206.0%) and Uruguay (unconfirmed doses). On the other hand, Uruguay (210.7%) and Chile (238.3%) have applied twice as many doses as their populations. Argentina (194.3%), Brazil (173.6%), Ecuador (170.3%), Peru (170.3%), Costa Rica (161.1%), and Panama (153.5%) are on the way to achieving this goal. In addition, Latin American countries also showed an insufficient distribution of vaccines and a storage capacity limited to only a few cities and multiple frequencies of vaccine hesitancy. Due to these scenarios, the production of more vaccine doses and equitable distribution to the rest of the population within the Latin American region should remain a public health priority to achieve collective immunity in the shortest time possible. Copyright © 2022 Asociacion Colombiana de Infectologia. All rights reserved.

Antibiotic therapy in hospitalized patients with COVID-19: A Systematic review and meta-Analyses

Introduction: The aim of the study is based on determine whether the use of empirical antibiotic therapy increases the risk of death in adult patients older than 18 years hospitalized with COVID-19. Material and Methods: A systematic review and meta-analysis were performed, taking into account retrospective and prospective studies. The electronic databases Medline/PubMed, Embase, LILACS, and CINAHL were used for the systematic search in the period from December 2019 to May 2021. Odds Ratio and 95% confidence intervals were calculated using the random effect, depending on whether or not heterogeneity exists, the Funnel Plot graph was elaborated to assess the risk of bias. Results: 528 articles were located, which met the inclusion and exclusion criteria, and the eligibility of the full texts of 90 studies was evaluated, resulting in 10 articles. The Odds Ratio of the 10 studies_ is 1.55 (1.20-2.01), in favor of the non-use of antibiotics, with an I2 of heterogeneity between studies of 50%, and the empirical antibiotic therapy guided with procalcitonin < 0.5 ng/dl the Odds Ratio was 28.99 (10.17-82.64) with an I2 of heterogeneity of 0%. Conclusion: The results indicate that administering antibiotics without evidence of microbiological data increases mortality in these patients and, on the contrary, not using empirical antibiotic therapy reduces mortality in patients infected with severe COVID-19 who arrived at the hospital. © 2022 Publicado por Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo.

Clinical and epidemiological features of patients with COVID-19 reinfection: a systematic review.

Recurrent positivity in a patient with COVID-19 may be due to various reasons, not necessarily reinfection. There is concern about the occurrence frequency of reinfection. Five databases and a preprint/preprint repository were searched. All case reports, case series, and observational studies were included. Bias was assessed for each study with the Newcastle-Ottawa Scale tool and reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA-2020). After eligibility, 77 studies were included for qualitative synthesis (52 case reports, 21 case series, and four case-controls; 1131 patients included). Of these, 16 studies described a second contact with the SARS-CoV-2 positive case, five studies described healthcare profession-related infection, ten studies described that the source of reinfection was likely to be from the community, one study described travel-related infection, nine studies described vulnerability-related infection due to comorbidity. The mean number of days from discharge or negative test to reinfection ranged from 23.3 to 57.6 days across the different included studies. The risk of bias for all case report/series studies was moderate/high. For observational studies, the risk of bias was low. Reinfection of patients with COVID-19 occurs between the first and second month after the first infection, but beyond, and 90 days have been proposed as a point to begin to consider it. The main factor for reinfection is contact with COVID-19 positive cases.

Epidemiology of COVID-19 in Latin America

Over the year 2020, the Coronavirus Disease 2019 (COVID-19) impact, caused by the Severe Respiratory Syndrome Coronavirus 2, has been highly significant in the world. As expected, resource-constrained areas of the world, as is the case of Latin America, have been more affected given their previous epidemiological context, health care systems, and socioeconomic conditions. In this chapter the main epidemiological features of the COVID-19 during the first year of the pandemic in this region are revised. © 2021 Elsevier Inc. All rights reserved.

Emerging coronavirus disease COVID-19, a pandemic public health emergency with animal linkages: current status update

After the appearance of first cases of pneumonia of unknown origin in the Wuhan city, China, during late 2019, the disease progressed fast. Its cause was identified as a novel coronavirus, named provisionally 2019-nCoV. Subsequently, an official name was given as SARS-CoV-2 Severe Acute Respiratory Syndrome Coronavirus-2 by the International Committee on Taxonomy of Viruses ICTV study group. The World Health Organization WHO named the Coronavirus disease-2019 as COVID-19. The epidemics of COVID-2019 have been recorded over 113 countries/territories/areas apart from China and filched more than 4,292 humans, affecting severely around 1,18,326 cases in a short span. The status of COVID-2019 emergency revised by the WHO within 42 days from Public Health International Emergency January 30, 2020 to a pandemic March 11, 2020. Nonetheless, the case fatality rate CFR of the current epidemic is on the rise between 2-4%, relatively is lower than the previous SARS-CoV 2002/2003 and MERS-CoV 2012 outbreaks. Even though investigations are on its way, the researchers across the globe have assumptions of animal-origin of current SARS-CoV-2. A recent case report provides evidence of mild COVID-2019 infection in a pet dog that acquired COVID-2019 infection from his owner in Hong Kong. The news on travellers associated spread across the globe have also put many countries on alert with the cancellation of tourist visa to all affected countries and postponement of events where international visits were required. A few diagnostic approaches, including quantitative and differential real-time polymerase chain reaction assays, have been recommended for the screening of the individuals at risk. In the absence of any selective vaccine against SARS-CoV-2, re-purposed drugs are advocated in many studies. This article discourse the current worldwide situation of COVID-2019 with information on virus, epidemiology, host, the role of animals, effective diagnosis, therapeutics, preventive and control approaches making people aware on the disease outcomes.

Potential Dermatological Conditions Resulting from a Prolonged Stay at Home during the COVID-19 Pandemic: A Review

A new coronavirus emerged in 2019 in Wuhan, China named Severe Acute Respiratory Syndrome type 2 coronavirus (SARS-CoV-2). Later, this virus spread worldwide, causing a disease called coronavirus disease (COVID-19). To control the outbreak, many countries announced mandatory quarantine;thus, people changed their lifestyles and started engaging in most activities from home. This review explains how some dermatological pathologies may be precipitated by prolonged stays at home, considering that quarantine was a widely used public health measure during 2020. Most of these dermatoses had to be seen, diagnosed, and treated through tele-dermatology, a remote health care system that took force during the COVID-19 pandemic because of its ease and efficiency in connecting health care professionals and their patients;therefore, reducing the risk of contagion and costs associated to medical care. This review of the principal dermatologic conditions during confinement could allow for a better preparation of health professionals.

Comorbidity, poverty and social vulnerability as risk factors for mortality in pregnant women with confirmed SARS-CoV-2 infection: analysis of 13 062 positive pregnancies including 176 maternal deaths in Mexico.

OBJECTIVE: Mortality in pregnancy due to coronavirus disease 2019 (COVID-19) is a current health priority in developing countries. Identification of clinical and sociodemographic risk factors related to mortality in pregnant women with COVID-19 could guide public policy and encourage such women to accept vaccination. We aimed to evaluate the association of comorbidities and socioeconomic determinants with COVID-19-related mortality and severe disease in pregnant women in Mexico. METHODS: This is an ongoing nationwide prospective cohort study that includes all pregnant women with a positive reverse-transcription quantitative polymerase chain reaction result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the Mexican National Registry of Coronavirus. The primary outcome was maternal death due to COVID-19. The association of comorbidities and socioeconomic characteristics with maternal death was explored using a log-binomial regression model adjusted for possible confounders. RESULTS: There were 176 (1.35%) maternal deaths due to COVID-19 among 13 062 consecutive SARS-CoV-2-positive pregnant women. Maternal age, as a continuous (adjusted relative risk (aRR), 1.08 (95% CI, 1.05-1.10)) or categorical variable, was associated with maternal death due to COVID-19; women aged 35-39 years (aRR, 3.16 (95% CI, 2.34-4.26)) or 40 years or older (aRR, 4.07 (95% CI, 2.65-6.25)) had a higher risk for mortality, as compared with those aged < 35 years. Other clinical risk factors associated with maternal mortality were pre-existing diabetes (aRR, 2.66 (95% CI, 1.65-4.27)), chronic hypertension (aRR, 1.75 (95% CI, 1.02-3.00)) and obesity (aRR, 2.15 (95% CI, 1.46-3.17)). Very high social vulnerability (aRR, 1.88 (95% CI, 1.26-2.80)) and high social vulnerability (aRR, 1.49 (95% CI, 1.04-2.13)) were associated with an increased risk of maternal mortality, while very low social vulnerability was associated with a reduced risk (aRR, 0.47 (95% CI, 0.30-0.73)). Being poor or extremely poor were also risk factors for maternal mortality (aRR, 1.53 (95% CI, 1.09-2.15) and aRR, 1.83 (95% CI, 1.32-2.53), respectively). CONCLUSION: This study, which comprises the largest prospective consecutive cohort of pregnant women with COVID-19 to date, has confirmed that advanced maternal age, pre-existing diabetes, chronic hypertension, obesity, high social vulnerability and low socioeconomic status are risk factors for COVID-19-related maternal mortality. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

The ignored pandemic of public health corruption: a call for action amid and beyond SARS-CoV-2/COVID-19

Corruption in healthcare is on the rise. When corruption infiltrates global health, causes embezzlement of public health funds, malfunctioning medical equipment, fraudulent or ineffective health services such as expired medicines and fake vaccines that could have life-or-death consequences. A corrupt healthcare system, amid global health crises like the COVID-19 pandemic, when resources are in constraint and trust is in high demand, can lead to devastating, though avoidable, health and economic consequences. It is imperative for policymakers, health experts, patients, caregivers, and global health funders to promptly acknowledge and address corruption in healthcare. The current pandemic generates an emergency and disorder state on health care systems across the globe, especially in low- and middleincome countries, where a weakening of control measures is evident, creating the perfect storm for corruption. This paper builds on existing research to examine processes that support essential stakeholder engagement in anti-corruption efforts. In this context, an extensive review of literature has been conducted by using various databases such as PubMed, Science direct, SCOPUS, Research Gate, and Google Scholar and a total of 45 articles and documents on corruption and COVID-19 were screened and selected by authors independently. To fill the knowledge gaps about the need for actions to be taken during a pandemic like COVID-19, we propose an anti-corruption grassroots movement that focuses on changing the social norms surrounding corruption in healthcare. By pushing forward a practice that normalizes conversations about corruption in everyday health practices and involving more stakeholders in the protection of public health resources, we argue that not only local health systems can become more resilient and resistant to corruption, but also global health initiatives can become more effective and efficient to improve individual and global health.

Antibiotic use and fatal outcomes among critically III patients with COVID-19 in Tacna, Peru

Overuse of antibiotics during the Coronavirus Disease 2019 (COVID-19) pandemic could increase the selection of extensively resistant bacteria (XDR). However, it is unknown what impact they could have on the evolution of patients, particularly critically ill patients. This study aimed to evaluate the characteristics and impact of ICU-acquired infections in patients with COVID-19. A retrospective cohort study was conducted, evaluating all patients with critical COVID-19 admitted to the intensive care unit (ICU) of a hospital in Southern Peru from 28 March 2020 to 1 March 2021. Of the 124 patients evaluated, 50 (40.32%) developed a healthcare-associated infection (HAI), which occurred at a median of 8 days (IQR 6-17) after ICU admission. The proportion of patients with HAI that required ceftriaxone was significantly higher;the same was true for the use of dexamethasone. Forty bacteria isolations (80%) were classified as XDR to antibiotics, with the most common organisms being Acinetobacter baumannii (54%) and Pseudomonas aeruginosa (22%);33% (41/124) died at the ICU during the follow-up. In the adjusted analysis, healthcare-associated infection was associated with an increased risk of mortality (aHR= 2.7;95% CI: 1.33-5.60) and of developing acute renal failure (aRR = 3.1;95% CI: 1.42-6.72). The incidence of healthcare infection mainly by XDR pathogens is high in critically ill patients with COVID-19 and is associated with an increased risk of complications or death.

Generalized urticaria as a vasculitic manifestation in a patient with SARS-CoV-2 infection: A case report in Colombia

Skin manifestations have been reported in up to 20% of cases of SARS-CoV-2 infection, including morbilliform rash (22%), pernio-like acral lesions (18%), urticaria (16%), and macular erythema (13%). It is believed that in the case of SARS-CoV-2 infection, the mechanism involved is an inflammatory response that generates immune dysregulation, vascular congestion, vasculitis, vascular thrombosis, or neoangiogenesis. This case study, present the case of a patient with no previous history of urticarial reactions, autoimmune diseases, or exposure to medications who develops generalized urticaria lasting more than 24 hours and who was diagnosed with SARS-CoV-2 infection by RT-PCR with a nasopharyngeal swab. We suggest in this patient vasculitic urticaria as a manifestation of SARS-CoV-2 infection. © 2021, Editorial board of Journal of Experimental Biology and Agricultural Sciences. All rights reserved.

Blood scarcity at the blood banks during COVID-19 pandemic and strategies to promote blood donations: current knowledge and futuristic vision

The course of the coronavirus disease (COVID-19) pandemic has significantly affected the healthcare systems in multiple ways, the programs of control and the management of patients with other infectious diseases as well as with chronic and acute non-communicable diseases, including those conditions requiring blood transfusions. Blood donations have been decreasing over time in multiple countries with their expected consequences. Although the spread of SARS-CoV-2 has not been detected via blood transfusion, the increasing fear and anxiety among communities have led to a substantial decrease in blood donations. Several research groups have raised concerns about the consequences associated with the scarcity of blood. However, it is critical to understand the underlying causes of the sharp decline in blood donations, as well as the consequences. Hence, we discuss the impact of blood scarcity at the blood banks during the COVID-19 pandemic as well as strategies to promote blood donations, given the experience in some countries with this situation. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Economy or health, constant dilemma in times of pandemic: the case of Coronavirus disease 2019 (COVID-19). (Special Issue: Coronaviruses and COVID-19- Past, Present, and Future.)

The multiple faces of the Coronavirus Disease 2019 (COVID-19), also included the impact on the economy. As a consequence of the significant life and society disruption, multiple implications are derived from the COVID-19 crisis and pandemic, including a significant backward on the economy. In the current mini-review, we discuss some potential considerations about it, including some specific examples of the COVID-19 impact on the economy.

Possibilities of "crushing" the transmission curve of COVID-19 in Latin America - we still have time. (Special Issue: Coronaviruses and COVID-19- Past, Present, and Future.)

Latin America is suppose to have significant advantages over other developing regions, such as Asia and Africa, given the time where the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), causing the Coronavirus Diseases 2019 (COVID-19), arrived, mainly from Europe. This occurred on February 26, 2020. Then, multiple previous measures were taken in order to prevent and mitigate the impact of pandemic in the region. In the current mini-review update we discuss the possibilities of "crushing" the transmission curve of COVID-19 in the region after two months of the arrival of this emerging coronavirus.

Importance of bats in wildlife: not just carriers of pandemic SARS-CoV-2 and other viruses. (Special Issue: Coronaviruses and COVID-19- Past, Present, and Future.)

Bats are the only flying mammals that carry multiple pathogens, such as the SARS-CoV-2. As a consequent of fear of the zoonotic origin of SARS-CoV-2, there is an adverse reaction in multiple countries against these animals. Bats contribute with arthropod control and pollination, among other positive roles of these animals.

Concerns on the emerging research of SARS-CoV-2 on felines: could they be significant hosts/reservoirs? (Special Issue: Coronaviruses and COVID-19- Past, Present, and Future.)

With the growing evidence of cases and studies showing natural and experimental infection due to SARS-CoV-2 in felines, including cats, lion, and tigers, there is also an increasing concern about its susceptibility and their role in urban cycles of SARS-CoV-2 transmission, initially from humans-to-animals, but with uncertainty about reverse transmission. In this review, we addressed the evidence around this situation.

Bacterial translocation: Microbiota-intestine-lung axis and pro-inflammatory status in the severity of COVID-19

Although severe acute respiratory syndrome coronavirus – 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) pandemic, is primarily associated with a respiratory infection, it has also been linked to multisystem involvement that includes the digestive tract. Gastrointestinal (GI) manifestations are common in patients with COVID-19 due to the high viral load lodged in the small intestine's mucosa. As a result, it causes an increase in the permeability of the intestinal barrier that favours the passage and translocation of bacteria, from the lumen of the intestine, towards the internal environment, with the appearance of sepsis, with evidence that SARS-CoV-2 has been found in faeces. This article highlights epidemiology, clinical symptoms, and mechanisms related to manifestations of disease in the GI tract and its pathogenesis in patients with COVID-19. It highlights bacterial translocation and COVID-19, mechanisms that control bacterial translocation, intestinal infection and feco-oral transmission, defense mechanisms against microbial invasion, role of microbiota/microbiome and implications of their dysbiosis and alterations during SARS-CoV-2 infection, and lastly protective health benefits by improving dietary habits with nutritional foods approaches amid the ongoing pandemic. Increasing evidence indicates that bacterial translocation appears due to the high viral load of COVID-19 in the mucosa of the GI tract, and the intestinal microbiota contributes to the COVID-19 course owing to their bidirectional relationship with the immune system and lungs. Dysbiosis in gut microbiota leads to increased gut permeability thus predisposing to secondary infection and multiple organ dysfunction. Disruption of intestinal barrier integrity due to dysbiosis may cause translocation of SARS-CoV-2 from lungs into the intestinal lumen via the circulatory and lymphatic system, initiating severe clinical presentation of the infection. A thorough understanding of the key role of gut microbiota, gastrointestinal symptoms, and pathology along with immunomodulatory approaches would help in alleviating morbidity and mortality during the ongoing COVID-19 pandemic. © 2021, Editorial board of Journal of Experimental Biology and Agricultural Sciences.

Reinfection after SARS-CoV2 infection: a looming concern. (Special Issue: SARS-CoV-2.)

Many unanswered questions remain about COVID-19 infection caused by SARS-CoV-2 coronavirus. One such looming concern is the possibility of reinfection of recovered cases. We conducted a literature review on various aspects of this possibility, including the case presentations of relapsed/re-infected patients, the immune response of production of neutralizing antibodies, immunity in response to coronavirus during SARS-CoV2 and MERS, possibility of false-positive results of real-time polymerase chain reaction. We concluded that further studies are required to establish whether relapse or reinfection is possible firmly. However, these possibilities point towards the needs of change in the protocol of isolation, quarantine, and discharge. It also undermines the role of the upcoming vaccine in disease prevention and treatment.

The Broad Range of Coronaviruses Co-Existing in Chiropteran: Implications for One Health

Bats are a group of mammals that harbor the most significant number of coronaviruses. The aim of present review article was to analyze the broad spectrum of the coronavirus coexisting in Chiropterans hosts. Bats have certain types of cell receptors that allow them to be the potential hosts of a large number of viruses without the presence of any clinical manifestations, and to be a source of contagion infections for other animals and human species. Emphasis can be placed on five coronaviruses, such as Porcine Epidemic Diarrhea Disease, Severe Acute Diarrhea Syndrome, Middle East Respiratory Syndrome, Severe Acute Respiratory Syndrome, and Severe Acute Respiratory Syndrome 2, which have had significant impacts causing epidemic outbreaks in different parts of the world, and generating implications for both human and animal health. In conclusion, recent research indicated the importance of bats as potential hosts of multiple coroaviruses leading to some zoonotic diseases.