Factors Associated with Mortality in Patients with COVID-19 from a Hospital in Northern Peru

We aimed to identify the factors associated with mortality in patients with COVID-19 from the hospitalization service of the Cayetano Heredia Hospital, Piura, Peru, from May to June 2020. A prospective study was conducted in hospitalized patients with a confirmed diagnosis of COVID-19 through serological and/or molecular reactive testing. The dependent variable was death due to COVID-19, and the independent variables were the epidemiological, clinical and laboratory characteristics of the patient. The chi-square test and the non-parametric Mann–Whitney U test were used, with a significance level of 5%. Of 301 patients with COVID-19, the majority of them were male (66.1%), and the mean age was 58.63 years. Of the patients analyzed, 41.3% of them died, 40.2% of them were obese and 59.8% of them had hepatic steatosis. The three most frequent signs/symptoms were dyspnea (90.03%), fatigue (90.03%) and a cough (84.72%). Being an older adult (p = 0.011), being hospitalized in the ICU (p = 0.001), overweight (p = 0.016), obese (p = 0.021) and having compromised consciousness (p = 0.039) and thrombocytopenia (p = 0.024) were associated with mortality due to COVID-19. Overall, the mortality rate due to COVID-19 was 41.3%. Having an older age, being hospitalized in the ICU, overweight, obese and having compromised consciousness and thrombocytopenia were positively associated with mortality in patients with COVID-19. These findings highlight the need to establish an adequate system of surveillance and epidemiological education in hospitals and communities in the event of new outbreaks, especially in rural and northern Peru. © 2023 by the authors.

Family functioning, social skills and lifestyles in students during the COVID-19 pandemic

Introduction: The school population has been affected due to the suspension of face-to-face classes during the initial months of the COVID-19 pandemic. Objective: To determine the association between family functionality with social skills and lifestyles in secondary school students. Methodology: Cross-sectional study conducted in 107 students. Sociodemographic data and data on family functionality, lifestyles and social skills were collected. A simple and multiple regression analysis was performed to estimate the association between family functionality with lifestyle, social skills and sociodemographic variables. Results: The 91.7 % of students reported high family functionality, 94.8 % had a good lifestyle, and 81.3 % had a low level of social skills. In the multiple regression, those who came from urban environments had a lower prevalence of presenting low average social skills (PR: 0.87;CI 95 %: 0.76-0.97, p= 0.014). Women presented better levels of healthy lifestyles (PR: 0.96, CI 95 %: 0.92-0.99, p= 0.034). No association was found between family functionality and the level of social skills (PR: 1.17;CI 95 %: 0.56-2.46, p= 0.678) and with healthy lifestyles (PR: 1.07;CI 95 %: 0.87-1.31, p= 0.548). Conclusions: There is no association between family functionality and social skills and lifestyles in students. © 2022, Editorial Ciencias Medicas. All rights reserved.

Impact of virtualization of medical education on academic performance in 2020

Introduction: The declaration of the pandemic in March 2020 has forced the world's universities to adapt to a new methodology based entirely on virtuality. Objective: To identify the impact generated by the virtualization of education on the academic performance of medical students in 2020. Methods: An observational, descriptive study with a cross-sectional. The data of the academic performance of the students of the fourth and fifth years of the years 2019 and 2020 were obtained anonymously from the university's database. The data were entered in Excel and analyzed by EpiInfo;qualitative variables were expressed as absolute and relative frequency, continuous ones as mean and standard deviation. The chi square test was used at a significance level of 0,05 to establish associations between variables. Results: In the fourth year regarding the pharmacology subject, the average percentage during 2020 was 80 %, in surgical semiology 87.3 % and in medical semiology 87.9 %. In the fifth year in terms of gynecology and obstetrics, the average percentage during 2020 was 92 %, in pediatrics 74.7 % and in medical clinic 89.6 %. Conclusion: There was a significant impact generated by the virtualization of education on the academic performance of medical students in 2020 compared to 2019. © 2022, Editorial Ciencias Medicas. All rights reserved.

Mortality in patients hospitalized with COVID-19 in northern Peru

Background: Peru has one of the highest mortality rates due to COVID-19 in the world. Aim: To describe the clinical features, evolution and explore factors associated with mortality in patients with moderate to severe Covid-19. Material and Methods: Prospective analytical study. The clinical, laboratory, imaging, and mortality data of patients admitted at a COVID service of the Santa Rosa de Piura Hospital were recorded from April to June 2020.

Human development and Covid-19 lethality rate: Ecological study in America

Background: The Human Development Index (HDI), uses three dimensions of development such as life expectancy, access to education and income level. It has been seen worldwide that socioeconomically vulnerable groups are the least protected and face the highest risk of COVID-19. This study aims to evaluate the correlation between HDI, GINI inequality index and COVID-19 case fatality rate in American countries. Study: An ecological observational study was developed, using COVID-19 metrics from Latin American countries. The outcome variable was COVID-19 case fatality rate, and the exposure variables were HDI, GINI, life expectancy, years of schooling, proportion of people over 60 years of age and GDP per capita. Once the data were collected, analyses were performed. We used the spearman correlation method, with a significance level of 95%. Findings: Twenty-four Latin American countries were evaluated, finding a COVID 19 case fatality rate with a median of 2.41 and with 1.55 and 3.04 as 25th and 75th percentile respectively, obtaining also with extreme values Ecuador, Mexico and Peru with 6.41, 7.57 and 9.12 respectively. When evaluating the correlation of the COVID 19 case fatality rate, a weak negative linear correlation was found between HDI, schooling index and life expectancy with rho= -0.253, -0.342 and -0.342 respectively, however, statistical significance was not found (p-value >0.05). Conclusions: It was found among Latin American countries that there is a weak negative linear correlation between COVID 19 case fatality rate and HDI, schooling index and life expectancy. © 2021 Revista del Cuerpo Medico Hospital Nacional Almanzor Aguinaga Asenjo. All rights reserved.

Factors associated with psychological coping with covid-19 during quarantine period

Introduction: Although multiple clinical evidence is being generated about COVID-19, it is also critical to address the strategies and actions that people have adopted to face stressful situations during the mandatory quarantine due to the pandemic. Objective: To determine the factors associated with psychological coping to COVID-19 in the general population. Method: Analytical cross-sectional study. Participants were recruited through an online survey during the COVID-19 pandemic period. The level of passive and active coping was evaluated, using the coping scale against extreme risks. Additionally, using the mean of the passive and active coping scores, the association with sociodemographic variables, group membership, compliance with social isolation and the report of knowing someone diagnosed with COVID-19 was evaluated. Prevalence ratios (PR) were estimated using generalized linear models. Results: Of 463 participants, the majority was Peruvian (67,4 %), fully complying with social isolation measures (78,4 %). The mean active and passive coping scores were 54,1 and 30,3, respectively. 57,2 % and 54 % of the participants presented a level of active and passive coping above the mean, respectively. The factors associated with a high level of active coping were a high educational level (RP = 1,23) and complete compliance with social isolation measures (RP = 1,35). Conclusion: Having a high educational level and compliance with social isolation were positively associated with a high level of active coping. © 2020, Editorial Ciencias Medicas. All rights reserved.

Vaccination coverage in times of COVID-19: An analysis from social epidemiology in the region of Cusco

Introduction: The COVID-19 pandemic could have affected vaccination coverage. Objetive: Was to estimate vaccination coverage for the years 2018-2020 and to analyze the social, economic and educational conditions related to this indicator. Material and Methods: Social epidemiological study carried out in the Cusco region with a report of vaccination coverage in the years 2018-2020 for the period January - May and with economic and educational indicators for 2019. Rates of vaccination coverage were estimated (pentavalent, polio, pneumococcal and SPR) as well as inequality variables. Gap metrics were expressed through absolute Kuznets (ika) and relative Kuznets (ikr). Results: Of 112 districts, the vaccination coverage for the 4 vaccines were on average 39%, 38% and 24% for 2018, 2019 and 2020;respectively. Accumulated vaccination coverage is similar between 2018 and 2019 according to educational and economic stratifier, but in all quintiles of 2020 there was a decrease in coverage of approximately 40%. In the years 2019 and 2020 according to schooling, the absolute and relative differences between the extreme quintiles are reversed, with higher coverage in the quintiles with less schooling compared to those with higher schooling. Conclusion: There is a decrease in accumulated vaccination coverage rates for 2020 and they differ according to quintiles of schooling and income, which is attributed to the state of sanitary emergency due to COVID-19. It is critical to monitor recovery vaccination coverage activities to prevent outbreaks of immuno-preventable diseases.

Factors associated with non-adherence to antihypertensive treatment in a Social Security Health hospital in Chiclayo during the state of health emergency due to COVID-19

Background: Previous studies indicate poor therapeutic adherence in hypertensive patients, however, evidence on factors is limited. Objective: To determine the factors associated with non-adherence to antihypertensive treatment in a Social Health Security hospital in Chiclayo, Peru during November-December 2020. Material and Methods: Analytical cross-sectional study in adult patients with chronic diseases at Hospital I Naylamp, to whom the Morisky-Green questionnaire was applied to measure therapeutic adherence and the Bonilla and Gutiérrez instrument to evaluate factors that influence adherence to pharmacological treatment. Results: Of 234 participants, the non-adherence frequency was 52,7%, of these 68,7% were women and the main age was 71,82 + 9,15 years. In the simple regression, disease time was positively associated with non-adherence to treatment (RP: 1.02, 95%CI. Additionally, socio-economic factors related to the provider, therapy and patient were associated with a lower frequency of non-adherence to treatment. In multiple regression, people at risk of not developing treatment adherence behaviors due to socioeconomic factors (RP: 0.67, 95%CI: 0,50-0,91) and to factors related to provider (RP: 0.71, 95%CI:0,54-0,92) have lower frequency of non-adherence to treatment compared to those that haver adherence. Conclusion: 5 to 6 out of 10 patients presented non-adherence to their antihypertensive treatment. Socio-economic factors, provider-related factors and patient-related factors were associated with a lower frequency of not developing adherence behaviors to their treatment. © 2022 Columbia Data Analytics. All rights reserved.

Factors associated with seropositivity for SARS-CoV-2 in patients treated at a hospital in the Peruvian highlands

Background: COVID 19 is an infectious disease caused by SARS-CoV-2 that has affected Peru on a large scale. Potential clinical and/or epidemiological factors that are related to the positivity of SARS-CoV-2 in the high Andean population are not documented. Objective: To determine factors associated with positivity of SARS-CoV-2 in people living in Ancash. Material and methods: Analytical transversal study. We used the records of patients treated for suspected COVID-19 in a public hospital in Huaraz in March-May 2020. Prevalence ratios (PR) with confidence intervals were estimated. In simple regression analysis, prevalence ratios and 95% confidence intervals were estimated, using Poisson distribution family, log-link function and robust variance. Results: Out of 903 patients, 13.7% tested positive for SARS-CoV-2. In simple regression, male (RP=2.98), cough (RP=2.27), respiratory distress (RP=2.97), diarrhea (RP=2.69), general malaise (RP=1.82), odynophagia (RP=1.69) were positively associated with having a positive SARS-CoV-2 test. In the multiple regressions, the association was maintained in four characteristics: Being male (RP=2.7), having a cough (RP=1.45), respiratory distress (RP=2.15), and diarrhea (RP=1.89). Conclusion: In high Andean areas, most positive cases present typical symptoms. The factors associated with positivity were male sex and the presence of cough, respiratory difficulty and diarrhea. © 2021 Medical Body of the Almanzor Aguinaga Asenjo National Hospital.