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Am J Manag Care ; 27(11): e365, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1552170


This letter describes the experience of long-stay patients and provides a perspective of the need for more studies on outliers' impact on health care.

Hospitals, Teaching , Colombia , Humans , Length of Stay
Viruses ; 13(12)2021 11 29.
Article in English | MEDLINE | ID: covidwho-1542800


This review aims to explore the role and value of serology testing in the context of COVID-19 immunization policies in Latin American countries and the barriers and challenges to the adequate use and uptake of this tool. It builds on a review of the academic literature, evidence, and existing policies, and includes a multistage process of discussion and feedback by a group of five experts. Regional and country-level evidence and resources from five focus countries-Argentina, Brazil, Chile, Colombia, and Mexico-were collected and analyzed. This review contains an overview of (1) the impact of the SARS-CoV-2 pandemic, the variants of concern and current testing strategies, (2) the introduction of COVID-19 vaccination, (3) the potential use of serology testing to support immunization initiatives, (4) the current frameworks for the use of serology testing in the region, and (5) the barriers and challenges to implementing serology testing in the context of COVID-19 immunization policies, including a discussion on the potential actions required to address these barriers and facilitate the uptake of this strategy in the region. Stakeholders can use elements of this document to guide timely decision-making, raise awareness, and inspire further studies.

COVID-19 Serological Testing , COVID-19 Vaccines/immunology , COVID-19/prevention & control , Health Policy , Immunization/standards , Antibodies, Viral , Argentina , Brazil , COVID-19/diagnosis , COVID-19/immunology , Chile , Colombia , Humans , Latin America , Mexico , Pandemics , SARS-CoV-2 , Vaccination
Biomedica ; 41(Sp. 2): 86-102, 2021 10 15.
Article in English, Spanish | MEDLINE | ID: covidwho-1529016


INTRODUCTION: Immunological markers have been described during COVID-19 and persist after recovery. These immune markers are associated with clinical features among SARSCoV-2 infected individuals. Nevertheless, studies reporting a comprehensive analysis of the immune changes occurring during SARS-CoV-2 infection are still limited. OBJECTIVE: To evaluate the production of proinflammatory cytokines, the antibody response, and the phenotype and function of NK cells and T cells in a Colombian family cluster with SARS-CoV-2 infection. MATERIALS AND METHODS: Proinflammatory cytokines were evaluated by RT-PCR and ELISA. The frequency, phenotype, and function of NK cells (cocultures with K562 cells) and T-cells (stimulated with spike/RdRp peptides) were assessed by flow cytometry. Anti-SARS-CoV-2 antibodies were determined using indirect immunofluorescence and plaque reduction neutralization assay. RESULTS: During COVID-19, we observed a high proinflammatory-cytokine production and a reduced CD56bright-NK cell and cytotoxic response. Compared with healthy controls, infected individuals had a higher frequency of dysfunctional CD8+ T cells CD38+HLA-DR-. During the acute phase, CD8+ T cells stimulated with viral peptides exhibited a monofunctional response characterized by high IL-10 production. However, during recovery, we observed a bifunctional response characterized by the co-expression of CD107a and granzyme B or perforin. CONCLUSION: Although the proinflammatory response is a hallmark of SARS-CoV-2 infection, other phenotypic and functional alterations in NK cells and CD8+ T cells could be associated with the outcome of COVID-19. However, additional studies are required to understand these alterations and to guide future immunotherapy strategies.

Introducción. Se han descrito diferentes marcadores inmunológicos durante la COVID-19, los cuales persisten incluso después de la convalecencia y se asocian con los estadios clínicos de la infección. Sin embargo, aún son pocos los estudios orientados al análisis exhaustivo de las alteraciones del sistema inmunológico en el curso de la infección. Objetivo. Evaluar la producción de citocinas proinflamatorias, la reacción de anticuerpos, y el fenotipo y la función de las células NK y los linfocitos T en una familia colombiana con infección por SARS-CoV-2. Materiales y métodos. Se evaluaron las citocinas proinflamatorias mediante RT-PCR y ELISA; la frecuencia, el fenotipo y la función de las células NK (en cocultivos con células K562) y linfocitos T CD8+ (estimulados con péptidos spike/RdRp) mediante citometría de flujo, y los anticuerpos anti-SARS-CoV-2, mediante inmunofluorescencia indirecta y prueba de neutralización por reducción de placa. Resultados. Durante la COVID-19 hubo una producción elevada de citocinas proinflamatorias, con disminución de las células NK CD56bright y reacción citotóxica. Comparados con los controles sanos, los individuos infectados presentaron con gran frecuencia linfocitos T CD8+ disfuncionales CD38+HLA-DR-. Además, en los linfocitos T CD8+ estimulados con péptidos virales, predominó una reacción monofuncional con gran producción de IL-10 durante la fase aguda y una reacción bifuncional caracterizada por la coexpresión de CD107a y granzima B o perforina durante la convalecencia. Conclusión. Aunque la reacción inflamatoria caracteriza la infección por SARS-CoV-2, hay otras alteraciones fenotípicas y funcionales en células NK y linfocitos T CD8+ que podrían asociarse con la progresión de la infección. Se requieren estudios adicionales para entender estas alteraciones y guiar futuras estrategias de inmunoterapia.

COVID-19/immunology , Killer Cells, Natural , SARS-CoV-2/immunology , T-Lymphocytes , Adult , Antibodies, Viral/analysis , CD56 Antigen/immunology , Case-Control Studies , Colombia , Family Health , Granzymes/metabolism , Humans , Interleukin-10/metabolism , Interleukin-1beta/blood , Interleukin-6/blood , Interleukin-8/blood , K562 Cells , Killer Cells, Natural/cytology , Killer Cells, Natural/immunology , Lymphocyte Activation , Male , Middle Aged , Perforin/metabolism , Phenotype , Receptors, CCR7/metabolism , T-Lymphocytes/cytology , T-Lymphocytes/immunology , Tumor Necrosis Factor-alpha/blood , Young Adult
J Infect Dev Ctries ; 15(10): 1404-1407, 2021 10 31.
Article in English | MEDLINE | ID: covidwho-1518655


INTRODUCTION: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) affects mainly the lungs causing pneumonia and complications like acute respiratory distress syndrome. Pneumothorax is a rare manifestation of the disease. This report is a description of a series of patients with COVID-19 and spontaneous pneumothorax, some of them with associated pulmonary cysts. METHODOLOGY: Cases were collected retrospectively. We included clinical data from medical records and described radiologic findings. Patients that developed pneumothorax during mechanical ventilation were excluded. RESULTS: Ten cases were included in this report, nine of them were male. The median age of our series was 62 years (IQR = 57-68). The median days since the onset of symptoms until the development of pneumothorax was 27 (IQR = 17-31), most cases developed after the second week of the diagnosis of pneumonia. Two cases required invasive mechanical ventilation, but pneumothorax occurred after ventilator weaning. Three cases showed subpleural pulmonary cysts. CONCLUSIONS: Cysts and pneumothorax are rare manifestations of SARS-CoV-2 pneumonia with mechanisms not completely understood. This report highlights the role of CT scan in diagnosis of COVID-19 complications.

COVID-19/complications , Cysts/etiology , Lung/pathology , Pneumothorax/etiology , Aged , COVID-19/diagnostic imaging , COVID-19/epidemiology , Colombia/epidemiology , Cysts/diagnostic imaging , Cysts/epidemiology , Cysts/virology , Female , Humans , Lung/diagnostic imaging , Lung/virology , Male , Middle Aged , Pneumothorax/diagnostic imaging , Pneumothorax/epidemiology , Retrospective Studies , SARS-CoV-2/pathogenicity , Tomography, X-Ray Computed
Biomedica ; 41(Sp. 2): 118-129, 2021 10 15.
Article in English, Spanish | MEDLINE | ID: covidwho-1478424


INTRODUCTION: Breastfeeding has a protective effect against acute respiratory and diarrheal infections. There are psychological and social effects due to physical isolation in the population in the mother-child group. OBJECTIVE: To assess the impact on infant mortality due to a decrease in the prevalence of breastfeeding during 2020 due to the physical isolation against the SARS CoV-2 (COVID-19) pandemic in Colombia. MATERIALS AND METHODS: We used the population attributable risk approach taking into account the prevalence of breastfeeding and its potential decrease associated with the measures of physical isolation and the relative risk (RR) of the association between exclusive breastfeeding and the occurrence of acute infection consequences in the growth (weight for height) of children under the age of five through a mathematical modeling program. RESULTS: We found an increase of 11.39% in the number of cases of growth arrest in the age group of 6 to 11 months with a 50% decrease in breastfeeding prevalence, as well as an increase in the number of diarrhea cases in children between 1 and 5 months of age from 5% (5.67%) on, and an increased number of deaths in children under 5 years (9.04%) with a 50% decrease in the prevalence of exclusive breastfeeding. CONCLUSIONS: A lower prevalence of breastfeeding has an impact on infant morbidity and mortality in the short and medium-term. As a public health policy, current maternal and childcare strategies must be kept in order to reduce risks in the pediatric population.

Introducción. La lactancia materna tiene un efecto protector frente a infecciones respiratorias y diarreicas agudas. Hay efectos psicológicos y sociales por el aislamiento físico en la población en el grupo materno-infantil. Objetivo. Evaluar el eventual impacto en la mortalidad infantil de la disminución en la prevalencia de la lactancia materna durante el 2020 a causa del aislamiento físico por la pandemia del SARS CoV-2 (COVID-19) en Colombia. Materiales y métodos. Se utilizó el enfoque de riesgo atribuible poblacional, teniendo en cuenta la prevalencia de la lactancia materna y su potencial disminución asociada con las medidas de aislamiento físico y el riesgo relativo (RR) de la asociación entre la lactancia materna exclusiva y el efecto de la aparición de infecciones agudas en el crecimiento (peso para la altura) de niños menores de cinco años mediante un programa de modelamiento matemático. Resultados. Se registró un aumento del número casos de detención del crecimiento en el grupo etario de 6 a 11 meses de 11,39 % al disminuir en 50 % la prevalencia de la lactancia materna, así como un mayor número de casos por diarrea en los cinco primeros meses a partir del 5 % (5,67 %), y un incremento en el número de muertes en menores de 5 años (9,04 %) al disminuirse en 50 % la prevalencia de la lactancia materna. Conclusiones. Se registró un impacto en la morbilidad y la mortalidad infantil a corto y mediano plazo al disminuir la prevalencia en la lactancia materna. Como política pública en salud, deben mantenerse las estrategias actuales de atención materno-infantil para disminuir riesgos en la población infantil.

Breast Feeding/statistics & numerical data , COVID-19/epidemiology , Pandemics , Child Mortality , Child, Preschool , Colombia/epidemiology , Diarrhea, Infantile/epidemiology , Female , Growth Disorders/epidemiology , Humans , Infant , Infant Mortality , Models, Theoretical , Prevalence , SARS-CoV-2 , Social Isolation
BMC Palliat Care ; 20(1): 161, 2021 Oct 18.
Article in English | MEDLINE | ID: covidwho-1477412


BACKGROUND: Cancer patients' end-of-life care may involve complex decision-making processes. Colombia has legislation regarding provision of and access to palliative care and is the only Latin American country with regulation regarding euthanasia. We describe medical end-of-life decision-making practices among cancer patients in three Colombian hospitals. METHODS: Cancer patients who were at the end-of-life and attended in participating hospitals were identified. When these patients deceased, their attending physician was invited to participate. Attending physicians of 261 cancer patients (out of 348 identified) accepted the invitation and answered a questionnaire regarding end-of-life decisions: a.) decisions regarding the withdrawal or withholding of potentially life-prolonging medical treatments, b.) intensifying measures to alleviate pain or other symptoms with hastening of death as a potential side effect, and c.) the administration, supply or prescription of drugs with an explicit intention to hasten death. For each question addressing the first two decision types, we asked if the decision was fully or partially made with the intention or consideration that it may hasten the patient's death. RESULTS: Decisions to withdraw potentially life-prolonging treatment were made for 112 (43%) patients, 16 of them (14%) with an intention to hasten death. For 198 patients (76%) there had been some decision to not initiate potentially life-prolonging treatment. Twenty-three percent of patients received palliative sedation, 97% of all patients received opioids. Six patients (2%) explicitly requested to actively hasten their death, for two of them their wish was fulfilled. In another six patients, medications were used with the explicit intention to hasten death without their explicit request. In 44% (n = 114) of all cases, physicians did not know if their patient had any advance care directives, 26% (n = 38) of physicians had spoken to the patient regarding the possibility of certain treatment decisions to hasten death where this applied. CONCLUSIONS: Decisions concerning the end of life were common for patients with cancer in three Colombian hospitals, including euthanasia and palliative sedation. Physicians and patients often fail to communicate about advance care directives and potentially life-shortening effects of treatment decisions. Specific end-of-life procedures, patients' wishes, and availability of palliative care should be further investigated.

Decision Making , Neoplasms , Colombia , Death , Hospitals , Humans , Neoplasms/therapy , Surveys and Questionnaires
Rev Colomb Obstet Ginecol ; 72(2): 162-170, 2021 06 30.
Article in English, Spanish | MEDLINE | ID: covidwho-1456600


Objective: To make an approximation to the prevalence of sleep disorders in Colombian menopausal women during the COVID-19 pandemic Materials and Methods: Cross-sectional study as part of the Quality of Life in Menopause and Colombian Ethnic Groups research project [CAVIMEC+COVID STUDY]. The population consisted of women born and residing in Colombia, 40 to 59 years of age, who signed an informed consent and agreed to participate by completing an online form, freely and anonymously, in the first five days of June 2020. Sleep disorders were identified using the third item on the Menopause Rating Scale. Sociodemographic characteristics, presence and severity of sleep disorders and menopause status were explored. Descriptive statistics are provided. Results: Overall, 984 women aged 47.0 [IQR: 42.0-53.5] years were included: 84.5% mestizo, 13.7% Afro-Colombian, 1.7% indigenous; 39.3% were postmenopausal; 70% lived in the Caribbean region of Colombia. Sleep disorders were reported by 637 women (64.7%), and 112 (11.3%) had severe sleep disorders. Among postmenopausal women, 65.1% reported sleep disorders with 10.1% reporting severe disorders, while 64.5% of premenopausal reported sleep disorders, and 12.2% severe disorders. Conclusions: Sleep disorders could be a frequent problem among premenopausal as well as postmenopausal women in the pandemic time. This issue should be explored during gynecological visits in order to offer solutions. Population studies that confirm these observations are required.

COVID-19 , Sleep Wake Disorders/epidemiology , Adult , Colombia/epidemiology , Cross-Sectional Studies , Female , Humans , Menopause , Middle Aged , Prevalence
PLoS One ; 16(10): e0258402, 2021.
Article in English | MEDLINE | ID: covidwho-1456096


Mycobacterium tuberculosis (M. tuberculosis) was the pathogen responsible for the highest number of deaths from infectious diseases in the world, before the arrival of the COVID-19 pandemic. Whole genome sequencing (WGS) has contributed to the understanding of genetic diversity, the mechanisms involved in drug resistance and the transmission dynamics of this pathogen. The object of this study is to use WGS for the epidemiological and molecular characterization of M. tuberculosis clinical strains from Chinchiná, Caldas, a small town in Colombia with a high incidence of TB. Sputum samples were obtained during the first semester of 2020 from six patients and cultured in solid Löwenstein-Jensen medium. DNA extraction was obtained from positive culture samples and WGS was performed with the Illumina HiSeq 2500 platform for subsequent bioinformatic analysis. M. tuberculosis isolates were typified as Euro-American lineage 4 with a predominance of the Harlem and LAM sublineages. All samples were proven sensitive to antituberculosis drugs by genomic analysis, although no phenotype antimicrobial tests were performed on the samples, unreported mutations were identified that could require further analysis. The present study provides preliminary data for the construction of a genomic database line and the follow-up of lineages in this region.

Drug Resistance, Multiple, Bacterial , Genotype , Mycobacterium tuberculosis/genetics , Phylogeny , Tuberculosis, Multidrug-Resistant/genetics , Whole Genome Sequencing , Adult , Aged , COVID-19 , Colombia , Female , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2
Infect Genet Evol ; 95: 105038, 2021 11.
Article in English | MEDLINE | ID: covidwho-1433673


Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genetic diversity has the potential to impact the virus transmissibility and the escape from natural infection- or vaccine-elicited neutralizing antibodies. Here, representative samples from circulating SARS-CoV-2 in Colombia between January and April 2021, were processed for genome sequencing and lineage determination following the nanopore amplicon ARTIC network protocol and PANGOLIN pipeline. This strategy allowed us to identify the emergence of the B.1.621 lineage, considered a variant of interest (VOI) with the accumulation of several substitutions affecting the Spike protein, including the amino acid changes I95I, Y144T, Y145S and the insertion 146 N in the N-terminal domain, R346K, E484K and N501Y in the Receptor binding Domain (RBD) and P681H in the S1/S2 cleavage site of the Spike protein. The rapid increase in frequency and fixation in a relatively short time in Magdalena, Atlantico, Bolivar, Bogotá D.C, and Santander that were near the theoretical herd immunity suggests an epidemiologic impact. Further studies will be required to assess the biological and epidemiologic roles of the substitution pattern found in the B.1.621 lineage.

Amino Acid Substitution , COVID-19/epidemiology , Genome, Viral , Mutation , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , COVID-19/transmission , COVID-19/virology , Colombia/epidemiology , Epidemiological Monitoring , Evolution, Molecular , High-Throughput Nucleotide Sequencing , Humans , Phylogeny , Phylogeography , Protein Domains , SARS-CoV-2/classification , SARS-CoV-2/pathogenicity , Severity of Illness Index
Int J Med Inform ; 155: 104589, 2021 11.
Article in English | MEDLINE | ID: covidwho-1433353


BACKGROUND: During the COVID 19 pandemic, direct-to-consumer telehealth (DTC) services allowed patients real-time virtual access to healthcare providers, especially those with an established relationship. In Colombia, this care modality was implemented between 2019 and 2020, under national considerations, it was implemented for outpatient care in a highly complex university hospital in Cali, Colombia. METHODS: A descriptive study with prospective information collection was used to describe the implementation of the outpatient teleconsultation care model for patients. We constructed the clinical and process indicators with which we evaluated the model. FINDINGS: A total of 56,560 patients from our institution were treated by virtual outpatient consultation during the first nine months of the health emergency declared by COVID 19 in Colombia. The strategy made it possible to achieve coverage more significant than 100% in Cali and the departments of Colombia. Attention by teleconsultation was 19% of the total ambulatory care. The effectiveness in carrying out scheduled teleconsultations had an overall result of 91.5%. The accessibility results demonstrated the need to strengthen connectivity and accessibility to payments and strengthen technology adoption in the institution, health personnel, and patients. INTERPRETATION: Implementing an outpatient teleconsultation model allowed the continuity of the management with comprehensive coverage nationwide from a highly complex hospital in southwestern Colombia. The indicators' analysis should help strengthen the policies of access to telemedicine, especially with the consequences of the pandemic in low- and middle-income countries. Latin American evidence is necessary to establish the safety profile of telemedicine and the costs associated with the provision.

COVID-19 , Remote Consultation , Ambulatory Care , Colombia/epidemiology , Hospitals , Humans , Pandemics , Prospective Studies , SARS-CoV-2
Ann Clin Microbiol Antimicrob ; 20(1): 66, 2021 Sep 14.
Article in English | MEDLINE | ID: covidwho-1408349


BACKGROUND: To date, there is no specific antiviral therapy for severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) that causes Coronavirus disease 2019 (Covid-19). Since there is no specific therapy against SARS-CoV2, current efforts aim to prevent contagion through public health measures and develop a protective vaccine. While waiting for the latter, it is necessary to evaluate the drugs that at least, in initial studies, suggested some degree of utility in the management of Covid-19 or its complications. The main objective of the study was to describe the clinical manifestations and outcomes of patients with severe Covid-19 Pneumonia treated with corticosteroids and colchicine. MATERIALS AND METHODS: A cross sectional study of 301 adult patients with Covid-19 Pneumonia confirmed by Real-Time Polymerase Chain Reaction for SARS-CoV2 (RT-PCR SARS-CoV2), Berlin protocol, who required hospitalization in three hospitals in Antioquia, Colombia. Patients were treated according to the institutional protocol (from March 20, 2020 to June 30, 2020) with corticosteroid if the patient required supplemental oxygen. From July 1, 2020, the management protocol changed with the addition of colchicine to all patients admitted to the institutions. The treatment was supervised and monitored by the same specialist in Infectology of the institutions. We describe the clinical manifestations and outcomes of the patients who received these treatments. The information of the patients was analyzed according to the outcome of interest (alive/dead) with univariate, bivariate, and multivariate measures to adjust the variables that presented statistical association. RESULTS: All patients had pneumonia documented by chest computed tomography with ground glass images and presented an alveolar pressure/inspired oxygen fraction (PaFi) less than 300. Three hundred one patients were included, 240 (79.7%) received corticosteroids, within these 145 (48.2%) received colchicine also, and the remaining 61 (20.3%) patients did not receive corticosterioids or colchicine. Mortality in the group that received colchicine was lower compared to the group that did not receive it (9.6 vs 14.6%, p-value = 0.179). CONCLUSIONS: Treatment with corticosteroids and colchicine for managing patients with severe Covid-19 Pneumonia was associated with low mortality at the hospital level. Randomized, placebo-controlled studies are required to evaluate the effect of corticosteroids and colchicine on complications or death from Covid-19.

Adrenal Cortex Hormones/therapeutic use , COVID-19/drug therapy , Colchicine/therapeutic use , Adult , Aged , COVID-19/diagnosis , COVID-19 Nucleic Acid Testing , Colombia , Cross-Sectional Studies , Female , Hospitalization , Humans , Male , Middle Aged , RNA, Viral , SARS-CoV-2/drug effects , Treatment Outcome
rev. cuid. (Bucaramanga. 2010) ; 12(3): 1-14, 20210821.
Article in English | LILACS (Americas) | ID: covidwho-1395465


Introduction: This article shows an analysis of the evolution up until date (May 4-2021), of official coronavirus cases statistics (CC) and the total number of deaths (TND) due to SARS-CoV-2 in Colombia. Additionally, said information is shown in correlation to other variables such as Case Fatality Rate (CFR), age range of persons, their typical reported co-morbidities and the cities where there has been highest concentration of cases. Materials and Methods: From March 16 2020 until today, information regarding the daily number of new confirmed cases (DNC) and daily confirmed deaths (DD) was registered in a database with the purpose of estimating the evolution of CC, TND and CFR. The age of deceased was also registered, as well as their gender, prior co-morbidities and city of death. The evolution of TND with the time of other countries were compared to that of Colombia. A mathematical equation that represents the epidemiological curve of TND evolution of different countries across time was defined. Results: In Colombia, the average age of people who die due to COVID-19 is of 69.5±14.7 years (median and mode of 71 and 80 years, respectively), and the virus is less lethal amongst a population under the age of 40. The greater part of deaths have taken place in people with prior co-morbidities and of the male gender. Conclusion: Most of the persons that have deceased are those of senior age, mainly with prior co-morbidities, and predominantly of male gender. Epidemiological peaks of COVID-19 are consistent with the rainy and winter seasons, and with the traditional epidemiological peaks of flu or influenza.

Introducción: El artículo muestra un análisis de la evolución hasta la fecha (4 de mayo de 2021), de las estadísticas oficiales de casos de coronavirus (CC) y el número total de muertes (TND) por SARS-CoV-2 en Colombia. Dicha información se muestra en correlación con otras variables como son la tasa de casos fatales (CFR), el rango de edad de las personas, sus comorbilidades típicas reportadas y las ciudades donde ha habido mayor concentración de casos. Materiales y Métodos: En una base de datos fue registrada diariamente, desde el 16 de marzo de 2020 a la fecha, información concerniente al número diario de nuevos casos confirmados (DNC) y los fallecimientos diarios confirmados (DD). También se registró la edad de las personas fallecidas, así como su género, sus comorbilidades previas y ciudad de deceso. La evolución del TND con el tiempo de diferentes países fueron modelados matemáticamente y comparados con el de Colombia. Resultados: En Colombia, la edad promedio de las personas que mueren por COVID-19 es de 69.5±14.7 años (mediana y moda de 71 y 80 años, respectivamente) y el virus es menos letal en la población menor de 40 años. La mayor parte de las muertes se han producido en personas con comorbilidades previas y del género masculino. Conclusión: La mayoría de las personas fallecidas son personas de edad avanzada, principalmente con comorbilidades previas, y predominantemente de sexo masculino. Los picos epidemiológicos de COVID-19 son consistentes con las temporadas de lluvias e invierno, y con los picos epidemiológicos tradicionales de gripe o influenza.

Introdução: O artigo mostra uma análise da evolução até o momento (4 de maio de 2021) das estatísticas oficiais de casos de coronavírus (CC) e do número total de mortes (TND) por SARS-CoV-2 na Colômbia. Além disso, essa informação se mostra em correlação com outras variáveis ​​como a taxa de casos fatais (CFR), a faixa etária das pessoas, suas comorbidades típicas relatadas e os municípios onde houve maior concentração de casos. Materiais e Métodos: Em um banco de dados, as informações referentes ao número diário de casos novos confirmados (DNC) e óbitos diários confirmados (DD) foram registradas diariamente, de 16 de março de 2020 até a data, para cálculo da evolução do CC, TND e CFR. Também foi registrada a idade do falecido, gênero, comorbidades anteriores e cidade do falecimento. A evolução do TND ao longo do tempo de outros países foi comparada com a da Colômbia. Foi definida uma equação matemática que representa a evolução do TND nos diferentes países ao longo do tempo. Resultados: Na Colômbia, a idade média das pessoas que morrem por COVID-19 é de 69.5±14.7 anos (mediana e moda de 71 e 80 anos, respectivamente), e o vírus é menos letal entre uma população com menos de 40 anos. A maior parte das mortes ocorreu em pessoas com comorbidades anteriores e do gênero masculino. Conclusão: A maioria das pessoas que faleceram são idosos, principalmente com comorbidades prévias, e predominantemente do sexo masculino. Os picos epidemiológicos de COVID-19 são consistentes com as estações chuvosa e de inverno e com os picos epidemiológicos tradicionais de gripe ou influenza.

Humans , Male , Female , Colombia , SARS-CoV-2 , COVID-19
Int J Environ Res Public Health ; 17(23)2020 12 03.
Article in English | MEDLINE | ID: covidwho-1389353


This is a mixed-methods research study carried out on a cohort of airport workers during the SARS-CoV-2 pandemic. We used quantitative and qualitative methods to describe the infection and risk perception of SARS-CoV-2 in a cohort of workers at the International Airport El Dorado/Luis Carlos Galán Sarmiento in Bogotá, Colombia. An incidence of SARS-CoV-2 infection of 7.9% was found in the workers. A high perception of risk was associated with activities such as using public transport. Risk perception is strongly influenced by practices related to work conditions and environments. These findings could help us understand the pandemic's dynamics and the conceptions of the risk of transmission to promote policies on health and safety in this group of workers.

Airports , COVID-19/epidemiology , Risk Assessment , Adult , Colombia/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2
PLoS One ; 16(9): e0256566, 2021.
Article in English | MEDLINE | ID: covidwho-1381283


BACKGROUND: Adequate testing is critically important for control of the SARS-CoV-2 pandemic. Antibody testing is an option for case management and epidemiologic studies, with high specificity and variable sensitivity. However, characteristics of local populations may affect performance of these tests. For this reason, the National Institute of Health (INS) and regulatory agencies in Colombia require verification of diagnostic accuracy of tests introduced to the Colombian market. METHODS: We conducted a validation study of the Abbott SARS-CoV-2 test for qualitative detection of IgG using the Abbott Architect i2000SR. Participants and retrospective samples were included from patients with suspected SARS-CoV-2 infection, age ≥18 years, and ≥8 days elapsed since initiation of symptoms. Pre-pandemic plasma samples (taken before October 2019) were used as controls. We estimated the sensitivity, specificity and agreement (kappa) of the Abbott IgG test compared to the gold standard (RT-PCR). RESULTS: The overall sensitivity was 83.1% (95% CI: 75.4-100). Sensitivity among patients with ≥14 days since the start of symptoms was 85.7%, reaching 88% in samples collected from patients with COVID-19 symptoms onset >60 days. Specificity was 100% and the kappa index of agreement was 0.804 (95% CI: 0.642-0.965). CONCLUSIONS: Our findings show high sensitivity and specificity of the Abbott IgG test in a Colombian population, which meet the criteria set by the Colombian INS to aid in the diagnosis of COVID-19. Data from our patient groups also suggest that IgG response is detectable in a high proportion of individuals (88.1%) during the first two months following onset of symptoms.

Antibodies, Viral/blood , COVID-19 Serological Testing/instrumentation , COVID-19/blood , Immunoglobulin G/blood , Pandemics , SARS-CoV-2/metabolism , Adult , Aged , COVID-19/epidemiology , Colombia/epidemiology , Female , Humans , Male , Middle Aged , Prospective Studies , Retrospective Studies , Sensitivity and Specificity
Int J Environ Res Public Health ; 18(8)2021 04 08.
Article in English | MEDLINE | ID: covidwho-1378334


This study explored the general and oral health perceptions in the Venezuelan immigrant population in Medellín (Colombia) and its conditioning factors. A qualitative study involving Venezuelan immigrants ≥18 years with a minimum stay of six months in Colombia was conducted. Dentists, dental students, and other health professionals also participated. Semi-structured interviews (n = 17), focus groups (n = 2), and key informants' interviews (n = 4) were utilized. The interviews and focus groups were recorded and transcribed for later narrative content analysis. A high degree of vulnerability of participants was found due to the precarious living conditions from the premigratory moment and the lack of job placement possibilities at the time of settling in Colombia, where the migratory status played a fundamental role. Among the perceived needs, the mitigation of noncommunicable diseases stood out. Poor mental health symptoms (depression and anxiety) were perceived, and oral health was not a priority. Barriers to accessing health and dental care were found. The migrant condition was found to be a determinant that affected physical, mental, and oral health and the provision of health care. This situation is of interest to the construction of public health policies that guarantee access to fundamental rights.

Emigrants and Immigrants , Colombia , Focus Groups , Health Services Accessibility , Humans , Perception , Qualitative Research
BMC Infect Dis ; 21(1): 878, 2021 Aug 27.
Article in English | MEDLINE | ID: covidwho-1376574


BACKGROUND: Healthcare Workers (HCW) are repeatedly exposed to SARS-CoV-2 infection. The aim of this study was to identify factors associated with SARS-CoV-2 infection among HCW in one of the largest cities in Colombia. METHODS: We conducted a case-control study, where cases had a positive reverse transcription-polymerase chain reaction and controls had a negative result. Participants were randomly selected and interviewed by phone. Analyses were performed using logistic regression models. RESULTS: A total of 110 cases and 113 controls were included. Men (AdjOR 4.13 95% CI 1.70-10.05), Nurses (AdjOR 11.24 95% CI 1.05-119.63), not using a high-performance filtering mask (AdjOR 2.27 95% CI 1.02-5.05) and inadequate use of personal protective equipment (AdjOR 4.82 95% CI 1.18-19.65) were identified as risk factors. Conversely, graduate (AdjOR 0.06 95% CI 0.01-0.53) and postgraduate (AdjOR 0.05 95% CI 0.005-0.7) education, feeling scared or nervous (AdjOR 0.45 95% CI 0.22-0.91), not always wearing any gloves, caps and goggles/face shields (AdjOR 0.10 95% CI 0.02-0.41), and the use of high-performance filtering or a combination of fabric plus surgical mask (AdjOR 0.27 95% CI 0.09-0.80) outside the workplace were protective factors. CONCLUSION: This study highlights the protection provided by high-performance filtering masks or double masking among HCW. Modifiable and non-modifiable factors and the difficulty of wearing other protective equipment needs to be considered in designing, implementing and monitoring COVID-19 biosafety protocols for HCW.

COVID-19 , SARS-CoV-2 , Case-Control Studies , Colombia/epidemiology , Health Personnel , Humans , Male