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1.
Front Public Health ; 9: 734065, 2021.
Article in English | MEDLINE | ID: covidwho-1591400

ABSTRACT

Background: In an elderly population with hypertension, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a higher incidence of mortality and a protracted course of clinical symptoms. Objective: To assess the perceived risk of infection and complications due to COVID-19 in people with hypertension living in a semi-urban city of Ecuador. Methods: A cross-sectional telephone survey of adult outpatients with a previous diagnosis of hypertension in the semi-urban community of Conocoto in Quito, Ecuador was conducted from August to December 2020. Results: A total of 260 adult outpatients, aged 34-97 years, completed telephone surveys. Of total, 71.5% (n = 186) of respondents were women and 28.5% (n = 74) of respondents were men. Overall, 18.1% believe that their risk of infection is "very high," 55.4% believe that their risk of infection is "high," 21.5% believe that their risk of infection is "low," and 5% believe that their risk of infection is "very low." The perceived risk of complications, if infected by COVID-19, revealed that 21.9% believe that their risk of complication is "very high," 65.0% believe that their risk of complication is "high," 10.4% believe that their risk of complication is "low," and 2.7% believe that their risk of complication is "very low." Conclusion: Patients with hypertension are aware of the risks posed by COVID-19 infection and its impact on their health. However, the health system must educate the population on health practices and behaviors to avoid COVID-19 infection until the majority of the population of Ecuador can be vaccinated.


Subject(s)
COVID-19 , Hypertension , Adult , Aged , Cross-Sectional Studies , Ecuador/epidemiology , Female , Health Knowledge, Attitudes, Practice , Humans , Hypertension/epidemiology , Male , Perception , SARS-CoV-2
2.
High Alt Med Biol ; 22(4): 406-416, 2021 12.
Article in English | MEDLINE | ID: covidwho-1569559

ABSTRACT

Ortiz-Prado, Esteban, Raul Patricio Fernandez Naranjo, Eduardo Vasconez, Katherine Simbaña-Rivera, Trigomar Correa-Sancho, Alex Lister, Manuel Calvopiña, and Ginés Viscor. Analysis of excess mortality data at different altitudes during the COVID-19 outbreak in Ecuador. High Alt Med Biol. 22:406-416, 2021. Background: It has been speculated that living at high altitude confers some risk reduction in terms of SARS-CoV-2 infection, reduced transmissibility, and arguable lower COVID-19-related mortality. Objective: We aim to determine the number of excess deaths reported in Ecuador during the first year of the COVID-19 pandemic in relation to different altitude categories among 221 cantons in Ecuador, ranging from sea level to 4,300 m above. Methods: A descriptive ecological country-wide analysis of the excess mortality in Ecuador was performed since March 1, 2020, to March 1, 2021. Every canton was categorized as lower (for altitudes 2,500 m or less) or higher (for altitudes >2,500 m) in a first broad classification, as well as in two different classifications: The one proposed by Imray et al. in 2011 (low altitude <1,500 m, moderate altitude 1,500-2,500 m, high altitude 2,500-3,500 m, or very high altitude 3,500-5,500 m) and the one proposed by Bärtsch et al. in 2008 (near sea level 0-500 m, low altitude 500-2,000 m, moderate altitude 2,000-3,000 m, high altitude 3,000-5,500 m, and extreme altitude 5,500 m). A Poisson fitting analysis was used to identify trends on officially recorded all-caused deaths and those attributed to COVID-19. Results: In Ecuador, at least 120,573 deaths were recorded during the first year of the pandemic, from which 42,453 were catalogued as excessive when compared with the past 3 years of averages (2017-2019). The mortality rate at the lower altitude was 301/100,000 people, in comparison to 242/100,000 inhabitants in elevated cantons. Considering the four elevation categories, the highest excess deaths came from towns located at low altitude (324/100,000), in contrast to the moderate altitude (171/100,000), high-altitude (249/100,000), and very high-altitude (153/100,000) groups. Conclusions: This is the first report on COVID-19 excess mortality in a high-altitude range from 0 to 4,300 m above sea level. We found that absolute COVID-19-related excess mortality is lower both in time and in proportion in the cantons located at high and very high altitude when compared with those cantons located at low altitude.


Subject(s)
COVID-19 , Altitude , Ecuador/epidemiology , Humans , Pandemics , SARS-CoV-2
3.
BMC Public Health ; 21(1): 2079, 2021 11 12.
Article in English | MEDLINE | ID: covidwho-1515441

ABSTRACT

BACKGROUND: The SARS-CoV-2/COVID-19 pandemic has claimed nearly 900,000 lives worldwide and infected more than 27 million people. Researchers worldwide are studying ways to decrease SARS-CoV-2 transmission and COVID-19 related deaths. Several studies found altitude having a negative association with both COVID-19 incidence and deaths. Ecuadorian data was used to explore the relationship between altitude and COVID-19. METHODS: This is an ecological study examining province-level data. To explore a relationship between altitude and COVID-19, this study utilized publicly available COVID-19 data and population statistics. ANOVA, correlation statistics, and a multivariate linear model explored the relationship between different Ecuadorian altitudes against incidence, mortality, and case-fatality rates. Population statistics attributed to COVID-19 were included in the linear model to control for confounding factors. RESULTS: Statistically significant differences were observed in the regions of Amazónica, Sierra, Costa of Ecuador for incidence, mortality, and case fatality rates, suggesting an association between altitude and SARS-CoV-2 transmission and COVID-19 disease severity (p-value ≤0.05). In univariate analysis, altitude had a negative association to mortality rate with a 1-unit change in altitude resulting in the decrease of 0.006 units in mortality rate (p-value = 0.03). The multiple linear models adjusted for population statistics showed a statistically significant negative association of altitude with mortality rate (p-value = 0.01) with a 1-unit change in altitude resulting in the decrease in mortality rate by 0.015 units. Overall, the model helped in explaining 50% (R2 = 0.4962) of the variance in mortality rate. CONCLUSION: Altitude may have an effect on COVID-19 mortality rates. However, based on our model and R2 value, the relationship between our variables of interest and COVID-19 mortality may be nonlinear. More research is needed to understand why altitude may have a protective effect against COVID-19 mortality and how this may be applicable in a clinical setting.


Subject(s)
Altitude , COVID-19 , Ecuador/epidemiology , Humans , Pandemics , SARS-CoV-2
4.
Placenta ; 115: 146-150, 2021 11.
Article in English | MEDLINE | ID: covidwho-1514252

ABSTRACT

There is inadequate screening for SARS-COV-2 during pregnancy. We aimed to determine the impact of maternal and neonatal cord blood SARS-COV-2 antibodies and placental transfer ratios in a region with a low screening plan. We performed a blind study in one of the SARS-CoV-2 epicenters in South America. 32% of pregnant women were serological positive. Importantly, there is an efficient passive immunization of the fetus to SARS-CoV-2. We report high incidence of SARS-CoV-2 infection during pregnancy, which is higher than officially reported. Therefore the need of active immunization to enhance maternal protection and fetal passive immunization.


Subject(s)
COVID-19/epidemiology , Fetal Blood/immunology , Pregnancy Complications, Infectious/epidemiology , SARS-CoV-2/immunology , Adolescent , Adult , Antibodies, Viral/blood , COVID-19/blood , COVID-19/immunology , Ecuador/epidemiology , Female , Fetal Blood/metabolism , Humans , Immunization, Passive/statistics & numerical data , Immunoglobulin G/blood , Immunoglobulin M/blood , Incidence , Infant, Newborn , Infectious Disease Transmission, Vertical/statistics & numerical data , Male , Middle Aged , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/immunology , Seroepidemiologic Studies , Young Adult
5.
J Prim Care Community Health ; 12: 21501327211054989, 2021.
Article in English | MEDLINE | ID: covidwho-1496103

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic is affecting millions of people living in rural areas of Low- and Middle-Income Countries and is causing an already anticipated devastating effect on the health and economics of these populations. More information is needed to modify behaviors that may counterbalance the consequences of mass spread of the virus in these underserved communities. This study aimed to identify factors associated with a persistent SARS-CoV-2 seronegative status 1 year after a massive infection outbreak in middle-aged and older adults living in rural Ecuador. METHODS: Individuals enrolled in the Atahualpa Project Cohort as of March 2020 received 5 rounds of tests for determination of SARS-CoV-2 antibodies in blood. Individuals who remained seronegative up to April 2021 were considered "persistently seronegative." An adjusted Poisson regression model was fitted to estimate the incidence risk ratio of factors directly or inversely associated with a persistent seronegative status. RESULTS: A total of 673 individuals received baseline tests. Thirty-one declined consent or died and 429 seroconverted, leaving 213 seronegative subjects. Average SARS-CoV-2 incidence rate was 9.87 events (95% C.I.: 8.91-10.83) per 100 person-months of observation. The use of flushing toilet systems (instead of open latrines) increased 1.5 times the possibility of remaining seronegative. Likewise, every additional bedroom in the house increased by 15% the possibility of remaining seronegative. In contrast, every additional person in the house and having high cholesterol levels significantly reduced the possibility of remaining seronegative. CONCLUSIONS: The use of flushing toilet systems and the number of bedrooms in the house directly influenced the possibility of remaining seronegative among individuals living in this rural setting. Study results also demonstrated a sustained transmission of the virus even after a significant proportion of the population has been infected. Our findings reinforce the mass spread of SARS-CoV-2 in rural communities.


Subject(s)
COVID-19 , SARS-CoV-2 , Aged , Ecuador/epidemiology , Humans , Middle Aged , Pandemics , Prospective Studies , Rural Population
6.
BMJ Open ; 11(11): e052971, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1495469

ABSTRACT

INTRODUCTION: Asthma is a common long-term disorder and strategies to improve asthma control are still a challenge. Integrated delivery of health systems is critical for effective asthma care: there is limited information on experiences of care coordination for asthma from Latin America, especially on perspectives of health personnel and in the context of the COVID-19 pandemic. METHODS AND ANALYSIS: This protocol details a qualitative approach to analyse health workers' perspectives of healthcare coordination for asthma control during COVID-19 pandemic in Ecuador and Brazil, at primary and specialised levels, through in-depth semistructured interviews using a video communications platform. The analysis will identify knowledge and perspectives based on coordination of clinical information, clinical management and administrative coordination. Theoretical sampling will be used to obtain approximately equal numbers of women and men within each level of healthcare; data saturation will be used to determine sample size. Transcripts will be analysed using content-coding procedures to mark quotations related to major topics and subthemes included in the interview guide, and narrative analysis will be based on a theoretical framework for healthcare coordination to identify new themes and subthemes. ETHICS AND DISSEMINATION: Ethical approval was obtained from the ethics committees of Hospital General Docente Calderón, Quito, Ecuador; and Universidade Federal da Bahia, Salvador, Brazil. The findings of this study will be disseminated through peer-reviewed articles, conference presentations and condensed summaries for key stakeholders and partners.


Subject(s)
Asthma , COVID-19 , Asthma/epidemiology , Asthma/therapy , Brazil/epidemiology , Delivery of Health Care , Ecuador/epidemiology , Female , Health Personnel , Humans , Male , Pandemics , Qualitative Research , SARS-CoV-2
7.
BMJ Glob Health ; 6(9)2021 Sep.
Article in English | MEDLINE | ID: covidwho-1443585

ABSTRACT

Latin America has struggled to control the transmission of COVID-19. Comparison of excess death (ED) rates during the pandemic reveals that Ecuador is among the highest impacted countries. In this analysis, we update our previous findings with the most complete all-cause mortality records available for 2020, disaggregated by sex, age, ethnicity and geography. Our study shows that in 2020, Ecuador had a 64% ED rate (95% CI 63% to 65%) or 64% more deaths than expected. Men had a higher ED rate, 75% (95% CI 73% to 76%), than women's 51% (95% CI 49% to 52%), and this pattern of higher EDs for men than women held for most age groups. The only exception was the 20-29 age group, where women had 19% more deaths, compared to 10% more deaths for men, but that difference is not statistically significant. The analysis provides striking evidence of the lack of COVID-19 diagnostic testing in Ecuador: the confirmed COVID-19 deaths in 2020 accounted for only 21% of total EDs. Our significant finding is that indigenous populations, who typically account for about 5% of the deaths, show almost four times the ED rate of the majority mestizo group. Indigenous women in each age group have higher ED rates than the general population and, in ages between 20 and 49 years, they have higher ED rates than indigenous men. Indigenous women in the age group 20-29 years had an ED rate of 141%, which is commensurate to the ED rate of indigenous women older than 40 years.


Subject(s)
COVID-19 , Adult , COVID-19 Testing , Ecuador/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Young Adult
8.
PLoS One ; 16(9): e0257661, 2021.
Article in English | MEDLINE | ID: covidwho-1435619

ABSTRACT

BACKGROUND: The effects of the COVID 19 pandemic on the mental health of citizens from Asia, Europe, or North America begin to be known, but there are fewer publications on its effects in Latin American countries. In this study, its impact in Ecuador is described, with data collected during the first phase of the pandemic. The objective of this study was to analyse the level of psychological distress in the population of Ecuador during the first phase of the COVID-19 pandemic. METHODS AND FINDINGS: Cross-sectional observational study. The questionnaires were collected through an online self-developed questionnaire, between April 2 and May 17, 2020, using the non-probabilistic sampling methodology: snowball method. The variables considered were sociodemographic variables, physical symptoms, health status, COVID-19 contact history, preventive measures, and the General Health Questionnaire (GHQ-12). The percentage with high psychological distress (PD) (GHQ-12 ≥ 3) has been somewhat lower than that found in Europe, being women, young people, people with higher level of education, living without a partner, not living with children or children under 16 years of age, and with worse perception of health the groups with the highest PD. Differences have been observed with European studies regarding common symptoms, preventive measures to avoid contagion, percentage of infected relatives, or diagnostic tests performed. CONCLUSIONS: The use of the same research instrument, validated in Europe and adapted to Ecuador, has facilitated the comparison of the found results and differences, which can be explained by socio-economic or cultural variables, the health system, level of information, or by preventive measures put in place to prevent the pandemic.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Pandemics/statistics & numerical data , Psychological Distress , Adolescent , Adult , Child , Cross-Sectional Studies , Ecuador/epidemiology , Female , Humans , Male , Surveys and Questionnaires , Young Adult
9.
Sleep ; 44(8)2021 08 13.
Article in English | MEDLINE | ID: covidwho-1388020

ABSTRACT

STUDY OBJECTIVES: This study assessed changes in sleep quality before and after the peak of the SARS-CoV-2 pandemic in community dwellers enrolled in the Atahualpa Project. METHODS: Atahualpa residents aged ≥40 years were eligible if they had a Pittsburgh Sleep Quality Index (PSQI) 9 months before the pandemic and a lateral flow-based test for identification of SARS-CoV-2 antibodies during the peak of the pandemic. Six months later, individuals completed a follow-up PSQI. The independent relationship between SARS-CoV-2 infection and deterioration in sleep quality was assessed by fitting logistic mixed models for longitudinal data. RESULTS: Of 639 participants (mean age at baseline: 59 ± 12.8 years), 325 (51%) had SARS-CoV-2 antibodies. A total of 185 (29%) individuals at baseline and 311 (49%) at follow-up were poor sleepers (p < 0.001). Mixed logistic regression models demonstrated a significant increase in poor sleepers at follow-up (odds ratio [OR]: 2.85; 95% CI: 2.16 to 3.75), which was more marked among SARS-CoV-2 seropositive subjects (OR: 3.8; 95% CI: 2.48 to 5.81). The adjusted proportion of poor sleepers increased from 29% to 56.2% (95% CI: 50.9% to 61.6%) among SARS-CoV-2 seropositive individuals, but only to 40.7% (95% CI: 35.3% to 46.1%) in their seronegative counterparts (p < 0.001). Likewise, progression from a good to a poor sleeper status was higher among seropositive individuals than in their seronegative counterparts (38.1% vs 22.3%; p < 0.001), after adjusting for relevant covariates. CONCLUSIONS: This study shows a deleterious effect of SARS-CoV-2 in sleep quality. An effect of SARS-CoV-2 in disrupting sleep-related pathways cannot be ruled out. TRIAL REGISTRATION: The Atahualpa Project has been registered at ClinicalTrials.gov; the identifier number is NCT01627600, and the date was: 10/02/2012 (https://clinicaltrials.gov/ct2/show/NCT01627600?cond=Atahualpa&draw=2&rank=1). The Sleep Disorders substudy has been registered at ClinicalTrials.gov; the identifier number is NCT01877616, and the date was: 06/13/2013 (https://clinicaltrials.gov/ct2/show/NCT01877616?cond=Atahualpa&draw=2&rank=4).


Subject(s)
COVID-19 , SARS-CoV-2 , Aged , Ecuador/epidemiology , Humans , Middle Aged , Pandemics , Prospective Studies , Sleep
10.
Int J Environ Res Public Health ; 18(16)2021 08 18.
Article in English | MEDLINE | ID: covidwho-1360761

ABSTRACT

Adherence to preventive measures is influenced by people's knowledge, attitudes and practices towards a disease; therefore, assessing knowledge of COVID-19 is critical in the overall effort to contain the outbreak. This cross-sectional study was conducted among undergraduates (n = 3621) of different programs and different levels of education associated with universities in north-central Ecuador. The form consisted of 32 questions covering demographics, symptoms, detection, treatment, transmission, prevention and knowledge of the virus. The rate of correct answers was 75.5% (21.1 ± 5 out of 28), with differences observed regarding program of study, educational level and location of institution (α = 0.05), although effect size analyses showed that these differences could not be considered large. Multiple linear regression analyses showed that lower scores were associated with initial stages of education, careers related to social sciences and location of institution. Participants possessed sufficient knowledge about detection, transmission and prevention, although they overestimated fatality rate and were less confident about the characteristics of the virus and the effectiveness of traditional medicine. Consequently, future educational programs must place emphasis on addressing deficient knowledge. Certainly, improving COVID-19 literacy will promote the appropriate application of protective measures aimed at preventing the virus' spread.


Subject(s)
COVID-19 , Cross-Sectional Studies , Ecuador/epidemiology , Health Knowledge, Attitudes, Practice , Humans , SARS-CoV-2 , Students , Surveys and Questionnaires
11.
Int J Infect Dis ; 108: 531-536, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1351706

ABSTRACT

BACKGROUND: One of the constraints in containing the impact of the COVID-19 pandemic in Ecuador is limited testing capacity, especially in high-risk populations such as people living in humanitarian shelters. OBJECTIVES: The "United Nations High Commissioner for Refugees" office in Ecuador in collaboration with "Universidad de Las Américas" performed surveillance screening at shelters for women victims of gender-based violence. They had been granted access to RT-qPCR tests for SARS-CoV-2 diagnosis since July 2020, a few weeks after the general population lockdown was lifted. RESULTS: From 411 people tested, 52 tests were SARS-CoV-2 positive, yielding an overall high attack rate of 12.65%. Moreover, COVID-19 outbreaks were found in nine of 11 shelters that were included in the study. While attacks rates varied among shelters, no association was found with occupancy. CONCLUSION: This study is key to clarifying the epidemiological situation in this highly vulnerable population in Latin America. It highlights the importance of mass testing beyond the symptomatic population to prevent the spread of COVID-19.


Subject(s)
COVID-19 , Gender-Based Violence , COVID-19 Testing , Communicable Disease Control , Disease Outbreaks , Ecuador/epidemiology , Female , Humans , Pandemics , SARS-CoV-2
12.
Int J Infect Dis ; 108: 53-56, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1351683

ABSTRACT

OBJECTIVES: To date, reported SARS-CoV-2 reinfection cases are mainly from strains belonging to different clades. As the pandemic advances, a few lineages have become dominant in certain areas leading to reinfections by similar strains. Here, we report a reinfection case within the same clade of the initial infection in a symptomatic 28-year-old-male in Quito-Ecuador. METHODS: Infection was detected by reverse transcription-polymerase chain reaction, and immune response evaluated by antibody testing. Whole-genome sequencing was performed and phylogenetic analysis conducted to determine relatedness. RESULTS: Both the infection and the reinfection strains were assigned as Nextstrain 20B, Pangolin lineage B.1.1 and GISAID clade O. Our analysis indicated 4-6 fold more nucleotide changes than are expected for reactivation or persistence compared with the natural rate of SARS-CoV-2 mutation (∼2-3 nucleotide changes per month), thus supporting reinfection. Furthermore, approximately 3 months after the second infection, COVID-19 antibodies were not detectable in the patient, suggesting potential vulnerability to a third infection. CONCLUSIONS: Our results showed evidence of SARS-CoV-2 reinfection within the same clade in Ecuador, indicating that previous exposure to SARS-CoV-2 does not guarantee immunity in all cases.


Subject(s)
COVID-19 , SARS-CoV-2 , Adult , Ecuador/epidemiology , Humans , Male , Phylogeny , Reinfection
13.
Rev Colomb Psiquiatr (Engl Ed) ; 50(3): 166-175, 2021.
Article in English, Spanish | MEDLINE | ID: covidwho-1347800

ABSTRACT

INTRODUCTION: Since the emergence of the novel coronavirus disease (COVID-19), the world has faced a pandemic with consequences at all levels. In many countries, the health systems collapsed and healthcare professionals had to be on the front line of this crisis. The adverse effects on the mental health of healthcare professionals have been widely reported. This research focuses on identifying the main factors associated with adverse psychological outcomes. METHODS: Descriptive, cross-sectional study based on surveys, applying the PHQ-9, GAD-7, ISI and EIE-R tests to healthcare professionals from Ecuador during the COVID-19 pandemic. RESULTS: 1028 participants, distributed in: 557 physicians (54.18%), 349 nurses (33.94%), 29 laboratory workers (2.82%), 27 paramedics (2.62%), 52 psychologists (5.05%) and 14 respiratory therapists (1.36%), from 16 of the 24 provinces of Ecuador. Of these, 27.3% presented symptoms of depression, 39.2% anxiety symptoms, 16.3% insomnia and 43.8% symptoms of PTSD, with the 4 types of symptoms ranging from moderate to severe. The most relevant associated factors were: working in Guayas (the most affected province) (OR = 2.18 for depressive symptoms and OR = 2.59 for PTSD symptoms); being a postgraduate doctor (OR = 1.52 for depressive symptoms and OR = 1.57 for insomnia), perception of not having the proper protective equipment (OR = 1.71 for symptoms of depression and OR = 1.57 for symptoms of anxiety) and being a woman (OR = 1.39 for anxiety). CONCLUSIONS: Healthcare professionals can suffer a significant mental condition that may require psychiatric and psychological intervention. The main associated factors are primarily related to living and working in cities with a higher number of cases and the characteristics of the job, such as being a postgraduate doctor, as well as the perception of security. The main risk factors are primarily related to geographical distribution and job characteristics, such as being a resident physician and self-perception of safety. Further studies are required as the pandemic evolves.


Subject(s)
COVID-19/psychology , Health Personnel/psychology , Mental Disorders/etiology , Occupational Diseases/etiology , Adolescent , Adult , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Ecuador/epidemiology , Female , Health Surveys , Humans , Logistic Models , Male , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Middle Aged , Occupational Diseases/diagnosis , Occupational Diseases/epidemiology , Pandemics/prevention & control , Psychological Tests , Risk Factors , Young Adult
15.
J Am Geriatr Soc ; 69(10): 2722-2731, 2021 10.
Article in English | MEDLINE | ID: covidwho-1268124

ABSTRACT

OBJECTIVE: To assess the association between SARS-CoV-2 infection and decreased hand grip strength (HGS). DESIGN: Longitudinal population-based study. SETTING: Community-dwelling older adults (aged ≥60 years) living in a rural Ecuadorian village struck by the SARS-CoV-2 pandemic. PARTICIPANTS: Of 282 enrolled individuals, 254 (90%) finished the study. MEASUREMENTS: HGS was measured 3 months before (January 2020) and 9 months after the introduction of the virus into the population (January 2021). SARS-CoV-2 antibody testing was performed in two rounds: in May-June (early) and September-November (late), 2020. An independent association between SARS-CoV-2 infection and HGS decline was assessed by fitting linear mixed models for longitudinal data. Changes in HGS scores in SARS-CoV-2 seropositive subjects, according to the time elapsed since seroconversion, were compared with those who remained seronegative. RESULTS: Overall, 149 (59%) individuals became seropositive for SARS-CoV-2. The mean HGS (in kg) was 25.3 ± 8.3 at baseline and 23.7 ± 8.1 at follow-up (p = 0.028), with 140 individuals having >5% HGS decline between both measurements. The follow-up HGS measurement decreased by 1.72 kg in seropositive individuals, and by 0.57 kg in their seronegative counterparts (p < 0.001). SARS-CoV-2 seropositive individuals were 2.27 times more likely (95% CI: 1.33-3.87) to have a lower HGS measurement at the time of follow-up than those who remained seronegative. When compared with seronegative subjects, seropositive patients with early seroconversion were 3.41 times (95% CI: 1.73-6.74) more likely to have >5% HGS decline at the time of the follow-up than those with later, i.e., more recent, infections. CONCLUSIONS: This study shows an independent deleterious impact of SARS-CoV-2 on HGS that is more marked among individuals with infections that occurred more than 8 months before follow-up HGS. Results suggest the possibility of chronic damage to skeletal muscles by SARS-CoV-2.


Subject(s)
COVID-19/complications , Geriatric Assessment , Hand Strength , SARS-CoV-2/isolation & purification , Aftercare/methods , Aftercare/statistics & numerical data , Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19 Serological Testing/methods , Ecuador/epidemiology , Female , Geriatric Assessment/methods , Geriatric Assessment/statistics & numerical data , Health Services for the Aged/statistics & numerical data , Humans , Independent Living/statistics & numerical data , Longitudinal Studies , Male , Rural Population
16.
PLoS One ; 16(5): e0251295, 2021.
Article in English | MEDLINE | ID: covidwho-1231261

ABSTRACT

The World Health Organization (WHO) declared coronavirus disease-2019 (COVID-19) a global pandemic on 11 March 2020. In Ecuador, the first case of COVID-19 was recorded on 29 February 2020. Despite efforts to control its spread, SARS-CoV-2 overran the Ecuadorian public health system, which became one of the most affected in Latin America on 24 April 2020. The Hospital General del Sur de Quito (HGSQ) had to transition from a general to a specific COVID-19 health center in a short period of time to fulfill the health demand from patients with respiratory afflictions. Here, we summarized the implementations applied in the HGSQ to become a COVID-19 exclusive hospital, including the rearrangement of hospital rooms and a triage strategy based on a severity score calculated through an artificial intelligence (AI)-assisted chest computed tomography (CT). Moreover, we present clinical, epidemiological, and laboratory data from 75 laboratory tested COVID-19 patients, which represent the first outbreak of Quito city. The majority of patients were male with a median age of 50 years. We found differences in laboratory parameters between intensive care unit (ICU) and non-ICU cases considering C-reactive protein, lactate dehydrogenase, and lymphocytes. Sensitivity and specificity of the AI-assisted chest CT were 21.4% and 66.7%, respectively, when considering a score >70%; regardless, this system became a cornerstone of hospital triage due to the lack of RT-PCR testing and timely results. If health workers act as vectors of SARS-CoV-2 at their domiciles, they can seed outbreaks that might put 1,879,047 people at risk of infection within 15 km around the hospital. Despite our limited sample size, the information presented can be used as a local example that might aid future responses in low and middle-income countries facing respiratory transmitted epidemics.


Subject(s)
COVID-19/diagnostic imaging , COVID-19/epidemiology , Hospitals, Special/organization & administration , Hospitals, Special/trends , Pandemics/prevention & control , SARS-CoV-2/genetics , Triage/methods , Adult , Aged , Artificial Intelligence , COVID-19/prevention & control , COVID-19/virology , COVID-19 Nucleic Acid Testing , Ecuador/epidemiology , Female , Humans , Intensive Care Units , Male , Mass Chest X-Ray/methods , Middle Aged , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain Reaction , Risk Factors , Tomography, X-Ray Computed/methods
17.
Int J Environ Res Public Health ; 18(10)2021 05 11.
Article in English | MEDLINE | ID: covidwho-1224013

ABSTRACT

Due to the COVID-19 global pandemic, guidelines for people's confinement have been implemented to prevent the disease's spread. As a result of this, companies have implemented teleworking as an emerging way to work from home using information technology. This cross-sectional study was conducted in Ecuador, with a sample of 204 teleworkers in the city of Quito. The results show that the teleworkers rearranged their bedrooms to carry out their activities. The respondents in each age group stated they did not perceive more significant ailments than those experienced before beginning teleworking. The relationships between the variables were analyzed utilizing the Chi-Square test and Fisher's exact test, finding a relationship between neck ailments and age of p = 0.031 * and between arm/forearm ailments of p = 0.032 *. This study contributes to a greater understanding of the ergonomic situation of the teleworkers and provides us with information to mitigate the ergonomic risks to which they are exposed.


Subject(s)
COVID-19 , Teleworking , Cross-Sectional Studies , Ecuador/epidemiology , Ergonomics , Humans , Pandemics , Risk Factors , SARS-CoV-2
18.
Hist. ciênc. saúde-Manguinhos ; 28(2): 587-591, abr.-jun. 2021.
Article in Spanish | LILACS (Americas) | ID: covidwho-1216981

ABSTRACT

Resumen El caso de la covid-19 en Guayaquil demuestra que las esferas médica y científica no están divorciadas de los factores coyunturales políticos, sociales y económicos, sino que se condicionan mutuamente. En particular, las crisis políticas y desigualdades socioeconómicas que afectaban al Ecuador antes de la llegada de la pandemia prepararon el camino para los estragos causados por el nuevo coronavirus en el país.


Abstract The case of covid-19 in Guayaquil shows that the medical and scientific spheres are not divorced from contemporary political, social and economic factors, but that they act upon one another. In particular, the political crises and socioeconomic inequalities that affected Ecuador before the arrival of the pandemic paved the way for the havoc caused by the new coronavirus in the country.


Subject(s)
Humans , COVID-19/epidemiology , Politics , Socioeconomic Factors , Public Health , Ecuador/epidemiology
19.
BMC Psychiatry ; 21(1): 212, 2021 04 28.
Article in English | MEDLINE | ID: covidwho-1207595

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a global pandemic with serious consequences that have led to the implementation of unprecedented social isolation measures. At the early stages of the pandemic, Ecuador was one of the most affected countries in Latin America. The objective of this study was to assess the levels of depression, anxiety and stress in the Ecuadorian general population during the social isolation period due to COVID-19. METHODS: A web-based survey consisting of 31 short-answer and multiple-choice questions was administered to the general population from April 22-May 3, 2020. Mental health status was assessed through the Depression, Anxiety and Stress Scale-21 Items (DASS-21) questionnaire. Ordinal logistic analyses were used to identify potential risk factors associated with the severity of mental health issues. RESULTS: A total of 626 individuals were included. Most of them were females (60.5%), and their mean age was 29.6 ± 11.7 years. Approximately 17.7% of the respondents had moderate to very severe levels of depression, 30.7% had similar levels of anxiety, and 14.2% experienced stress. Female sex, younger age, student status, and having a relative diagnosed with COVID-19 were associated with significantly higher levels of depression, anxiety and stress. Ordinal regression models showed that being a student was a risk factor for having more severe levels of depression (OR = 3.67; 95% CI = 2.56-5.26, p: 0.0001), anxiety (OR= 1.86; 95% CI= 1.35-2.55, p: 0.0001), and stress (OR = 2.17; 95% CI= 1.47-3.19, p: 0.0001). Having a relative with COVID-19 was also found to be a risk factor only for depression (OR= 1.70; 95% CI= 1.03-2.80, p: 0.036) and anxiety (OR = 2.17; 95% CI= 1.35-3.47, p: 0.001). Additionally, male sex,  older age, and having more children were found to be protective factors for the three conditions. CONCLUSIONS: Our findings suggest that social isolation due to the COVID-19 outbreak has impacted the mental health of the general population in Ecuador. We identified potential risk and protective factors that could serve as a foundation from which to develop psychological strategies to safeguard the mental health of our population during the current pandemic.


Subject(s)
COVID-19 , Depression , Adolescent , Adult , Aged , Anxiety/epidemiology , Child , Cross-Sectional Studies , Depression/epidemiology , Disease Outbreaks , Ecuador/epidemiology , Female , Humans , Male , SARS-CoV-2 , Social Isolation , Stress, Psychological/epidemiology , Surveys and Questionnaires , Young Adult
20.
Aten Primaria ; 53(5): 102021, 2021 May.
Article in Spanish | MEDLINE | ID: covidwho-1196671

ABSTRACT

OBJECTIVE: The present study seeks to analyse sociodemographic determinants related to severe acute respiratory infections (SARI) and calculate the priorization index in the cantons of Ecuador to identify areas probably most vulnerable to COVID-19 transmission. DESIGN: This descriptive ecological observational study. SETTING: 224 cantons (geographical area) of Ecuador with secondary data sources of hospital information. PARTICIPANTS: The unit of measurement was 224 cantons of Ecuador, in which analysed morbidity and lethality rates for SARI using hospital release data (2016-2018). MAIN MEASUREMENTS: Eight sociodemographic indicators were structuralized, and correlation tests applied for a multiple regression model. The priorization index was created with criteria of efficiency, efficacy, effect size (IRR) and equity. Using the sum of the index for each indicator, the priorization score was calculated and localized in a territorial map. RESULTS: Morbidity associated factors where: school attendance years, urbanization and population density; for mortality resulted: school attendance and ethnics (indigenous) IRR: 1.09 (IC95%:1.06-1.15) and IRR: 1.024 (IC95%:102-1.03) respectively. With lethality where related cantons, with population older than 60 years, IRR: 1.049 (IC95%: 1.03-1.07); 87 cantons had high priority mostly localized in the mountain region and the Morona Santiago Province. CONCLUSIONS: Morbidity and mortality of SARI in Ecuador are associated to social and demographic factors. Priorization exercises considering these factors permit the identification of vulnerable territories facing respiratory disease propagation. The social determinants characteristic for each territory should be added to known individual factors to analyse the risk and vulnerability for COVID in the population.


Subject(s)
COVID-19/etiology , COVID-19/prevention & control , Social Determinants of Health , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/transmission , Child , Child, Preschool , Ecuador/epidemiology , Environment , Female , Geographic Mapping , Humans , Infant , Infant, Newborn , Influenza, Human/epidemiology , Influenza, Human/etiology , Influenza, Human/prevention & control , Influenza, Human/transmission , Male , Middle Aged , Pandemics , Risk Assessment , Risk Factors , Severity of Illness Index , Socioeconomic Factors , Vulnerable Populations , Young Adult
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