RESUMEN
Health personnel (HP) have been universally recognized as especially susceptible to COVID-19. In Mexico, our home country, HP has one of the highest death rates from the disease. From the beginning of the SARS-CoV-2 pandemic, an office for initial attention for HP and a call center were established at a COVID-19 national reference pediatric hospital, aimed at early detection of COVID-19 cases and stopping local transmission. The detection and call center implementation and operation, and tracing methodology are described here. A total of 1,042 HP were evaluated, with 221 positive cases identified (7.7% of all HP currently working and 26% of the HP tested). Community contagion was most prevalent (46%), followed by other HP (27%), household (14%), and hospitalized patients (13%). Clusters and contact network analysis are discussed. This is one of the first reports that address the details of the implementation process of contact tracing in a pediatric hospital from the perspective of a hybrid hospital with COVID-19 and non-COVID-19 areas.
RESUMEN
BACKGROUND: During the Covid-19 pandemic, children and adolescents faced poverty, potentially dying from preventable causes, or missing out essential vaccines. The aim of this study was to assess potential environmental and individual factors associated to COVID-19 mortality in children and adolescents in Mexico. METHODS: This cross-sectional study analysed the official data of 131,001 children under 10 years of age and adolescents between 10 and 19 years of age with COVID-19 disease, in Mexico. Participants were diagnosticated between March 2020 and June 13, 2021. The environmental variables such as malnutrition, vaccination coverage and social lag index were evaluated at the state level. Multilevel models were fitted to evaluate the association between environmental and individual factors and COVID-19 mortality. FINDINGS: A total of 773 (0.6%) children and adolescents died due to COVID-19. Younger age (OR = 0.878, 95%CI: 0.869-0.888), diabetes (OR = 3.898, 95%CI: 2.596-5.851), immunosuppression (OR = 5.410, 95%CI: 4.088-7.158), obesity (OR = 1.876, 95%CI: 1.397-2.521), hypertension (OR = 1.906, 95%CI: 1.239-2.932), cardiovascular disease (OR = 2.288, 95%CI: 1.482-3.531), and chronic kidney disease (OR = 13.250, 95%CI: 9.066-19.350) were associated with mortality. COVID-19 mortality was directly associated with social lag index and malnutrition (ORvery high = 2.939, 95%CI: 1.111-7.775, and OR = 1.390, 95%CI: 1.073-1.802, respectively), and inversely associated with population density (OR = 0.374, 95%CI: 0.204-0.688). Finally, children and adolescents living in areas with a higher percentage of people with incomplete education (OR = 1.045, 95%CI: 1.011-1.081), of children of school age of 6-14 years who do not attend school (OR = 1.266, 95%CI: 1.032-1.554), and of illiterate population aged 15 and over (OR = 1.086, 95%CI: 0.999-1.179) were associated with a higher risk of COVID-19 mortality. INTERPRETATION: Malnutrition, social lag index and population density are key factors to understand COVID-19 mortality in children and adolescents. Also, age and pre-existing comorbidities were also associated with worse COVID-19 prognosis. FUNDING: No funding was secured for this study.
RESUMEN
The health, economic, and social impact of COVID-19 has been significant across the world. Our objective was to evaluate the association between air pollution (through NO2 and PM2.5 levels) and COVID-19 mortality in Spanish provinces from February 3, 2020, to July 14, 2020, adjusting for climatic parameters. An observational and ecological study was conducted with information extracted from Datadista repository (Datadista, 2020). Air pollutants (NO2 and PM2.5 levels) were analyzed as potential determinants of COVID-19 mortality. Multilevel Poisson regression models were used to analyze the risk of mortality after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Models were adjusted by four climatic variables (hours of solar radiation, precipitation, daily temperature and wind speed) and population size. The mean levels of PM2.5 and NO2 across all provinces and time in Spain were 8.7 µg/m3 (SD 9.7) and 8.7 µg/m3 (SD 6.2), respectively. High levels of PM2.5 (IRR = 1.016, 95% CI: 1.007-1.026), NO2 (IRR = 1.066, 95% CI: 1.058-1.075) and precipitation (IRRNO2 = 0.989, 95% CI: 0.981-0.997) were positively associated with COVID-19 mortality, whereas temperature (IRRPM2.5 = 0.988, 95% CI: 0.976-1.000; and IRRNO2 = 0.771, 95% CI: 0.761-0.782, respectively) and wind speed (IRRNO2 = 1.095, 95% CI: 1.061-1.131) were negatively associated with COVID-19 mortality. Air pollution can be a key factor to understand the mortality rate for COVID-19 in Spain. Furthermore, climatic variables could be influencing COVID-19 progression. Thus, air pollution and climatology ought to be taken into consideration in order to control the pandemic. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11869-021-01062-2.