Distribución de la población vulnerable a la enfermedad COVID-19 en La Habana, Cuba

RESUMEN Introducción: La Habana, en su condición de capital de Cuba, muestra la mayor complejidad en el enfrentamiento a la epidemia por el virus SARS-CoV-2. Objetivo: Proporcionar un análisis de la distribución de la población vulnerable a la COVID-19 en la provincia La Habana. Métodos: Investigación estructurada en tres etapas, en las áreas de salud de los municipios de La Habana: 1. Estudio del grupo de población de 60 años y más que padece enfermedades crónicas (etapa A). 2. Análisis de factores que pudieran estar favoreciendo la transmisión del virus SARS-CoV-2 (etapa B). 3. Integración de las dos etapas anteriores y adición del análisis espacial de la enfermedad COVID-19 según la ubicación de los casos confirmados positivos entre el 12 de marzo-22 de junio de 2020 (etapa C). Resultados: Se presentan en cuatro mapas que se corresponden con las etapas del estudio. El primero aporta el grado de vulnerabilidad de la población de 60 años y más con enfermedades crónicas de mayor riesgo a la COVID-19; el segundo, ofrece el grado de vulnerabilidad a la transmisión del virus SARS CoV-2; el tercero, el grado de vulnerabilidad una vez integradas las etapas A y B y el cuarto mapa, presenta la ubicación por lugar de residencia de los pacientes confirmados con la COVID-19 en La Habana. Conclusiones: Estos resultados constituyen una herramienta eficaz para asistir a las autoridades en la toma de decisiones mediante un mejor conocimiento de la distribución de la población vulnerable a la COVID-19 en la provincia La Habana.

ABSTRACT Introduction: Being the capital city in Cuba, Havana displays the greatest complexity in the response to the SARS-CoV-2 epidemic. Objective: Provide an analysis of the distribution of the population vulnerable to COVID-19 in the province of Havana. Methods: A study was conducted of the health areas in the municipalities of Havana which was structured into three stages: 1. Study of the population group aged 60 years and over with chronic diseases (Stage A). 2. Analysis of the factors which might be facilitating transmission of the SARS-CoV-2 virus (Stage B). 3. Integration of the two previous stages and addition of a spatial analysis of COVID-19 based on the location of positive cases confirmed from 12 March to 22 June 2020 (Stage C). Results: The data collected is presented in four maps corresponding to the stages of the study. The first map presents the degree of vulnerability of the population aged 60 and over with chronic diseases of highest risk for COVID-19; the second the degree of vulnerability to SARS-CoV-2 virus transmission; the third the degree of vulnerability upon integration of Stages A and B; and the fourth the location by place of residence of the patients confirmed with COVID-19 in Havana. Conclusions: These results constitute an effective tool to assist authorities in decision making by providing broader knowledge about the distribution of the population vulnerable to COVID-19 in the province of Havana.

N,N'-Bis(2-amino-benz-yl)ethane-1,2-diaminium dinitrate.

In the title salt, C16H24N4 (2+)·2NO3 (-), both the cation and anion are placed in general positions, although the cation displays non-crystallographic inversion symmetry, with the aliphatic chain extended in an all-trans conformation. The benzene rings are almost parallel, with a dihedral angle between their mean planes of 3.3 (6)°. The nitrate ions are placed in the vicinity of the protonated amine groups, forming efficient N-H⋯O inter-ion hydrogen bonds. Each nitrate ion in the asymmetric unit bridges two symmetry-related cations, forming an R 4 (4)(18) ring, a common motif in organic ammonium nitrate salts. This results in the formation of chains along [010] with alternating cations and anions. The neutral amine groups are involved in slightly weaker N-H⋯O hydrogen bonds with the nitrate O atoms, and there are also a number of C-H⋯O hydrogen bonds present. The resulting supra-molecular structure is based on a two-dimensional network extending in the ab plane.

Tris[2-(2H-indazol-2-yl)eth-yl]amine.

The title tertiary amine, C(27)H(27)N(7), a potential tripodal ligand for coordination chemistry, crystallizes with the central N atom located on a threefold axis of a trigonal cell. The gauche conformation of the N(amime)-CH(2)-CH(2)-N(indazole) chain [torsion angle = -64.2 (2)°] places the pendant 2H-indazole heterocycles surrounding the symmetry axis, affording a claw-like shaped mol-ecule. Two symmetry-related indazole planes in the mol-ecule make an acute angle of 60.39 (4)°. The lone pair of the tertiary N atom is located inside the cavity, and should thus be inactive (as a ligand). In the crystal, neither significant π-π nor C-H⋯π inter-actions between molecules are found.

N,N'-Bis(2-aza-niumylbenz-yl)ethane-1,2-diaminium tetra-chloride.

The title compound, C(16)H(26)N(4) (4+)·4Cl(-), is based on a fully protonated tetra-amine. In the cation, both benzene rings are connected by an all-trans chain, and the rings are almost parallel, with an angle between the mean planes of 8.34 (12)°. The benzene rings are arranged in such a way that the NH(3) (+) substituents are oriented cis with respect to the central chain. This arrangement is a consequence of multiple N-H⋯Cl hydrogen bonds, involving all N-H groups in the cation and the four independent Cl(-) anions. These contacts have strengths ranging from weak to strong (based on H⋯Cl separations), and generate a complex three-dimensional crystal structure with no preferential crystallographic orientation for the contacts.

2,2'-(Propane-1,3-di-yl)bis-(2H-indazole).

The title mol-ecule, C(17)H(16)N(4), is a bis-indazole crystallized in the rare 2H-tautomeric form. Indazole heterocycles are connected by a propane C(3) chain, and the mol-ecule is placed on a general position, in contrast to the analogous compound with a central C(2) ethane bridge, which was previously found to be placed on an inversion center in the same space group. In the title mol-ecule, indazole rings make a dihedral angle of 60.11 (7)°, and the bridging alkyl chain displays a trans conformation, resulting in a W-shaped mol-ecule. In the crystal, mol-ecules inter-act weakly through π-π contacts between inversion-related pyrazole rings, with a centroid-centroid separation of 3.746 (2) Å.

Tris{2-[(2-amino-benzyl-idene)amino]-ethyl}amine.

The title Schiff base, C(27)H(33)N(7), is a tripodal amine displaying C(3) symmetry, with the central tertiary N atom lying on the threefold crystallographic axis. The N-CH(2)-CH(2)-N conformation of the pendant arms is gauche [torsion angle = 76.1 (3)°], which results in a claw-like mol-ecule, with the terminal aniline groups wrapped around the symmetry axis. The lone pair of the apical N atom is clearly oriented inwards towards the cavity, and should thus be chemically inactive. The amine NH(2) substituents lie in the plane of the benzene ring to which they are bonded. With such an arrangement, one amine H atom forms an S(6) motif through a weak N-H⋯N hydrogen bond with the imine N atom, while the other is engaged in an inter-molecular N-H⋯π contact involving the benzene ring of a neighbouring mol-ecule related by inversion. The benzene rings also participate in an intra-molecular C-H⋯π contact of similar strength. In the crystal structure, mol-ecules are separated by empty voids (ca 5% of the crystal volume), although the crystal seems to be unsolvated.

N,N'-Bis(2-ammonio-benz-yl)ethane-1,2-diammonium-nitrate-perchlorate (1/1.5/2.5).

The title compound, C(16)H(26)N(4) (4+)·2.5ClO(4) (-)·1.5NO(3) (-), is an organic salt in which the cation is a fully protonated tetra-mine. The cation lies on an inversion center and, as a consequence, both benzene rings are parallel. The central chain is found in an all-trans arrangement, a conformation different from that observed in the crystal structure of the non-protonated mol-ecule. The charges are balanced by a mixture of nitrate and perchlorate ions. One site is occupied by an ordered perchlorate ion, while the other contains both nitrate and perchlorate ions, with occupancies of 0.75 and 0.25, respectively. In the crystal, the NH(2) (+) groups of the cation form N-H⋯O hydrogen bonds with the anions. The NH(3) (+) groups also behave as donor groups, allowing the building of chains along [100], alternating cations and disordered anions being connected via N-H⋯O hydrogen bonds.