COVID-19 cases, hospitalizations, outpatients, and deaths in Mexico by ethnicity and state-level income.

INTRODUCTION: Mexico is one of the countries that is most affected by mortality due to COVID-19. Once infected, the indigenous population living in the lower-income states had worse outcomes. Our objectives were to analyze outcomes by ethnic group, and determine the association between state-level income and the incidence, hospitalizations, outpatients, and death rates per 100,000 population. METHODOLOGY: We analyzed 1,037,567 confirmed COVID-positive cases from February 29 to November 13, 2020 recorded in the Mexican COVID-19 cases database. Sociodemographic characteristics, comorbidities, and outcomes were analyzed. Data was allocated according to the state where the patients were treated. Statistical association between age-adjusted incidence and death rates with state-level GDP per capita (as a measure of income), were ascertained using Spearman correlations. Kruskal-Wallis tests examine the association of cumulative incidence, hospitalizations, outpatients, and death rates, with income quartiles. When significant, a follow-up analysis (Mann-Whitney) was conducted. RESULTS: Respective cumulative incidence rates and death rates were: 900.3 (non-indigenous) and 94.4 (indigenous), and 87.1 (non-indigenous) and 13.9 (indigenous). Spearman correlation coefficients of income with age-standardized incidence and death rates were 0.657 and 0.607 (p < 0.001 for both). Kruskal-Wallis H-Values indicate significant median differences by income in total population rates: cumulative incidence 13.47 (p < 0.01), hospitalizations 11.67 (p < 0.01), outpatients 12.86 (p < 0.01), and deaths 8.92 (p < 0.05). CONCLUSIONS: Cumulative incidence, hospitalizations, outpatients, and mortality rates presented a reversed socioeconomic status health gradient in Mexico. Less adverse outcomes were observed in the lowest-income states compared to higher-income states.

Anti-inflammatory, anti-bacterial, and cytotoxic activity of fibrous clays.

Produced worldwide at 1.2m tons per year, fibrous clays are used in the production of pet litter, animal feed stuff to roof parcels, construction and rheological additives, and other applications needing to replace long-fiber length asbestos. To the authors' knowledge, however, information on the beneficial effects of fibrous clays on health remains scarce. This paper reports on the anti-inflammatory, anti-bacterial, and cytotoxic activity by sepiolite (Vallecas, Spain) and palygorskite (Torrejon El Rubio, Spain). The anti-inflammatory activity was determined using the 12-O-tetradecanoylphorbol-13-acetate (TPA) and myeloperoxidase (MPO) methods. Histological cuts were obtained for quantifying leukocytes found in the epidermis. Palygorkite and sepiolite caused edema inhibition and migration of neutrophils ca. 68.64 and 45.54%, and 80 and 65%, respectively. Fibrous clays yielded high rates of infiltration, explained by cleavage of polysomes and exposure of silanol groups. Also, fibrous clays showed high inhibition of myeloperoxidase contents shortly after exposure, but decreased sharply afterwards. In contrast, tubular clays caused an increasing inhibition of myeloperoxidase with time. Thus, clay structure restricted the kinetics and mechanism of myeloperoxidase inhibition. Fibrous clays were screened in vitro against human cancer cell lines. Cytotoxicity was determined using the protein-binding dye sulforhodamine B (SRB). Exposing cancer human cells to sepiolite or palygorskite showed growth inhibition varying with cell line. This study shows that fibrous clays served as an effective anti-inflammatory, limited by chemical transfer and cellular-level signals responding exclusively to an early exposure to clay, and cell viability decreasing significantly only after exposure to high concentrations of sepiolite.