Objective Explore the factors that could explain the differences of fatality rates among indigenous groups with COVID-19 diagnosis compared to the rest of the population in Mexico. Study design We analyzed the public data of COVID-19 surveillance, of the Mexican Ministry of Health, to estimate COVID-19 fatality rates by ethnicity. Methods  We explored associated factors using Cox proportional hazards models stratified by outpatient and hospital management at diagnosis; analysis was conducted in three scenarios: national level, states with 89% of indigenous population, and South Pacific region. Results 412,017 COVID-19 cases were included, with 1.1% of indigenous population. Crude fatality rate per 1,000 person-weeks was 64.8% higher among indigenous than in non-indigenous (29.97 vs. 18.18, respectively), and it increased more than twice within outpatients (5.99 vs. 2.64). Cox analysis revealed that indigenous with outpatient management had higher fatality rate compared to non-indigenous outpatients; at national level (HR 1.63 95% CI 1.34-1.98), within the subgroup of 13 states (HR 1.66 95% CI 1.33-2.07), and South Pacific region (HR 2.35 95% CI 1.49-3.69). Factors associated with higher fatality rates among non-indigenous and indigenous outpatients were age, sex and comorbidities. Conclusions COVID-19 fatality is higher among indigenous populations, particularly within cases managed as outpatients.

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Background: Inconsistent epidemiological evidence between uric acid (UA) and bone mineral density (BMD) has been observed. Therefore, we evaluated the association between UA and BMD in Mexican adults. Methods: This analysis was conducted on 1423 participants from the Health Workers Cohort Study. We explored cross-sectional associations using linear regression and longitudinal associations using fixed-effects linear regression by sex and age groups (<45 and ≥45 years). Results: In females <45 years old, the cross-sectional analysis showed that UA levels were positively associated with total hip BMD. However, in the longitudinal analysis, we observed a negative association with the femoral neck and lumbar spine BMD. In contrast, in males <45 years old, we found an increase in total hip and femoral neck BMD in the groups with high levels of UA in the longitudinal association. On the other hand, in females ≥45 years old, we observed a longitudinal association between UA and loss of BMD at different sites. We did not observe an association between UA levels and BMD in males ≥45 years old. Conclusions: Our results suggest higher serum UA levels are associated with low BMD at different skeletal sites in Mexican females. Further studies are needed to delineate the underlying mechanisms behind this observation.

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