The coronavirus disease 2019 , caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), represents the pandemic of the century, with approximately 3.5 million cases and 250,000 deaths worldwide as of May 2020. Although respiratory symptoms usually dominate the clinical presentation, COVID-19 is now known to also have potentially serious cardiovascular consequences, including myocardial injury, myocarditis, acute coronary syndromes, pulmonary embolism, stroke, arrhythmias, heart failure, and cardiogenic shock. The cardiac manifestations of COVID-19 might be related R ESUM ELa maladie à coronavirus 2019 (COVID-19), caus ee par le SARS-CoV-2 (severe acute respiratory syndrome coronarivus-2 pour coronavirus du syndrome respiratoire aigu s evère 2), est la pand emie du siècle; en mai 2020, on d enombrait quelque 3,5 millions de cas et 250 000 d ecès dans le monde. Bien que les symptômes respiratoires dominent g en eralement le tableau clinique, on sait maintenant que la COVID-19 peut aussi avoir de graves cons equences sur le plan cardiovasculaire, par exemple des l esions myocardiques, des myocardites, des syndromes coronariens aigus, des embolies pulmonaires, des accidentsThe coronavirus disease 2019 (COVID-19) is a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 1 which infected 3,524,429 patients and was linked to 247,838 deaths worldwide as of May 4, 2020. 2 SARS-CoV-2 infection is triggered by binding to angiotensin-converting enzyme-2 (ACE2), which is highly expressed in the nasopharynx and lungs, as well as in the cardiovascular system and gastrointestinal and genitourinary tracts. 3 Although respiratory symptoms usually dominate the clinical presentation of COVID-19, SARS-CoV-2 infection might also be responsible for a variety of potentially severe cardiovascular manifestations, particularly in patients with pre-existing cardiovascular conditions. 4-6 Indeed, subjects with cardiovascular diseases do suffer worse outcomes when infected with SARS-CoV-2. 5 Moreover, COVID-19 could

BackgroundIn the Americas, yellow fever virus transmission is a latent threat due to the proximity between urban and wild environments. Although yellow fever has nearly vanished from North and Central America, there are still 13 countries in the Americas considered endemic by the World Health Organization. Human cases usually occur as a result of the exposure to sylvatic yellow fever in tropical forested environments; but urban outbreaks reported during the last decade demonstrate that the risk in this environment still exists. The objective of this study was to identify spatial patterns and the relationship between key geographic and environmental factors with the distribution of yellow fever human cases in the Americas.Methodology/Principal findingsAn ecological study was carried out to analyze yellow fever human cases reported to the Pan American Health Organization from 2000 to 2014, aggregated by second administrative level subdivisions (counties). Presence of yellow fever by county was used as the outcome variable and eight geo-environmental factors were used as independent variables. Spatial analysis was performed to identify and examine natural settings per county. Subsequently, a multivariable logistic regression model was built. During the study period, 1,164 cases were reported in eight out of the 13 endemic countries. Nearly 83.8% of these cases were concentrated in three countries: Peru (37.4%), Brazil (28.1%) and Colombia (18.4%); and distributed in 57 states/provinces, specifically in 286 counties (3.4% of total counties). Yellow fever presence was significantly associated with altitude, rain, diversity of non-human primate hosts and temperature. A positive spatial autocorrelation revealed a clustered geographic pattern in 138/286 yellow fever positive counties (48.3%).Conclusions/SignificanceA clustered geographic pattern of yellow fever was identified mostly along the Andes eastern foothills. This risk map could support health policies in endemic countries. Geo-environmental factors associated with presence of yellow fever could help predict and adjust the limits of other risk areas of epidemiological concern.

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