Characterizing a two-pronged epidemic in Mexico of non-communicable diseases and SARS-Cov-2: factors associated with increased case-fatality rates

Monterrubio‐Flores, Eric; Ramírez-Villalobos, María D; Espinosa-Montero, Juan; Hernández, Bernardo; Barquera, Sı́món; Villalobos-Daniel, Victor E.; Campos-Nonato, Ismael

doi:10.1093/ije/dyab008

Cited by 18 publications

(12 citation statements)

References 25 publications

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“…Country-specific patterns in these shifts caused by socioeconomic factors provide detail in the changing landscape of this disease ( Leong et al, 2021 ). In Mexico, there appear to be more diseased young men than anywhere else, this is likely due to an underlying epidemic of non-communicable diseases, such as obesity and diabetes ( Monterrubio-Flores et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Physiological Network Is Disrupted in Severe COVID-19

et al. 2022

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The human body is a complex system maintained in homeostasis thanks to the interactions between multiple physiological regulation systems. When faced with physical or biological perturbations, this system must react by keeping a balance between adaptability and robustness. The SARS-COV-2 virus infection poses an immune system challenge that tests the organism’s homeostatic response. Notably, the elderly and men are particularly vulnerable to severe disease, poor outcomes, and death. Mexico seems to have more infected young men than anywhere else. The goal of this study is to determine the differences in the relationships that link physiological variables that characterize the elderly and men, and those that characterize fatal outcomes in young men. To accomplish this, we examined a database of patients with moderate to severe COVID-19 (471 men and 277 women) registered at the “Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán” in March 2020. The sample was stratified by outcome, age, and sex. Physiological networks were built using 67 physiological variables (vital signs, anthropometric, hematic, biochemical, and tomographic variables) recorded upon hospital admission. Individual variables and system behavior were examined by descriptive statistics, differences between groups, principal component analysis, and network analysis. We show how topological network properties, particularly clustering coefficient, become disrupted in disease. Finally, anthropometric, metabolic, inflammatory, and pulmonary cluster interaction characterize the deceased young male group.

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Section: Introductionmentioning

confidence: 99%

Physiological Network Is Disrupted in Severe COVID-19

et al. 2022

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“…This is considering that a similar number of people were tested among all quintiles. Thus, it reveals under-testing in those most vulnerable and an unequal distribution of a valuable resource, which adds another layer to the mortality disparity seen between private and public health-care systems in Mexico [25][26][27] . A study performed in Cameroon showed high sensitivity of POC tests when performed within 7 days of symptom onset 28 .…”

Section: Discussionmentioning

confidence: 99%

Result Turnaround Time of RT-PCR for SARS-CoV-2 is the Main Cause of COVID-19 Diagnostic Delay: A Country-Wide Observational Study of Mexico and Colombia

Núñez

Belaunzarán-Zamudio

Caro-Vega

2022

RIC

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Background: Delay in COVID-19 diagnosis due to late real-time reverse transcription-polymerase chain reaction reporting has been described to be an important cause of suboptimal COVID-19 surveillance and outbreak containment. Objective:The objective of the study was to determine the duration of diagnostic delay due to test turnaround time and its association with marginalization status. Methods: In this observational study using national open data of Mexico and Colombia, we quantified the delay in COVID-19 diagnosis that occurred in both countries. We considered two periods that contributed to the delay in diagnosis: the time from symptom onset until testing (delay-one) and test turnaround time (delay-two). Marginalization status was determined according to country-specific scores. Results: Among 3,696,773 patients from Mexico and Colombia, delay-two was generally longer than delay-one. Median delay-one was 3 days and delay-two 7 days in Colombia, while in Mexico, they were 3 days and 4 days, respectively. In Colombia, worse marginalization status prolonged delaytwo. In Mexico, a lower number and percentage of rapid tests were performed in areas with worse marginalization. Conclusion: Diagnostic delay was mostly due to test turnaround time. Marginalization status was an important barrier to diagnostic test access. (REV INVEST CLIN. [AHEAD OF PRINT]

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“…One study in Mexico used a multimorbidity perspective to estimate the risk of mortality from COVID [29]. Authors found that adults aged 20-39 years with three chronic diseases presented 16.1 (95% CI: 13.8, 18.7) times higher risk of death, adults aged 40-59 years presented 4.2 (95% CI: 4.0, 4.4) and adults 60-80 years 1.6 (95% CI:1.6 1.7), compared to disease-free individuals of the same age group.…”

Section: Discussionmentioning

confidence: 99%

Fraction of COVID-19 hospitalizations and deaths attributable to chronic diseases

Reyes-Sánchez¹,

Basto-Abreu²,

Torres‐Álvarez³

et al. 2021

Preprint

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Aim. To estimate the fraction of hospitalizations and deaths from COVID-19 attributable to chronic diseases due to poor nutrition and smoking in Mexico. Methods. We used data from the Mexican surveillance system of COVID-19. We considered six chronic diseases (obesity, COPD, hypertension, diabetes, cardiovascular disease, and chronic kidney disease) to define a multimorbidity variable: no diseases, 1 disease, 2 diseases, or 3 or more diseases. We calibrated the database using bias quantification methods to consider the undiagnosed cases of chronic diseases. To estimate the risks of hospitalization and death due to chronic diseases, we fitted Poisson regression models with robust standard errors, adjusting for possible confounders. Using these risks, we calculated attributable fractions using the population attributable fraction (PAF). Results. Chronic diseases accounted for to 25.4% (24.8%, 26.1%), 28.3% (27.8%, 28.7%) and 15.3% (14.9%,15.7%) of the hospitalizations among adults below 40 years, 40 to 59, and 60 years and older respectively (95% CI). For COVID-19-related deaths, 50.1% (48.6%, 51.5%), 40.5% (39.7%, 41.3%), and 18.7% (18.0%, 19.5%) were attributable to chronic diseases in adults under 40 years, 40 to 59, and 60 years and older, respectively. Conclusion. Chronic diseases linked to malnutrition and tobacco use contributed to a higher burden of hospitalization and deaths from COVID-19 in Mexico, particularly among younger adults. Medical and structural interventions to curb chronic disease incidence and facilitate disease control are urgently needed.

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Characterizing a two-pronged epidemic in Mexico of non-communicable diseases and SARS-Cov-2: factors associated with increased case-fatality rates

Cited by 18 publications

References 25 publications

Physiological Network Is Disrupted in Severe COVID-19

Physiological Network Is Disrupted in Severe COVID-19

Result Turnaround Time of RT-PCR for SARS-CoV-2 is the Main Cause of COVID-19 Diagnostic Delay: A Country-Wide Observational Study of Mexico and Colombia

Fraction of COVID-19 hospitalizations and deaths attributable to chronic diseases

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