COVID-19 and inequities in the Americas: lessons learned and implications for essential health services

Hennis, Anselm; Coates, Anna; Pino, Sandra del; Ghidinelli, Massimo; León, Rodolfo Gómez Ponce de; Bolastig, Edwin; Castellanos, Luis Gerardo; Souza, Renato Oliveira e; Luciani, Silvana

doi:10.26633/rpsp.2021.130

Cited by 22 publications

(22 citation statements)

References 15 publications

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“…Previous studies have shown that certain traits of poor countries have a direct impact on COVID-19 outcomes. This includes low socioeconomic status, overcrowding, higher use of public transportation, absence of potable water, and informal work ( 7 ). As a result of the worst scenarios experimented on by infected adults, healthcare services, including pediatric ones, were rearranged to meet the increasing requirements of that age group ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Children With SARS-CoV-2 Infection in a Hospital in Latin America

et al. 2022

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Objective:COVID-19 infections have shown a different behavior in children than in adults. The objective of this study was to describe the clinical characteristics and severity of SARS-CoV-2 infection in pediatric patients seen at a reference hospital in Colombia.MethodA descriptive, observational study in patients under the age of 18 years with a positive test for SARS-CoV-2 infection (RT-PCR or antigen) between April 2020 and March 2021. Multiple variables were studied, including demographic data, clinical characteristics, lab measurements, treatments administered, intensive care unit admission, and mortality.ResultsA total of 361 patients were included of whom 196 (54%) were males. The median age was 3 years. Of all the patients, 65 (18%) were asymptomatic. The majority of patients had no comorbidities (n = 225, 76%). In those who were symptomatic (n = 296, 82%), the most frequent complaints were fever (n = 178, 60%), nasal congestion (n = 164, 55%) and cough (n = 149, 50%). Chest x-rays were normal in 73 patients (50%). When abnormalities were found, interstitial (29%) and alveolar (12%) patterns were the most prevalent. One hundred and fifty-seven children (53%) required general ward hospitalization, and 24 patients (8%) required pediatric intensive care admission. The global mortality was 0.8% (3 patients).ConclusionsThe majority of cases were asymptomatic or mild. However, a significant percentage of patients required general ward admission, and some even required intensive care. The main symptom of COVID-19 infections in newborns was apnea. A second COVID-19 RT-PCR may be necessary to detect infections in critically ill patients with a high clinical suspicion of the disease if an initial test was negative.

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Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Children With SARS-CoV-2 Infection in a Hospital in Latin America

et al. 2022

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“…The COVID-19 pandemic has exacerbated pre-existing socioeconomic and health disparities worldwide [ 30 ] which, in turn, increase the risk of SARS-CoV-2 infection and COVID-19 morbidity in children. This is due to poverty-related comorbidities (e.g., malnutrition), reduced access to healthcare, low-quality and overcrowded housing, and parents′ exposure to high-risk occupations [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 seropositivity and COVID-19 among 5 years-old Amazonian children and their association with poverty and food insecurity

et al. 2022

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Background The epidemiology of childhood SARS-CoV-2 infection and COVID-19-related illness remains little studied in high-transmission tropical settings, partly due to the less severe clinical manifestations typically developed by children and the limited availability of diagnostic tests. To address this knowledge gap, we investigate the prevalence and predictors of SARS-CoV-2 infection (either symptomatic or not) and disease in 5 years-old Amazonian children. Methodology/Principal findings We retrospectively estimated SARS-CoV-2 attack rates and the proportion of infections leading to COVID-19-related illness among 660 participants in a population-based birth cohort study in the Juruá Valley, Amazonian Brazil. Children were physically examined, tested for SARS-CoV-2 IgG and IgM antibodies, and had a comprehensive health questionnaire administered during a follow-up visit at the age of 5 years carried out in January or June-July 2021. We found serological evidence of past SARS-CoV-2 infection in 297 (45.0%; 95% confidence interval [CI], 41.2–48.9%) of 660 cohort participants, but only 15 (5.1%; 95% CI, 2.9–8.2%) seropositive children had a prior medical diagnosis of COVID-19 reported by their mothers or guardians. The period prevalence of clinically apparent COVID-19, defined as the presence of specific antibodies plus one or more clinical symptoms suggestive of COVID-19 (cough, shortness of breath, and loss of taste or smell) reported by their mothers or guardians since the pandemic onset, was estimated at 7.3% (95% CI, 5.4–9.5%). Importantly, children from the poorest households and those with less educated mothers were significantly more likely to be seropositive, after controlling for potential confounders by mixed-effects multiple Poisson regression analysis. Likewise, the period prevalence of COVID-19 was 1.8-fold (95%, CI 1.2–2.6-fold) higher among cohort participants exposed to food insecurity and 3.0-fold (95% CI, 2.8–3.5-fold) higher among those born to non-White mothers. Finally, children exposed to household and family contacts who had COVID-19 were at an increased risk of being SARS-CoV-2 seropositive and–even more markedly–of having had clinically apparent COVID-19 by the age of 5 years. Conclusions/Significance Childhood SARS-CoV-2 infection and COVID-19-associated illness are substantially underdiagnosed and underreported in the Amazon. Children in the most socioeconomically vulnerable households are disproportionately affected by SARS-CoV-2 infection and disease.

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“…A medida que la vacunación contra la COVID-19 crea la oportunidad de superar la pandemia ( 19 ), el avance en el proceso de vacunación en todos los países del continente ha sido un aliciente entre la población, ya que provee de esperanzas a retornar a la normalidad. Además, acerca a la meta de lograr la inmunidad de rebaño contra la COVID-19, la cual según la OMS se logra cuando 70% de la población es inmune ( 20 ).…”

Section: Discussionunclassified

Análisis multidimensional de la evolución de la pandemia de la COVID-19 en países de las Américas

Hernández

Olite

Llerena³

2022

Revista Panamericana De Salud Pública

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Objetivo. Evaluar la evolución de pandemia de la COVID-19 entre los países de las Américas, comparando datos de los sistemas de salud previo a la llegada del virus a la Región, frente a los casos y muertes acumuladas antes del despliegue de las estrategias de inmunización de la población, y el estado actual de la vacunación. Métodos. Se realizo un análisis multivariante HJ-Biplot y análisis de cluster, para 28 países de la Región de las Américas, en tres momentos del tiempo: diciembre de los años 2019, 2020 y 2021. Resultados. En el continente americano se observa heterogeneidad en las acciones implementadas para contener la pandemia, la cual se refleja en diferentes grupos de naciones. Conclusiones. No todos los países de la Región de las Américas contaban con las condiciones de salubridad necesarias para afrontar la contención de la COVID-19. A cierre de 2019 Estados Unidos, Canadá, Brasil y Cuba se observaban con ventajas frente a los demás países de la Región, sin embargo, la pertinencia de las acciones implementadas durante el año 2020 para contener la pandemia, generaron diferentes grupos de países según la prevalencia de contagios y muertes. En tal momento, Bolivia, Ecuador y México, presentaban niveles críticos de letalidad. A cierre de 2021, tras la implementación de los planes de vacunación, Argentina, Brasil, Canadá, Chile, Colombia, Costa Rica, Cuba, Panamá, Estados Unidos y Uruguay registran más del 60% de su población con el esquema de vacunación completo.

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COVID-19 and inequities in the Americas: lessons learned and implications for essential health services

Cited by 22 publications

References 15 publications

Clinical Characteristics of Children With SARS-CoV-2 Infection in a Hospital in Latin America

Clinical Characteristics of Children With SARS-CoV-2 Infection in a Hospital in Latin America

SARS-CoV-2 seropositivity and COVID-19 among 5 years-old Amazonian children and their association with poverty and food insecurity

Análisis multidimensional de la evolución de la pandemia de la COVID-19 en países de las Américas

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