The digital repository system captures, stores, indexes, preserves, and distributes digital research material. http://covid19-evidence.paho.org:80 2021-04-21T09:34:30Z 2021-04-21T09:34:30Z Desai, Aakash et al. https://hdl.handle.net/20.500.12663/2592 2021-04-14T14:52:06Z 2020-12-30T00:00:00Z

Mortality in hospitalized patients with cancer and coronavirus disease 2019: A systematic review and meta‐analysis of cohort studies Desai, Aakash et al. Background: Heterogeneous evidence exists on the effect of coronavirus disease 2019 (COVID‐19) on the clinical outcomes of patients with cancer. Methods: A systematic review was performed using the Medline, Embase, and CENTRAL databases and the World Health Organization Novel Coronavirus website to identify studies that reported mortality and characteristics of patients with cancer who were diagnosed with COVID‐19. The primary study outcome was mortality, defined as all‐cause mortality or in‐hospital mortality within 30 days of initial COVID‐19 diagnosis. The pooled proportion of mortality was estimated using a random‐effects model, and study‐level moderators of heterogeneity were assessed through subgroup analysis and metaregression. Results: Among 2922 patients from 13 primarily inpatient studies of individuals with COVID‐19 and cancer, the pooled 30‐day mortality rate was 30% (95% CI, 25%‐35%). The overall pooled 30‐day mortality rate among 624 patients from 5 studies that included a mixture of inpatient and outpatient populations was 15% (95% CI, 9%‐22%). Among the hospitalized studies, the heterogeneity (I2 statistic) of the meta‐analysis remained high (I2, 82%). Cancer subtype (hematologic vs solid), older age, male sex, and recent active cancer therapy each partially explained the heterogeneity of mortality reporting. In multivariable metaregression, male sex, along with an interaction between the median patient age and recent active cancer therapy, explained most of the between‐study heterogeneity (R2, 96%). Conclusions: Pooled mortality estimates for hospitalized patients with cancer and COVID‐19 remain high at 30%, with significant heterogeneity across studies. Dedicated community‐based studies are needed in the future to help assess overall COVID‐19 mortality among the broader population of patients with cancer.

2020-12-30T00:00:00Z https://hdl.handle.net/20.500.12663/2591 2021-04-12T19:06:36Z 2021-04-01T00:00:00Z

Integración de la vigilancia genómica de SARS- CoV-2 a la vigilancia de COVID-19 a través del Sistema Nacional de Salud - abril 2021 El propósito de este documento es estandarizar conceptos y procedimientos para la implementación e integración de la vigilancia genómica de SARS-COV-2 a la vigilancia general de COVID-19 con el objetivo de identificar las variantes presentes en el país, detectar de manera oportuna variantes de interés para la salud pública que se introduzcan en el territorio; así como caracterizar la posible participación de las diferentes variantes en situaciones como reinfecciones o personas vacunadas.

2021-04-01T00:00:00Z https://hdl.handle.net/20.500.12663/2590 2021-04-12T18:38:58Z 2021-01-01T00:00:00Z

Monitoreo y evaluación de la situación epidemiológica de la COVID-19 - enero 2021 Existen diferentes maneras de evaluar la situación epidemiológica y los riesgos del país en sus diferentes niveles. A partir de la bibliografía disponible y de la experiencia adquirida, la Dirección Nacional de Epidemiología e Información Estratégica propone la utilización de indicadores que permitirán evaluar la situación en los diferentes niveles (provincial, departamental, municipal, etc.) de manera rápida y oportuna. Los indicadores propuestos se construyen con información de fácil disponibilidad mediante una metodología sencilla.

2021-01-01T00:00:00Z Vepa, Abhinav et al. https://hdl.handle.net/20.500.12663/2589 2021-04-07T17:30:45Z 2020-10-01T00:00:00Z

COVID-19 and ethnicity: A novel pathophysiological role for inflammation Vepa, Abhinav et al. Introduction There have been recent mounting concerns regarding multiple reports stating a significantly elevated relative-risk of COVID-19 mortality amongst the Black and Minority Ethnic (BAME) population. An urgent national enquiry investigating the possible reasons for this phenomenon has been issued in the UK. Inflammation is at the forefront of COVID-19 research as disease severity appears to correlate with pro-inflammatory cytokine dysregulation. This narrative review aims to shed light on the novel, pathophysiological role of inflammation in contributing towards the increased COVID-19 mortality risk amongst the BAME population. Methods Searches in PubMed, Medline, Scopus, medRxiv and Google Scholar were performed to identify articles published in English from inception to 18th June 2020. These databases were searched using keywords including: ‘COVID-19’ or ‘Black and Minority Ethnic’ or ‘Inflammation’. A narrative review was synthesized using these included articles. Results We suggest a novel pathophysiological mechanism by which acute inflammation from COVID-19 may augment existing chronic inflammation, in order to potentiate a ‘cytokine storm’ and thus the more severe disease phenotype observed in the BAME population. Obesity, insulin resistance, cardiovascular disease, psychological stress, chronic infections and genetic predispositions are all relevant factors which may be contributing to elevated chronic systemic inflammation amongst the BAME population. Conclusion Overall, this review provides early insights and directions for ongoing research regarding the pathophysiological mechanisms that may explain the severe COVID-19 disease phenotype observed amongst the BAME population. We suggest ‘personalization’ of chronic disease management, which can be used with other interventions, in order to tackle this.

2020-10-01T00:00:00Z