Vol 21. N°4. 2020  |  Octubre-Diciembre de 2020


ARTÍCULOS ORIGINALES - NUTRICIÓN


PRESENCIA DE COVID-19 EN ARGENTINOS MENORES DE 65 AÑOS


Autores: VALERIA HIRSCHLER, CONCEPCIÓN GARCÍA, PAULA LIFSZYC, FEDERICO BOERO, CLAUDIO GONZÁLEZ, ANDREA MARTÍNEZ


RESUMEN

Antecedentes: la presencia del virus COVID-19 se ha asociado con adultos de 65 años o más. Sin embargo, poco se ha destacado en los jóvenes.
Objetivos: determinar la asociación de COVID-19 positivo y edad, sexo, índice de masa corporal (IMC), condiciones de salud subyacentes, hospitalización y muerte.
Materiales y métodos: se realizó un estudio transversal en individuos de 18 a 65 años que fueron evaluados para COVID-19 en el Hospital de Agudos Carlos G. Durand de la Ciudad Autónoma de Buenos Aires, en julio de 2020, durante 15 días. Se calcularon datos sobre sexo, edad, tabaquismo, asma e hipertensión. Se utilizó reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR, del inglés reverse transcription polymerase chain reaction) para la detección del ácido ribonucleico ARN de SARS-CoV-2 (en inglés, severe acute respiratory syndrome coronavirus 2).
Resultados: se incluyó en el estudio un total de 407 (225 femenino, 55,3%) individuos de 37,5±11,4 años. El 48,6% (189) fue confirmado COVID-19. El IMC promedio fue 27,5±5,2. El 37,1% (151) tenía sobrepeso y el 26,8% (109) era obeso. Hubo una prevalencia significativamente mayor de COVID-19 confirmada en personas con asma (7,9% vs 2,5%; p=0,01). El resultado COVID-19 confirmado se asoció con el sexo masculino (r=-0,12; p=0,02) y la presencia de asma (r=0,11; p=0,02). Los análisis de regresión logística múltiple mostraron que la COVID-19 confirmada se asoció con el sexo masculino (OR 0,62; IC del 95%: 0,42-0,93; p 0,02) y el asma (OR3,30; IC del 95%: 1,17-9,34; p 0,02) ajustado por variables de confusión. Hubo una mayor prevalencia de hipertensión (21,1% vs 5,4%; p=0,024) entre quienes fueron hospitalizados. La hospitalización se asoció con hipertensión (OR5,71 IC del 95%: 1,43-22,75; p 0,014) ajustada por variables de confusión.
Conclusiones: la COVID-19 se diagnosticó en individuos menores de 65 años, que es un grupo de edad diferente al reportado habitualmente. La COVID-19 confirmada se asoció con el sexo masculino y el asma. La tasa de individuos hospitalizados fue del 4,4% y se asoció con hipertensión. La tasa de mortalidad de los examinados fue del 0%. Deben realizarse estudios longitudinales futuros para confirmar estos hallazgos.

REFERENCIAS:
1. https://www.worldometers.info/coronavirus/. Último acceso: 26/07/20.
2. Laurencin CT, McClinton A. The COVID-19 pandemic: a call to action to identify and address racial and ethnic disparities. J Racial Ethn Health Disparities 2020; 7:398-402.
3. Biscayart C, Angeleri P, Lloveras S, Chaves T, Schlagenhauf P, Rodríguez-Morales AJ. The next big threat to global health? 2019 novel coronavirus (2019-nCoV): what advice can we give to travellers? Interim recommendations January 2020, from the Latin-American society for Travel Medicine (SLAMVI) Trav Med Infect Dis 2020;101567.
4. Miller MJ, Loaiza JR, Takyar A, Gilman RH. COVID-19 in Latin America: Novel transmission dynamics for a global pandemic? PLoS Negl Trop Dis 2020 May; 14(5): e0008265. DOI: 10.1371/ journal.pntd.0008265.
5. Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus disease 2019 case surveillance. United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:759-765.
6. Rufo PA, Loughlin J. Pulmonology. In: Johnson KB, ed. The Harriet Lane handbook. 13th ed. St Louis: Mosby Year Book Inc, 1993:340–1.
7. Corman VM, Landt O, Kaiser M, Molenkamp R, Meijer A, Chu DKW, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill 2020; 25(3).
8. Kragholm K, Andersen MP, Gerds TA, Butt JH, Østergaard L, Polcwiartek C, Phelps M, Andersson C, Gislason GH, Torp-Pedersen C, Køber L, Schou M, Fosbøl EL. Association between male sex and outcomes of Coronavirus Disease 2019 (COVID-19). A Danish nationwide, register-based study. Clin Infect Dis 2020; 8:ciaa924. DOI: 10.1093/cid/ciaa924.
9. Palaiodimos L, Kokkinidis DG, Li W, Karamanis D, Ognibene J, Arora S, Southern WN, Mantzoros CS. Severe obesity, increasing age and male sex are independently associated with worse inhospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism 2020; 108:154262. DOI: 10.1016.
10. Belanger MJ, Hill MA, Angelidi AM, Dalamaga M, Sowers JR, Mantzoros CS. COVID-19 and disparities in nutrition and obesity. N Engl J Med 2020 Jul 15. DOI: 10.1056/NEJMp2021264.
11. Daniel H, Bornstein SS, Kane GC. Addressing social determinants to improve patient care and promote health equity: an American College of Physicians position paper. Ann Intern Med 2018; 168:577-578.
12. Daniels JP. COVID-19 cases surge in Colombia. Lancet 2020 25- 31 July; 396(10246): 227. DOI: 10.1016/S0140-6736(20)31638.
13. Vasquez-Apestegui V, Parras-Garrido E, Tapia V, Paz-Aparicio VM, Rojas JP, Sánchez-Ccoyllo OR, Gonzales GF. Association between air pollution in Lima and the high incidence of COVID-19: Findings from a post hoc analysis. Res Sq. 2020 6; rs.3.rs-39404. DOI: 10.21203/rs.3.rs-39404/v1.
14. Raifman MA, Raifman JR. Disparities in the population at risk of severe illness from COVID-19 by race/ethnicity and income. Am J Prev Med 2020; 59(1):137-139.
15. Adamkiewicz G, Zota AR, Fabian MP. Moving environmental justice indoors: understanding structural influences on residential exposure patterns in low-income communities. Am J Public Health 2011;101 (suppl1):S238-S245. DOI: 10.2105/ AJPH.2011.300119.
16. Escalera-Antezana JP, et al. Clinical features of the first cases and a cluster of Coronavirus Disease 2019 (COVID-19) in Bolivia imported from Italy and Spain. Travel Med Infect Dis 2020; 35. DOI: 10.1016/j.tmaid.2020.101653.
17. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW. Presenting characteristics, comorbidities, and outcomes among 5,700 patients hospitalized with COVID-19 in the New York City Area. JAMA 2020 May 26; 323(20): 2052- 2059. DOI: 10.1001/jama.2020.6775.
18. Docherty AB, Harrison EM, Green CA, Hardwick H, Pius R, Norman L. Features of 16,749 hospitalized UK patients with COVID-19 using the ISARIC WHO clinical characterization protocol. Med Rxiv 2020. DOI: 10.1101/2020.04.23.20076042.
19. Garg S, Kim L, Whitaker M, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 COVID-NET, 14 states, March 1–30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:458–64. 10.15585/mmwr.mm6915e3.




PRESENCE OF COVID-19 IN ARGENTINES UNDER 65 YEARS OF AGE

SUMMARY

Background: the presence of the COVID-19 virus has been associated with adults aged 65 years and older. However, little has been highlighted in younger people.
Objectives: to determine the association of positive COVID-19 and age, sex, body mass index (BMI), underlying health conditions, hospitalization, and death.
Materials and methods: a cross-sectional study was performed in individuals aged 18 to 65 who were tested for COVID-19 at a Hospital in Buenos Aires in July 2020 over 15 days. Data on sex, age, smoking, asthma, and hypertension were assessed. RT-PCR was used for the detection of the RNA of SARS-CoV-2.
Results: a total of 407 (225 female, 55.3%) individuals aged 37.5±11.4 were included in the study. 48.6% (189) were confirmed COVID-19. The average BMI was 27.5±5.2; 37.1% (151) were overweight and 26.8% (109) obese. There was a significantly higher prevalence of confirmed COVID-19 in individuals with asthma (7.9% vs 2.5%; p=0.01). Confirmed COVID-19 was associated with the male sex (r=-0.12; p=0.02) and the presence of asthma (r=0.11; p=0.02). Multiple logistic regression analyses showed that confirmed COVID-19 was associated with male sex (OR 0.62, 95% CI 0.42-0.93; p 0.02) and asthma (OR3.30, 95% CI 1.17-9.34; p 0.02) adjusted for confounding variables. There was a higher prevalence of hypertension (21.1% vs 5.4%; p=0.024) among those who were hospitalized. Hospitalization was associated with hypertension (OR5.71 95% CI 1.43-22.75; p 0.014) adjusted for confounding variables.
Conclusions: we found that COVID-19 was diagnosed in individuals younger than 65 years, which is a different age group than the usually reported. Confirmed COVID-19 was associated with male sex and asthma. The rate of hospitalized individuals was 4.4% and was associated with hypertension. The mortality rate for those tested was 0%. Future longitudinal studies should be performed to confirm these findings.



DESCARGAR TEXTO COMPLETO EN PDF