Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador.
Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador.
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DOI：
10.1371/journal.pntd.0008958
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发表时间：
2021-01
影响因子：
3.8
通讯作者：
Lowe R
中科院分区：
文献类型：
--
作者：
Ortiz-Prado E;Simbaña-Rivera K;Barreno LG;Diaz AM;Barreto A;Moyano C;Arcos V;Vásconez-González E;Paz C;Simbaña-Guaycha F;Molestina-Luzuriaga M;Fernández-Naranjo R;Feijoo J;Henriquez-Trujillo AR;Adana L;López-Cortés A;Fletcher I;Lowe R
SARS-CoV-2病毒在地球仪迅速传播。然而，描述拉丁美洲COVID-19患者特征和结局的信息有限。我们对厄瓜多尔报告的9，468例确诊COVID-19病例进行了横断面分析。我们计算了总发病率、死亡率、病死率、残疾调整生命年、发作和粗死亡率，以及相对风险和相对死亡几率，并根据年龄、性别和合并症的存在进行了调整。共有9，468例COVID-19阳性病例和474例死亡病例纳入分析。男性占病例的55.4%（n = 5，247），女性占44.6%（n = 4，221）。我们发现合并症的存在，男性和年龄超过65岁是死亡率的重要决定因素。沿海地区受COVID-19影响最大，死亡率高于高地。53.2%的患者报告疲劳，其次是头痛（43%）、干咳（41.7%）、味觉丧失（37.1%）和嗅觉丧失（36.1%）。我们对厄瓜多尔的COVID-19负担进行了分析。我们的研究结果表明，男性死于COVID-19的风险高于女性，并且风险随着年龄和合并症的存在而增加。我们还发现，蓝领工人和失业者的死亡风险更大。这些早期观察结果为医学界提供了临床见解，以帮助改善患者护理，并为公共卫生官员加强厄瓜多尔对疫情的应对提供了帮助。在这项研究中，我们总结了厄瓜多尔新型冠状病毒病（COVID-19）大流行早期的流行病学趋势，厄瓜多尔是全球COVID-19引发的全球健康危机开始时报告的超额死亡率最高的国家。我们对前9,468例患者的流行病学趋势、临床特征、与死亡相关的危险因素和主要人口统计学特征进行了全面分析。厄瓜多尔官方报告了474例COVID-19确诊死亡病例，然而，在同一时期，至少有4，780例死亡病例被报告为急性呼吸窘迫综合征（ARDS），这表明该国对COVID-19病例的报告和检测严重不足。在厄瓜多尔，COVID-19在失业患者中的致命性是白领工人的五倍，这表明贫困与死亡率之间存在密切联系。这是厄瓜多尔首次使用官方报告的COVID-19病例的流行病学报告。高海拔居民的发病率和死亡率低于低地居民，这可能是由于获得保健服务的机会减少。
The SARS-CoV-2 virus has spread rapidly around the globe. Nevertheless, there is limited information describing the characteristics and outcomes of COVID-19 patients in Latin America. We conducted a cross-sectional analysis of 9,468 confirmed COVID-19 cases reported in Ecuador. We calculated overall incidence, mortality, case fatality rates, disability adjusted life years, attack and crude mortality rates, as well as relative risk and relative odds of death, adjusted for age, sex and presence of comorbidities. A total of 9,468 positive COVID-19 cases and 474 deaths were included in the analysis. Men accounted for 55.4% (n = 5, 247) of cases and women for 44.6% (n = 4, 221). We found the presence of comorbidities, being male and older than 65 years were important determinants of mortality. Coastal regions were most affected by COVID-19, with higher mortality rates than the highlands. Fatigue was reported in 53.2% of the patients, followed by headache (43%), dry cough (41.7%), ageusia (37.1%) and anosmia (36.1%). We present an analysis of the burden of COVID-19 in Ecuador. Our findings show that men are at higher risk of dying from COVID-19 than women, and risk increases with age and the presence of comorbidities. We also found that blue-collar workers and the unemployed are at greater risk of dying. These early observations offer clinical insights for the medical community to help improve patient care and for public health officials to strengthen Ecuador’s response to the outbreak. In this study we summarize the epidemiological trends of the early phase of the novel coronavirus disease (COVID-19) pandemic in Ecuador, the country with the highest excess mortality reported at the beginning of the global health crisis due to COVID-19 worldwide. We have carried out a complete analysis of the epidemiological trends, clinical features, risk factors associated with death and the main demographic characteristics of the first 9,468 patients. Ecuador has officially reported 474 COVID-19 confirmed deaths, nevertheless, at least 4,780 deaths were reported as acute respiratory distress syndrome (ARDS) during the same period of time, suggesting an important underreporting and undertesting of COVID-19 cases in the country. In Ecuador, COVID-19 is five times more lethal among unemployed patients compared to white-collar workers, suggesting a strong association between poverty and mortality. This is the first epidemiological report from Ecuador that uses the official reported cases of COVID-19. High altitude dwellers had lower attack and mortality rates than those living in lowlands, possibly due to reduced access to health care services.
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