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Article ; Online: Profiling Cases With Nonrespiratory Symptoms and Asymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infections in Mexico City.

Bello-Chavolla, Omar Yaxmehen / Antonio-Villa, Neftali Eduardo / Vargas-Vázquez, Arsenio / Fermín-Martínez, Carlos A / Márquez-Salinas, Alejandro / Bahena-López, Jessica Paola

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2020 Volume 72, Issue 10, Page(s) e655–e658

Abstract: We profiled cases with nonrespiratory symptoms (NRS) and asymptomatic severe acute respiratory syndrome coronavirus 2 infections assessed within Mexico City's Epidemiological Surveillance System. Initially asymptomatic or NRS cases have decreased risk of ...

Abstract	We profiled cases with nonrespiratory symptoms (NRS) and asymptomatic severe acute respiratory syndrome coronavirus 2 infections assessed within Mexico City's Epidemiological Surveillance System. Initially asymptomatic or NRS cases have decreased risk of adverse outcomes compared with cases with respiratory symptoms. Comorbidity and age influence symptom development in initially asymptomatic cases.
MeSH term(s)	Asymptomatic Infections/epidemiology ; COVID-19 ; Comorbidity ; Humans ; Mexico/epidemiology ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-08-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa1288
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Article ; Online: Elevated serum uric acid is a facilitating mechanism for insulin resistance mediated accumulation of visceral adipose tissue.

Fernández-Chirino, Luisa / Antonio-Villa, Neftali Eduardo / Fermín-Martínez, Carlos A / Márquez-Salinas, Alejandro / Guerra, Enrique C / Vargas-Vázquez, Arsenio / Almeda-Valdés, Paloma / Gómez-Velasco, Donají / Viveros-Ruiz, Tania L / Rojas, Rosalba / Aguilar Salinas, Carlos A / Bello-Chavolla, Omar Yaxmehen

Clinical endocrinology

2022 Volume 96, Issue 5, Page(s) 707–718

Abstract: Objective: Serum uric acid (SUA) has been associated with cardiometabolic conditions such as insulin resistance (IR) and visceral adipose tissue (VAT) accumulation. Here, we aimed to clarify a unifying mechanism linking elevated SUA to IR and VAT.: ... ...

Abstract	Objective: Serum uric acid (SUA) has been associated with cardiometabolic conditions such as insulin resistance (IR) and visceral adipose tissue (VAT) accumulation. Here, we aimed to clarify a unifying mechanism linking elevated SUA to IR and VAT. Methods: We conducted analyses in 226 subjects from the UIEM cohort with both euglycemic hyperinsulinemic clamp (EHC) and dual X-ray absorptiometry (DXA) measurements for IR and VAT accumulation and explored the role of SUA and adiponectin by developing a network of causal mediation analyses to assess their impact on IR and VAT. These models were then translated to two population-based cohorts comprising 6337 subjects from NHANES 2003-2004 and 2011-2012 cycles in the US and ENSANUT Medio Camino 2016 in Mexico, using HOMA2IR and adipoIR as indicators of peripheral and adipose tissue IR, and METS-VF as a surrogate for VAT accumulation. Results: SUA has a mediating role inside a bidirectional relationship between IR and visceral obesity, which was similar using either gold standard measurements or surrogate measures for IR and VAT. Furthermore, adiponectin acts as a linking mediator between elevated SUA and both peripheral IR and VAT accumulation. The proportion of the mechanism for IR-mediated (in either peripheral or adipose tissue) VAT accumulation was greater, compared to VAT-mediated IR accumulation (10.53% [9.23%-12.00%] to 5.44% [3.78%-7.00%]). Normal-range SUA levels can be used to rule-out underlying cardio-metabolic abnormalities in both men and women. Conclusions: Elevated SUA acts as a mediator inside the bidirectional relationship between IR and VAT accumulation and these observations could be applicable at a phenotype scale.
MeSH term(s)	Adipose Tissue ; Female ; Glucose Clamp Technique ; Humans ; Insulin Resistance ; Intra-Abdominal Fat ; Nutrition Surveys ; Uric Acid
Chemical Substances	Uric Acid (268B43MJ25)
Language	English
Publishing date	2022-01-09
Publishing country	England
Document type	Journal Article
ZDB-ID	121745-8
ISSN	1365-2265 ; 0300-0664
ISSN (online)	1365-2265
ISSN	0300-0664
DOI	10.1111/cen.14673
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Article ; Online: Diagnostic performance and clinical implications of rapid SARS-CoV-2 antigen testing in Mexico using real-world nationwide COVID-19 registry data.

Bello-Chavolla, Omar Yaxmehen / Antonio-Villa, Neftali Eduardo / Fernández-Chirino, Luisa / Guerra, Enrique C / Fermín-Martínez, Carlos A / Márquez-Salinas, Alejandro / Vargas-Vázquez, Arsenio / Bahena-López, Jessica Paola

PloS one

2021 Volume 16, Issue 8, Page(s) e0256447

Abstract: Background: SARS-CoV-2 testing capacity is important to monitor epidemic dynamics and as a mitigation strategy. Given difficulties of large-scale quantitative reverse transcription polymerase chain reaction (qRT-PCR) implementation, rapid antigen tests ( ...

Abstract	Background: SARS-CoV-2 testing capacity is important to monitor epidemic dynamics and as a mitigation strategy. Given difficulties of large-scale quantitative reverse transcription polymerase chain reaction (qRT-PCR) implementation, rapid antigen tests (Rapid Ag-T) have been proposed as alternatives in settings like Mexico. Here, we evaluated diagnostic performance of Rapid Ag-T for SARS-CoV-2 infection and its associated clinical implications compared to qRT-PCR testing in Mexico. Methods: We analyzed data from the COVID-19 registry of the Mexican General Directorate of Epidemiology up to April 30th, 2021 (n = 6,632,938) and cases with both qRT-PCR and Rapid Ag-T (n = 216,388). We evaluated diagnostic performance using accuracy measures and assessed time-dependent changes in the Area Under the Receiver Operating Characteristic curve (AUROC). We also explored test discordances as predictors of hospitalization, intubation, severe COVID-19 and mortality. Results: Rapid Ag-T is primarily used in Mexico City. Rapid Ag-T have low sensitivity 37.6% (95%CI 36.6-38.7), high specificity 95.5% (95%CI 95.1-95.8) and acceptable positive 86.1% (95%CI 85.0-86.6) and negative predictive values 67.2% (95%CI 66.2-69.2). Rapid Ag-T has optimal diagnostic performance up to days 3 after symptom onset, and its performance is modified by testing location, comorbidity, and age. qRT-PCR (-) / Rapid Ag-T (+) cases had higher risk of adverse COVID-19 outcomes (HR 1.54 95% CI 1.41-1.68) and were older, qRT-PCR (+)/ Rapid Ag-T(-) cases had slightly higher risk or adverse outcomes and ≥7 days from symptom onset (HR 1.53 95% CI 1.48-1.59). Cases detected with rapid Ag-T were younger, without comorbidities, and milder COVID-19 course. Conclusions: Rapid Ag-T could be used as an alternative to qRT-PCR for large scale SARS-CoV-2 testing in Mexico. Interpretation of Rapid Ag-T results should be done with caution to minimize the risk associated with false negative results.
MeSH term(s)	Adult ; Antigens, Viral/analysis ; Area Under Curve ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/virology ; COVID-19 Nucleic Acid Testing ; COVID-19 Serological Testing ; Female ; Hospitalization/statistics & numerical data ; Humans ; Male ; Mexico/epidemiology ; Middle Aged ; Proportional Hazards Models ; RNA, Viral/analysis ; RNA, Viral/metabolism ; ROC Curve ; Registries ; Retrospective Studies ; SARS-CoV-2/isolation & purification ; SARS-CoV-2/metabolism ; Sensitivity and Specificity ; Young Adult
Chemical Substances	Antigens, Viral ; RNA, Viral
Language	English
Publishing date	2021-08-31
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0256447
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Article ; Online: AnthropoAge, a novel approach to integrate body composition into the estimation of biological age.

Fermín-Martínez, Carlos A / Márquez-Salinas, Alejandro / Guerra, Enrique C / Zavala-Romero, Lilian / Antonio-Villa, Neftali Eduardo / Fernández-Chirino, Luisa / Sandoval-Colin, Eduardo / Barquera-Guevara, Daphne Abigail / Campos Muñoz, Alejandro / Vargas-Vázquez, Arsenio / Paz-Cabrera, César Daniel / Ramírez-García, Daniel / Gutiérrez-Robledo, Luis Miguel / Bello-Chavolla, Omar Yaxmehen

Aging cell

2022 Volume 22, Issue 1, Page(s) e13756

Abstract: Aging is believed to occur across multiple domains, one of which is body composition; however, attempts to integrate it into biological age (BA) have been limited. Here, we consider the sex-dependent role of anthropometry for the prediction of 10-year ... ...

Abstract	Aging is believed to occur across multiple domains, one of which is body composition; however, attempts to integrate it into biological age (BA) have been limited. Here, we consider the sex-dependent role of anthropometry for the prediction of 10-year all-cause mortality using data from 18,794 NHANES participants to generate and validate a new BA metric. Our data-driven approach pointed to sex-specific contributors for BA estimation: WHtR, arm and thigh circumferences for men; weight, WHtR, thigh circumference, subscapular and triceps skinfolds for women. We used these measurements to generate AnthropoAge, which predicted all-cause mortality (AUROC 0.876, 95%CI 0.864-0.887) and cause-specific mortality independently of ethnicity, sex, and comorbidities; AnthropoAge was a better predictor than PhenoAge for cerebrovascular, Alzheimer, and COPD mortality. A metric of age acceleration was also derived and used to assess sexual dimorphisms linked to accelerated aging, where women had an increase in overall body mass plus an important subcutaneous to visceral fat redistribution, and men displayed a marked decrease in fat and muscle mass. Finally, we showed that consideration of multiple BA metrics may identify unique aging trajectories with increased mortality (HR for multidomain acceleration 2.43, 95%CI 2.25-2.62) and comorbidity profiles. A simplified version of AnthropoAge (S-AnthropoAge) was generated using only BMI and WHtR, all results were preserved using this metric. In conclusion, AnthropoAge is a useful proxy of BA that captures cause-specific mortality and sex dimorphisms in body composition, and it could be used for future multidomain assessments of aging to better characterize the heterogeneity of this phenomenon.
MeSH term(s)	Male ; Humans ; Female ; Nutrition Surveys ; Body Composition/physiology ; Anthropometry ; Aging ; Comorbidity ; Body Mass Index ; Adipose Tissue/metabolism
Language	English
Publishing date	2022-12-22
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2113083-8
ISSN	1474-9726 ; 1474-9718
ISSN (online)	1474-9726
ISSN	1474-9718
DOI	10.1111/acel.13756
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Zs.A 6581: Show issues

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Article ; Online: Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico.

Bello-Chavolla, Omar Yaxmehen / Bahena-López, Jessica Paola / Antonio-Villa, Neftali Eduardo / Vargas-Vázquez, Arsenio / González-Díaz, Armando / Márquez-Salinas, Alejandro / Fermín-Martínez, Carlos A / Naveja, J Jesús / Aguilar-Salinas, Carlos A

The Journal of clinical endocrinology and metabolism

2020 Volume 105, Issue 8

Abstract: Background: The SARS-CoV-2 outbreak poses a challenge to health care systems due to its high complication rates in patients with cardiometabolic diseases. Here, we identify risk factors and propose a clinical score to predict COVID-19 lethality, ... ...

Abstract	Background: The SARS-CoV-2 outbreak poses a challenge to health care systems due to its high complication rates in patients with cardiometabolic diseases. Here, we identify risk factors and propose a clinical score to predict COVID-19 lethality, including specific factors for diabetes and obesity, and its role in improving risk prediction. Methods: We obtained data of confirmed and negative COVID-19 cases and their demographic and health characteristics from the General Directorate of Epidemiology of the Mexican Ministry of Health. We investigated specific risk factors associated to COVID-19 positivity and mortality and explored the impact of diabetes and obesity on modifying COVID-19-related lethality. Finally, we built a clinical score to predict COVID-19 lethality. Results: Among the 177 133 subjects at the time of writing this report (May 18, 2020), we observed 51 633 subjects with SARS-CoV-2 and 5,332 deaths. Risk factors for lethality in COVID-19 include early-onset diabetes, obesity, chronic obstructive pulmonary disease, advanced age, hypertension, immunosuppression, and chronic kidney disease (CKD); we observed that obesity mediates 49.5% of the effect of diabetes on COVID-19 lethality. Early-onset diabetes conferred an increased risk of hospitalization and obesity conferred an increased risk for intensive care unit admission and intubation. Our predictive score for COVID-19 lethality included age ≥ 65 years, diabetes, early-onset diabetes, obesity, age < 40 years, CKD, hypertension, and immunosuppression and significantly discriminates lethal from non-lethal COVID-19 cases (C-statistic = 0.823). Conclusions: Here, we propose a mechanistic approach to evaluate the risk for complications and lethality attributable to COVID-19, considering the effect of obesity and diabetes in Mexico. Our score offers a clinical tool for quick determination of high-risk susceptibility patients in a first-contact scenario.
MeSH term(s)	Adult ; Age Factors ; Aged ; Betacoronavirus ; COVID-19 ; Comorbidity ; Coronavirus Infections/immunology ; Coronavirus Infections/mortality ; Databases, Factual ; Diabetes Mellitus/mortality ; Disease Susceptibility ; Female ; Hospitalization/statistics & numerical data ; Humans ; Immunocompromised Host ; Male ; Mexico/epidemiology ; Middle Aged ; Obesity/mortality ; Pandemics ; Pneumonia, Viral/immunology ; Pneumonia, Viral/mortality ; Prognosis ; Proportional Hazards Models ; Pulmonary Disease, Chronic Obstructive/mortality ; Renal Insufficiency, Chronic/mortality ; Risk Assessment/methods ; Risk Factors ; SARS-CoV-2 ; Sex Factors
Keywords	covid19
Language	English
Publishing date	2020-05-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgaa346
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Article ; Online: Arginine vasopressin regulates the renal Na

Carbajal-Contreras, Hector / Murillo-de-Ozores, Adrian Rafael / Magaña-Avila, German / Marquez-Salinas, Alejandro / Bourqui, Laurent / Tellez-Sutterlin, Michelle / Bahena-Lopez, Jessica P / Cortes-Arroyo, Eduardo / Behn-Eschenburg, Sebastián González / Lopez-Saavedra, Alejandro / Vazquez, Norma / Ellison, David H / Loffing, Johannes / Gamba, Gerardo / Castañeda-Bueno, Maria

American journal of physiology. Renal physiology

2023 Volume 326, Issue 2, Page(s) F285–F299

Abstract: Vasopressin regulates water homeostasis via the V2 receptor in the kidney at least in part through protein kinase A (PKA) activation. Vasopressin, through an unknown pathway, upregulates the activity and phosphorylation of ... ...

Abstract	Vasopressin regulates water homeostasis via the V2 receptor in the kidney at least in part through protein kinase A (PKA) activation. Vasopressin, through an unknown pathway, upregulates the activity and phosphorylation of Na
MeSH term(s)	Mice ; Humans ; Animals ; Phosphorylation ; Protein Serine-Threonine Kinases/metabolism ; HEK293 Cells ; Arginine Vasopressin/metabolism ; K Cl- Cotransporters ; Deamino Arginine Vasopressin ; Colforsin ; Protein Phosphatase 1/metabolism ; Kidney/metabolism ; Solute Carrier Family 12, Member 3/metabolism ; Cyclic AMP-Dependent Protein Kinases/metabolism
Chemical Substances	Protein Serine-Threonine Kinases (EC 2.7.11.1) ; Arginine Vasopressin (113-79-1) ; K Cl- Cotransporters ; Deamino Arginine Vasopressin (ENR1LLB0FP) ; Colforsin (1F7A44V6OU) ; Protein Phosphatase 1 (EC 3.1.3.16) ; Solute Carrier Family 12, Member 3 ; Cyclic AMP-Dependent Protein Kinases (EC 2.7.11.11)
Language	English
Publishing date	2023-12-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603837-2
ISSN	1522-1466 ; 0363-6127
ISSN (online)	1522-1466
ISSN	0363-6127
DOI	10.1152/ajprenal.00343.2023
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Article ; Online: Assessing the Burden of Coronavirus Disease 2019 (COVID-19) Among Healthcare Workers in Mexico City: A Data-Driven Call to Action.

Antonio-Villa, Neftali Eduardo / Bello-Chavolla, Omar Yaxmehen / Vargas-Vázquez, Arsenio / Fermín-Martínez, Carlos A / Márquez-Salinas, Alejandro / Pisanty-Alatorre, Julio / Bahena-López, Jessica Paola

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2020 Volume 73, Issue 1, Page(s) e191–e198

Abstract: Background: Healthcare workers (HCWs) could be at increased occupational risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections due to increased exposure. Information regarding the burden of coronavirus disease 2019 (COVID-19) ... ...

Abstract	Background: Healthcare workers (HCWs) could be at increased occupational risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections due to increased exposure. Information regarding the burden of coronavirus disease 2019 (COVID-19) epidemic in HCWs living in Mexico is scarce. Here, we aimed to explore the epidemiology, symptoms, and risk factors associated with adverse outcomes in HCWs in Mexico City. Methods: We explored data collected by the National Epidemiological Surveillance System in Mexico City, in HCWs who underwent real-time reverse transcription polymerase chain reaction (RT-PCR) test. We explored COVID-19 outcomes in HCWs and the performance of symptoms to detect SARS-CoV-2 infection. Results: As of 20 September 2020, 57 758 HCWs were tested for SARS-CoV-2 and 17 531 were confirmed (30.35%); 6610 were nurses (37.70%), 4910 physicians (28.0%), 267 dentists (1.52%), and 5744 laboratory personnel and other HCWs (32.76%). Overall, 2378 HCWs required hospitalization (4.12%), 2648 developed severe COVID-19 (4.58%), and 336 required mechanical-ventilatory support (.58%). Lethality was recorded in 472 (.82%) cases. We identified 635 asymptomatic SARS-CoV-2 infections (3.62%). Compared with general population, HCWs had higher incidence, testing, asymptomatic cases, and mortality rates. No individual symptom offers adequate performance to detect SARS-CoV2. Older HCWs with chronic noncommunicable diseases and severe respiratory symptoms were associated with higher risk for adverse outcome; physicians were at higher risk compared with nurses and other HCWs. Conclusions: We report a high prevalence of SARS-CoV-2 infection in HCWs in Mexico City. Symptoms as a screening method are not efficient to discern those HCWs with a positive PCR-RT test. Particular attention should focus on HCWs with risk factors to prevent adverse outcomes.
MeSH term(s)	COVID-19 ; Health Personnel ; Humans ; Mexico ; RNA, Viral ; SARS-CoV-2
Chemical Substances	RNA, Viral
Keywords	covid19
Language	English
Publishing date	2020-10-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1093/cid/ciaa1487
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Article: Profiling cases with non-respiratory symptoms and asymptomatic SARS-CoV-2 infections in Mexico City

Bello-Chavolla, Omar Yaxmehen / Antonio-Villa, Neftali Eduardo / Vargas-Vázquez, Arsenio / Fermín-Martínez, Carlos A / Márquez-Salinas, Alejandro / Bahena-López, Jessica Paola

Clin. infect. dis

Abstract: We profiled cases with non-respiratory symptoms (NRS) and asymptomatic SARS-CoV-2 assessed within Mexico City's Epidemiological Surveillance System. We show that initially asymptomatic or NRS cases have decreased risk of adverse COVID-19 outcomes ... ...

Abstract	We profiled cases with non-respiratory symptoms (NRS) and asymptomatic SARS-CoV-2 assessed within Mexico City's Epidemiological Surveillance System. We show that initially asymptomatic or NRS cases have decreased risk of adverse COVID-19 outcomes compared to cases with respiratory symptoms. Comorbidity and age influence likelihood of developing symptoms in initially asymptomatic cases.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #733396
Database	COVID19

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Article: Health-care workers with COVID-19 living in Mexico City: clinical characterization and related outcomes

Antonio-Villa, Neftali Eduardo / Bello-Chavolla, Omar Yaxmehen / Vargas-Vázquez, Arsenio / Fermín-Martínez, Carlos A / Márquez-Salinas, Alejandro / Bahena-López, Jessica Paola

Clin. infect. dis

Abstract: BACKGROUND: Health-care workers (HCWs) could be at increased occupational risk for SARS-CoV-2 infection. Information regarding prevalence and risk factors for adverse outcomes in HCWs is scarce in Mexico. Here, we aimed to explore prevalence of SARS-CoV- ... ...

Abstract	BACKGROUND: Health-care workers (HCWs) could be at increased occupational risk for SARS-CoV-2 infection. Information regarding prevalence and risk factors for adverse outcomes in HCWs is scarce in Mexico. Here, we aimed to explore prevalence of SARS-CoV-2, symptoms, and risk factors associated with adverse outcomes in HCWs in Mexico City. METHODS: We explored data collected by the National Epidemiological Surveillance System in Mexico City. All cases underwent real-time RT-PCR test. We explored outcomes related to severe COVID-19 in HCWs and the diagnostic performance of symptoms to detect SARS-CoV-2 infection in HCWs. RESULTS: As of July 5 th, 2020, 35,095 HCWs were tested for SARS-CoV-2 and 11,226 were confirmed (31.9%). Overall, 4,322 were nurses (38.5%), 3,324 physicians (29.6%), 131 dentists (1.16%) and 3,449 laboratory personnel and other HCWs (30.8%). After follow-up, 1,009 HCWs required hospitalization (9.00%), 203 developed severe outcomes (1.81%), and 93 required mechanical-ventilatory support (0.82%). Lethality was recorded in 226 (2.01%) cases. Symptoms associated with SARS-CoV-2 positivity were fever, cough, malaise, shivering, myalgias at evaluation but neither had significant predictive value. We also identified 341 asymptomatic SARS-CoV-2 infections (3.04%). Older HCWs with chronic non-communicable diseases, pregnancy, and severe respiratory symptoms were associated with higher risk for adverse outcomes. Physicians had higher risk for hospitalization and for severe outcomes compared with nurses and other HCWs. CONCLUSIONS: We report a high prevalence of SARS-CoV-2 infection in HCWs in Mexico City. No symptomatology can accurately discern HCWs with SARS-CoV-2 infection. Particular attention should focus on HCWs with risk factors to prevent adverse outcomes and reduce infection risk.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #798930
Database	COVID19

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Article ; Online: Health-care workers with COVID-19 living in Mexico City

Antonio-Villa, Neftali Eduardo / Bello-Chavolla, Omar Yaxmehen / Vargas-Vázquez, Arsenio / Fermín-Martínez, Carlos A / Márquez-Salinas, Alejandro / Bahena-López, Jessica Paola

Clinical Infectious Diseases ; ISSN 1058-4838 1537-6591

clinical characterization and related outcomes

2020

Abstract: Abstract Background Health-care workers (HCWs) could be at increased occupational risk for SARS-CoV-2 infection. Information regarding prevalence and risk factors for adverse outcomes in HCWs is scarce in Mexico. Here, we aimed to explore prevalence of ... ...

Abstract	Abstract Background Health-care workers (HCWs) could be at increased occupational risk for SARS-CoV-2 infection. Information regarding prevalence and risk factors for adverse outcomes in HCWs is scarce in Mexico. Here, we aimed to explore prevalence of SARS-CoV-2, symptoms, and risk factors associated with adverse outcomes in HCWs in Mexico City. Methods We explored data collected by the National Epidemiological Surveillance System in Mexico City. All cases underwent real-time RT-PCR test. We explored outcomes related to severe COVID-19 in HCWs and the diagnostic performance of symptoms to detect SARS-CoV-2 infection in HCWs. Results As of July 5 th, 2020, 35,095 HCWs were tested for SARS-CoV-2 and 11,226 were confirmed (31.9%). Overall, 4,322 were nurses (38.5%), 3,324 physicians (29.6%), 131 dentists (1.16%) and 3,449 laboratory personnel and other HCWs (30.8%). After follow-up, 1,009 HCWs required hospitalization (9.00%), 203 developed severe outcomes (1.81%), and 93 required mechanical-ventilatory support (0.82%). Lethality was recorded in 226 (2.01%) cases. Symptoms associated with SARS-CoV-2 positivity were fever, cough, malaise, shivering, myalgias at evaluation but neither had significant predictive value. We also identified 341 asymptomatic SARS-CoV-2 infections (3.04%). Older HCWs with chronic non-communicable diseases, pregnancy, and severe respiratory symptoms were associated with higher risk for adverse outcomes. Physicians had higher risk for hospitalization and for severe outcomes compared with nurses and other HCWs. Conclusions We report a high prevalence of SARS-CoV-2 infection in HCWs in Mexico City. No symptomatology can accurately discern HCWs with SARS-CoV-2 infection. Particular attention should focus on HCWs with risk factors to prevent adverse outcomes and reduce infection risk.
Keywords	Microbiology (medical) ; Infectious Diseases ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
DOI	10.1093/cid/ciaa1487
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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