Analysis of Hospital Lethality of COVID-19 in Mexico

Background. COVID-19 has caused 244,830 deaths in Mexico. Evaluating the severity of this contingency is possible if the hospital fatality rate of COVID-19 is described because hospitalized patients present more severe conditions. Objective. To analyze the fatality of COVID-19 in hospitalized patients. Methods. A quantitative, descriptive, analytical, cross-sectional, and retrospective study was conducted using open database from Ministry of Health in Mexico. Results. The analysis included 71,189 discharges from patients diagnosed with COVID-19 in the Mexican Ministry of Health Hospitals during 2020. Of them, 27,403 were due to death, predominantly in men and age groups from 50 to 69 years. The general hospital fatality due to COVID-19 was 38.49%, a hospital fatality of 40.75% in men and 35.03% in women. The 55-to-99-year-old age groups, Baja California, Puebla, and Coahuila had a higher hospital fatality than the general fatality. Conclusion. Besides the deaths caused directly by COVID-19 (those that occurred due to respiratory failures), many deaths were indirect in persons with comorbidities exacerbated by this disease. Access to health services, social changes derived from job loss, home protection, and changes in social dynamics, facts expressed in the general mortality excess, cannot be quantified in our study. There are similar patterns with other persons infected worldwide: this disease is more severe for males and older age subjects.

Municipality Data as a Rapid and Effective Tool to Analyse Spatial and Temporal Variations of All-Cause Mortality by Town District: The Experience in Genoa (Italy)

The main objective of this study was to analyse the space–time epidemiological differences by sex during the 2009–2020 period in the total mortality recorded among residents in each of the 25 districts of the Genoa municipality, net of the age effect. The analysis was based on official statistical data relating to total mortality and on the resident population. An estimate of the expected deaths was made to calculate the sex-specific age-standardised mortality ratio (SMR). The temporal trends and age-standardized death rates (SDRs) with respect to those of the European population specific to sex and calendar year were identified for each district. Over the entire observation period, the SMR for males ranged from 124.4 (Cornigliano) to 82.0 (Albaro); for females, the values ranged between 133.4 (Cornigliano) and 85.6 (Nervi-Quinto-S. Ilario). Between 2019 and 2020, Genoa recorded an increase in SDR of 24.5%, more pronounced in males (+26.7%) than in females (+22.4%). This epidemiological methodology is replicable and allows to quickly identify spatial, temporal, sex, and age differences in the general mortality within a municipality.

Healthcare-related impact of gout in hospitalized patients in Spain

To analyze the epidemiology, clinical features and costs of hospitalized patients with gout during the last decade in Spain. Retrospective observational study based on data from the Minimum Basic Data Set (MBDS) from the Spanish National Health Service database. Patients ≥ 18 years with any gout diagnosis at discharge who had been admitted to public or private hospitals between 2005 and 2015 were included. Patients were divided in two periods: p1 (2005–2010) and p2 (2011–2015) to compare the number of hospitalizations, mean costs and mortality rates. Data from 192,037 patients with gout was analyzed. There was an increase in the number of hospitalized patients with gout (p < 0.001). The more frequent comorbidities were diabetes (27.6% of patients), kidney disease (26.6%) and heart failure (19.3%). Liver disease (OR 2.61), dementia (OR 2.13), cerebrovascular diseases (OR 1.57), heart failure (OR 1.41), and kidney disease (OR 1.34) were associated with a higher mortality risk. Women had a lower risk of mortality than men (OR 0.85). General mortality rates in these hospitalized patients progressively increased over the years (p < 0.001). In addition, costs gradually rose, presenting a significant increase in p2 even after adjusting for inflation (p = 0.001). A progressive increase in hospitalizations, mortality rates and cost in hospitalized patients with gout was observed. This harmful trend in a preventable illness highlights the need for change and the search for new healthcare strategies.

Mortalidade Geral no Sudoeste do Pará: uma análise de Cluster entre sexos

Introdução: O acompanhamento precípuo da mortalidade geral viabiliza a identificação do perfil epidemiológico sobre as diferenças regionais que interferem na realidade da população. Objetivo: O estudo tevecomo objetivo identificar a razão de mortalidade geral por ano e por sexo, elencando as diferenças nos municípios pertencentes a um centro regional de saúde no sudeste do estado do Pará. Método: Trata-se de um estudo ecológico de série histórica, entre os anos 2000 a 2015, com dados secundários de todos os municípios pertencentes ao 11º Centro Regional de Saúde do estado do Pará. Resultados: Dos 23 municípios da regional de saúde, os municípios de Curionópolis, Jacundá, Marabá e Rondon do Pará, apresentaram elevada taxa de mortalidade para ambos os sexos. O maior percentual de óbitos masculinos ocorreu no ano de 2010 (67,9%), com razão igual a 5,40 por mil habitantes. Estima-se um aumentode até 55,1% (R2=0,55) da mortalidade para o sexo masculino nos próximos anos. Conclusões: A implementação e o aperfeiçoamento de políticas públicas em saúde voltadas para a redução dos índices de mortalidade que acometem principalmente os homens é fundamental e substancial nas ações para identificação dos fatores de risco e, principalmente, no monitoramento dos óbitos. GENERAL MORTALITY IN SOUTHEASTERN PARÁ: A CLUSTER ANALYSIS BETWEEN SEXES Introduction: The primary follow-up of general mortality enables the identification of the epidemiological profile on regional differences that interfere in the reality of the population. Objective: The study aimed to identify the ratio of general mortality per year and sex, electing the differences in municipalities belonging to a regional health center in the Southeast of Pará state. Method: This is an ecological study of historical series between the years 2000 to 2015, with secondary data from all municipalities belonging to the 11th Regional Health Center of the state of Pará. Results: Of the 23 municipalities of the regional health, the municipalities of Curionópolis, Jacundá, Marabá and Rondon do Pará presented a high mortality rate for both sexes. The highest percentage of male deaths occurred in 2010 (67.9%) with a ratio equal to 5.40 per thous and in habitants. An increase of up to 55.1% (R2=0.55) in male mortality is estimated for the coming years. Conclusions: The implementation and improvement of public health policies aimed at reducing mortality rates that mainly affect men, is fundamental and substantial in actions to identify risk factors and monitoring of deaths.

Increase in cocaine-related deaths in Slovenia

Background In 2016, sudden increase in cocaine related deaths was reported in Slovenia. Study aims to provide data for understanding this new trend and results will serve to create responds to prevent those deaths in the future. Methods We used a trendspotter study methodology. Data from General Mortality Register with forensic autopsies and toxicological analysis were overviewed. For further analysis we linked mortality data with the treatment database for the history of treatment. Data from Early Warning System and national Police service were used. Results All 18 cocaine deaths in 2016 were men with average age 38.9 years. The highest number of deaths occurred in the 30-34 age group. Deaths in time periods can not be linked with seizures of cocaine with certainty. An autopsy was performed in 17 people. Cocaine with benzodiazepines was found in 7 deaths or with opiates in five deaths. Followed are combinations with amphetamines, alcohol and cannabis. 33% were included in the treatment programs. Conclusions No detailed data on cocaine related deaths was available in Slovenia until now. With analysis we got an important inside on this problem and the basis for setting trends regarding cocaine deaths in Slovenia. Key messages Sudden increase in cocaine related deaths was reported in Slovenia. Study aims to provide data for understanding new trend in cocaine related deaths.

Mortality and causes of death: 6 years of monitoring treated drug users

Background This study aims to analyse mortality among deceased cohort members from 2009-2015 in Slovenia in terms of causes of death. Cohort follows illicit drug users who were registered for the first time or repeatedly in Centres for illicit drug usage prevention and treatment. Methods 5157 subjects entered in a retrospective cohort study who were observed for 29.146 years. Data on deceased drug users from 2009 to 2012 were cross-linked with data from the General Mortality Register for the period 2009-2015. Results During 2009-2015 total of 153 deaths were recorded, mean age at death was 39.5 years. In almost three quarters violent death was the prevalent cause; among somatic causes alcoholic liver cirrhosis was the most frequent cause of death, followed by malignancies. Violent deaths occurred due to unintentional poisoning in 37%, followed by deaths from unidentified causes (11%), suicides (17%) and road accidents (2%). One half of suicides were committed by hanging. Conclusions Public health policies in the field of addiction should be more intensely focused on education on alcohol damage due to drinking, screening for patients with overdose risk and in establishing specific programs and strategies for reducing the risk of suicide in this population. Key messages Drug users should receive education on alcohol damage due to drinking. Drug users are in the risk of suicide.

The Promise of Mesenchymal stem cells therapy for acute Respiratory Distress Syndrome Caused by COVID-19

: The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since Dec 2019, known as COVID-19 or 19-nCoV, has led to a major concern of the potential for not only an epidemic but a pandemic in China and now it seems to be a public health problem all over the world. The general mortality rate of the COVID-19 was about 3%. However, the mortality risk seems to be a significant increase in elderly and cases with chronic disease, who are more likely to develop into acute respiratory distress syndrome (ARDS). There still lacks effective methods for ARDS of COVID-19 patients and the prognosis was poor. Mesenchyma stem cells (MSCs) based treatment has the advantage of targeting numerous pathophysiological components of ARDS by secreting a series of cell factors, exerting anti-inflammatory, antioxidative, immunomodulatory, antiapoptotic, and proangiogenic effects, resulting in significant structural and functional recovery following ARDS in various preclinical models. And recently pilot clinical studies indicated MSCs based therapy was promise in treatment of ARDS caused by SARS-CoV-2. However, little is known about MSCs therapy for ARDS caused by COVID-19.