RESUMEN
BACKGROUND: Information on Paxlovid™ effectiveness must be monitored and updated in real world scenarios. Our research question was what is the effectiveness of Paxlovid™ in adult patients with COVID-19? Therefore, we investigated the effectiveness of Paxlovid™ on reducing the incidence of pneumonia, hospitalization, and mortality in a cohort of COVID-19 positive adult patients from northeast Mexico. METHODS: A retrospective cohort study of COVID-19 positive adult patients from Nuevo Leon, Mexico from December 2020 to May 2023 (after Omicron BA-5 circulation) was performed. Paxlovid™ use was authorized in September 2022. Therefore, we analyzed effectiveness in patients with confirmed diagnosis who met selection criteria between September 2022 and May 2023 (n = 20,799; 5,673 with and 15,126 without Paxlovid™). RESULTS: The pneumonia (0.1% vs. 0.4%, p < 0.0001), hospitalization (0.1% vs. 1.2%, p < 0.0001), and death rates (0.04% vs. 0.2%, p < 0.0001) were lower in patients with Paxlovid™ treatment independently of age, sex, comorbidity, and COVID-19 and pneumococcal vaccination history. Effectiveness was 88.2%, 95.9% y 91.9% for pneumonia, hospitalization, and death, respectively. CONCLUSIONS: Paxlovid™ reduces the presentation of pneumonia, hospitalization, and death secondary to COVID-19. It is recommended to continue monitoring Paxlovid™ effectiveness, as other SARS-CoV-2 variants continue to emerge.
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COVID-19 , Hospitalización , SARS-CoV-2 , Humanos , Masculino , México/epidemiología , Femenino , Hospitalización/estadística & datos numéricos , Estudios Retrospectivos , Persona de Mediana Edad , COVID-19/mortalidad , COVID-19/epidemiología , COVID-19/prevención & control , Incidencia , Adulto , Anciano , Tratamiento Farmacológico de COVID-19 , Neumonía/mortalidad , Neumonía/epidemiología , Neumonía/prevención & control , Anciano de 80 o más AñosRESUMEN
COVID-19 vaccines' safety has been extensively studied; however, further analysis is required in pregnant women, nursing mothers, and breastfed infants. Our aim was to compare the extension and severity of self-reported COVID-19 vaccine side effects in pregnant and breastfeeding women, and breastfed infants. In this cross-sectional study, COVID-19-vaccinated subjects were enrolled using an online survey in Mexico. Women were classified by pregnancy and breastfeeding status at the time of vaccination (n = 3167). After the first or only dose, there was a trend toward fewer systemic effects in pregnant women (p = 0.06). BNT162b2 (Pfizer-BioNTech) had a higher frequency of local symptoms in pregnancy. Lactating women experienced fewer local symptoms after the first or single dose (p = 0.04) and the opposite occurred after the second dose (p = 0.001). ChAdOx1 (AstraZeneca) increased the chances of developing both local and systemic symptoms after the first dose but decreased them after the second dose. The severity was similar across groups, although the result of lack of association in pregnancy requires studies with a larger sample size. Irritability was the most reported symptom in breastfed infants. This study contributes to the knowledge about the side effects in pregnant and lactating women, and breastfed babies.
RESUMEN
OBJECTIVES: Worksites have been considered a propitious environment for promoting health. In 2005, an integrated preventive care (IPC) system was implemented in Mexico consisting of health promotion and disease prevention interrelated activities, delivered on a single visit and on location. This project contributes relevant information on IPC coverage and its degree of effectiveness on providing health promotion services to workers at high-risk worksites. METHODS: There were included 68 worksites particularly affected by high fatal and nonfatal injury rates; the target population comprised 45,724 workers. Coverage referred to the completion of IPC actions within the last year, and effectiveness was defined as the extent to which an observed IPC coverage came close to an ideal IPC coverage. Means and 95% confidence intervals (CI) were calculated for given estimates. RESULTS AND CONCLUSIONS: Overall IPC mean coverage effectiveness was 61.2% (95% CI 60.8-61.6), a value below satisfactory range limits. Results broken down by sex and age showed higher mean coverage effectiveness for adult working men than adult working women (p < 0.0001). Promotion of reproductive health was the IPC process with the lowest mean coverage effectiveness (51.8%; 95% CI 50.8-52.7), followed by the disease detection process (59.0%; 95% CI 58.4-59.6) and the disease prevention and control process (61.0%; 95% CI 60.5-61.5). Maintaining the health of the workforce poses a significant challenge for health services. Therefore, analysis of coverage effectiveness represents a useful tool for evaluating and reorganizing preventive medicine care at worksites.
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Promoción de la Salud , Salud Laboral/estadística & datos numéricos , Servicios Preventivos de Salud/estadística & datos numéricos , Adolescente , Adulto , Femenino , Educación en Salud , Humanos , Masculino , México , Persona de Mediana Edad , Riesgo , Lugar de Trabajo , Adulto JovenRESUMEN
Currently, the population health needs are unlimited, but allocation of financial resources is not in accordance with these needs, probably due to the lack of specific information. In this work, we propose a new approach to allocate resources with equity as a tool for decision-making in planning. The grade of equity in resource allocation in decentralized management medical areas (DMMAs (AMGD, for its initials in Spanish)) was determined; these are limited geographical areas of a social security institution in three states of the northeastern region of Mexico. The areas with more health needs in the global index were DMMA no. 12 in Tamaulipas with a Z-score (ZS) of -5; area no. 3 in Coahuila with -4; and area no. 9 in Nuevo Leon, no. 16 and no. 17 in Tamaulipas with -2. Equity was measured according to the degree of concordance between the health needs index and the per capita health expenditure of each area: (r = 0.19, P > 0.05). Low concordance was found between these variables in the studied medical areas.