Ashktorab Hassan, Pizuorno Antonio, Fierro Nora A, Villagrana Edgar D Copado, Solis Maria E Herrera, Cardenas Graciela, Alvarez Daniela Zavala, Oskrochi Gholamreza, Adeleye Folake, Dalivand Maryam Mehdipour, Laiyemo Adeyinka O, Aduli Farshad, Sherif Zaki A, Brim Hassan
Department of Medicine, Department of Pathology and Cancer Center, Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington DC.
La Universidad Del Zulia, Faculty of Medicine, School of Medicine, Postal Code 4002, Maracaibo, Zulia state, Venezuela.
SOJ Microbiol Infect Dis. 2021;8(1):1-11. doi: 10.15226/sojmid/8/1/001108. Epub 2021 Sep 10.
Latin America has become the epicenter of the coronavirus disease 2019 (COVID-19) pandemic. We aim to perform a systematic comparative review of the clinical characteristics that are associated with this disease in Latin American countries.
We conducted a systematic review of published articles, journal and/or epidemiological reports of confirmed COVID-19 cases in Latin America. Data were obtained either through publicly available information from Ministries of Health, published journal reports and/or unpublished datasets. We analyzed data from SARS-CoV-2 positive patients evaluated at healthcare centers and hospitals of 8 countries including Brazil, Peru, Mexico, Argentina, Colombia, Venezuela, Ecuador, and Bolivia, between March 1 and July 30, 2020. These countries consist of a total population that exceeds 519 million. Demographics, comorbidities, and clinical symptoms were collected. Statistical descriptive analysis and correlation analyses of symptoms, comorbidities and mortality were performed.
A total of 728,282 COVID-19 patients were included in this study. Of these, 52.6% were female. The average age was 48.4 years. Peru had the oldest cohort with 56.8 years and highest rate of females (56.8%) while Chile had the youngest cohort (39 years old). Venezuela had the highest male prevalence (56.7%). Most common symptoms were cough with 60.1% (Bolivia had the highest rate 78%), fatigue/tiredness with 52.0%, sore throat with 50.3%, and fever with 44.2%. Bolivian patients had fever as the top symptom (83.3%). GI symptoms included diarrhea which was highest in Mexico with 22.9%. Hypertension was among the top (12.1%) comorbidities, followed by diabetes with 8.3% and obesity at 4.5%. In multivariate analyses, the leading and significant comorbidities were hypertension (r = 0.83, p = 0.02), diabetes (r = 0.91, p = 0.01), and obesity (r = 0.86, p = 0.03). Mortality was highest in Mexico (16.6%) and lowest in Venezuela (0.9%) among the analyzed cohorts.
Overall, COVID-19 patients in Latin America display cough, fatigue, and fever as main symptoms. Up to 53% of patients with COVID-19 have GI manifestations. Different clinical symptoms were associated with COVID-19 in Latin American countries. Metabolic syndrome components were the main comorbidities associated with poor outcome. Country-specific management and prevention plans are needed and can be established from this meta-analysis.
拉丁美洲已成为2019冠状病毒病（COVID-19）大流行的中心。我们旨在对拉丁美洲国家与该疾病相关的临床特征进行系统的比较性综述。
我们对拉丁美洲确诊COVID-19病例的已发表文章、期刊和/或流行病学报告进行了系统综述。数据通过卫生部公开信息、已发表的期刊报告和/或未发表的数据集获得。我们分析了2020年3月1日至7月30日期间在包括巴西、秘鲁、墨西哥、阿根廷、哥伦比亚、委内瑞拉、厄瓜多尔和玻利维亚在内的8个国家的医疗中心和医院评估的SARS-CoV-2阳性患者的数据。这些国家的总人口超过5.19亿。收集了人口统计学、合并症和临床症状信息。对症状、合并症和死亡率进行了统计描述性分析和相关性分析。
本研究共纳入728282例COVID-19患者。其中，52.6%为女性。平均年龄为48.4岁。秘鲁的队列年龄最大，为56.8岁，女性比例最高（56.8%），而智利的队列年龄最小（39岁）。委内瑞拉男性患病率最高（56.7%）。最常见的症状是咳嗽，占60.1%（玻利维亚发生率最高，为78%），疲劳/疲倦占52.0%，咽痛占50.3%，发热占44.2%。玻利维亚患者以发热为首要症状（83.3%）。胃肠道症状包括腹泻，墨西哥的腹泻发生率最高，为22.9%。高血压是主要合并症之一（12.1%），其次是糖尿病，占8.3%，肥胖占4.5%。在多变量分析中，主要的显著合并症是高血压（r = 0.83，p = 0.02）、糖尿病（r = 0.91，p = 0.01）和肥胖（r = 0.86，p = 0.03）。在所分析的队列中，墨西哥的死亡率最高（16.6%），委内瑞拉的死亡率最低（0.9%）。
总体而言，拉丁美洲的COVID-19患者以咳嗽、疲劳和发热为主要症状。高达53%的COVID-19患者有胃肠道表现。拉丁美洲国家COVID-19的临床症状各异。代谢综合征成分是与不良预后相关的主要合并症。需要根据具体国家制定管理和预防计划，本荟萃分析可为其提供依据。
