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Guijarro C, Pérez-Fernández E, González-Piñeiro B, Meléndez V, Goyanes MJ, Renilla ME, Casas ML, Sastre I, Velasco M. Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain. Rev Clin Esp 2021; 221:264-273. [PMID: 38108497 PMCID: PMC7678416 DOI: 10.1016/j.rce.2020.10.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION AND OBJECTIVES Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIAL AND METHODS We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS The crude cumulative incidence among migrants (n=20,419) was higher than among Spaniards (n=131,599): 8.81 and 6.51 and per 1,000 inhabitants, respectively (p<.001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found for people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p=.007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p<.001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p<.001). CONCLUSIONS Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest that the ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.
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Affiliation(s)
- C Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
| | - E Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - B González-Piñeiro
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - V Meléndez
- Concejalía de Asuntos sociales, Mayores y Salud Pública, Ayuntamiento de Alcorcón, Alcorcón, Madrid, España
| | - M J Goyanes
- Unidad de Microbiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - M E Renilla
- Unidad de Urgencias, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - M L Casas
- Unidad de Laboratorio, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - I Sastre
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España
| | - M Velasco
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Unidad de Medicina Interna, Sección Infecciosas, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
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Guijarro C, Pérez-Fernández E, González-Piñeiro B, Meléndez V, Goyanes MJ, Renilla ME, Casas ML, Sastre I, Velasco M. Differential risk for COVID-19 in the first wave of the disease among Spaniards and migrants from different areas of the world living in Spain. Rev Clin Esp 2021; 221:264-273. [PMID: 33998512 DOI: 10.1016/j.rceng.2020.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 10/27/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES Little is known regarding the relevance of racial/ethnic background to the risk for COVID-19 infection, particularly in Europe. We evaluated the risk of COVID-19 among migrants from different areas of the world within the context of universal free access to medical care. MATERIALS AND METHODS We conducted a population-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 among adult residents of Alcorcon (Spain) in the first wave of the disease up to April 25, 2020. RESULTS The crude cumulative incidence among migrants (n = 20419) was higher than among Spaniards (n = 131599): 8.81 and 6.51 and per 1000 inhabitants, respectively (p < .001), but differed by region of origin. As per a negative binomial regression adjusted for age and sex, relative risk (RR) for COVID-19 for individuals from Europe, Asia, or North Africa was not significantly different from Spaniards. In contrast, a markedly increased risk was found in people from Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p = .007), the Caribbean (RR 6.35, 95% CI 3.83-10.55, p < .001), and Latin America (RR 6.92, 95% CI 4.49-10.67, p < .001). CONCLUSIONS Migrants from Sub-Saharan Africa, the Caribbean, and Latin America exhibited increased risk for COVID-19 as compared to Spaniards or migrants from Europe, North Africa, or Asia. Our data suggest ethnic background may play a role in risk for COVID-19. Migrants from some areas of the world may merit closer attention for both clinical and epidemiological reasons.
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Affiliation(s)
- C Guijarro
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
| | - E Pérez-Fernández
- Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - B González-Piñeiro
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - V Meléndez
- Concejalía de Asuntos Sociales, Mayores y Salud Pública, Ayuntamiento de Alcorcón, Alcorcón, Madrid, Spain
| | - M J Goyanes
- Unidad de Microbiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M E Renilla
- Unidad de Urgencias, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M L Casas
- Unidad de Laboratorio, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - I Sastre
- Sistemas de Información y Tecnología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - M Velasco
- Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Unidad de Medicina Interna, Sección Infecciosas, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Unidad de Investigación, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain; Departamento de Especialidades Médicas y Salud Pública, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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Goyanes MJ, Cercenado E, Insa R, Morente A, Alcalá L, Bouza E. High rates of antimicrobial co-resistance among Enterobacteriaceae: comparative analysis between clinical isolates resistant and susceptible to third-generation cephalosporins. Rev Esp Quimioter 2007; 20:216-21. [PMID: 17893759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
We compared the antimicrobial co-resistance of 3,402 clinical isolates of Enterobacteriaceae resistant to third-generation cephalosporins (2,569 ESBL-producing and 833 AmpC overproducing) with that of 16,220 susceptible isolates, in order to determine the impact of resistance to third-generation cephalosporins on the likelihood of resistance to other antimicrobial classes. Enterobacteriaceae resistant to third-generation cephalosporins, independently of their mechanism of resistance, were significantly more resistant to other classes of antimicrobials than susceptible isolates (p <0.001). Percentages of co-resistance to ciprofloxacin, gentamicin, tobramycin and trimethoprim-sulfamethoxazole of resistant isolates were: 51%, 39%, 53% and 51%, respectively. However, among the susceptible isolates, percentages were 17%, 7%, 6% and 19%, respectively. Fosfomycin exhibited excellent in vitro activity against urinary isolates (92%), mainly against ESBL-producing organisms (90%), and is a good alternative treatment of infections caused by multidrug resistant Enterobacteriaceae. Amikacin and imipenem were the most active antimicrobials against all species tested.
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Affiliation(s)
- M J Goyanes
- Servicio de Microbiología, Hospital General Universitario Gregorio Marañón, Madrid
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