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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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Teira R, Espinosa N, Gutiérrez MM, Montero M, Martínez E, González F, Lozano de León F, Téllez F, Galindo MJ, Peraire J, Deig E, Muñoz-Sánchez P; para el Grupo de estudio VACH. Losses to follow-up of HIV-infected people in the Spanish VACH cohort over the period between 2013 and 2014: The importance of sociodemographic factors. Enferm Infecc Microbiol Clin 2019; 37:361-6. [PMID: 30514587 DOI: 10.1016/j.eimc.2018.09.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/23/2018] [Accepted: 09/08/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine the proportion of people infected by HIV or AIDS under follow-up in the VACH Cohort in 2012 who were lost to follow-up from 2013 to 2014, and to establish the sociodemographic features relating to this loss. METHODS We considered subjects with less than one recorded consultation per year studied to be lost to follow-up. We built logistic regression models to calculate the odds ratios (OR) and their 95% confidence intervals (95% CI), of the variables relating to loss to follow-up. RESULTS The overall percentage of losses to follow-up was 15.5% (95% CI 14.9-16-1). The variables associated with loss to follow up were: not receiving antiretroviral treatment (ART) (OR: 1.948, 95% CI: 1.651 -2.298), being an immigrant (OR: 1.746; 95%CI: 1.494-2.040), intravenous drug consumption being the mechanism for HIV transmission (OR: 1.498, 95% CI: 1.312-1.711), being unemployed (OR: 1.331; 95% CI: 1.179-1.503), being without a partner (OR: 1.948, 95% CI: 1.651-1.298), belonging to a low socioeconomic class (OR: 1.279; 95% CI: 1.143-1.431), and being attended in a hospital with fewer than 1000 patients under follow-up (OR: 1.257, 95% CI: 1.121-1.457), as well as being under age and having spent less time under follow-up in the Cohort. CONCLUSIONS 15.5% of the patients were lost to follow-up over a period of 2years in the VACH Cohort. This was associated with a series of sociodemographic and epidemiological variables that it might be useful to identify to design initiatives targeting the populations most likely to abandon the circuits of care, and guide strategies towards achieving Objective 90-90-90.
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García Villar C, Marín León I. [Critical reading of analytical observational studies]. Radiologia 2015; 57 Suppl 2:1-9. [PMID: 26123855 DOI: 10.1016/j.rx.2015.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/31/2014] [Revised: 04/10/2015] [Accepted: 04/18/2015] [Indexed: 11/24/2022]
Abstract
Analytical observational studies provide very important information about real-life clinical practice and the natural history of diseases and can suggest causality. Furthermore, they are very common in scientific journals. The aim of this article is to review the main concepts necessary for the critical reading of articles about radiological studies with observational designs. It reviews the characteristics that case-control and cohort studies must have to ensure high quality. It explains a method of critical reading that involves checking the attributes that should be evaluated in each type of article using a structured list of specific questions. It underlines the main characteristics that confer credibility and confidence on the article evaluated. Readers are provided with tools for the critical analysis of the observational studies published in scientific journals.
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Affiliation(s)
- C García Villar
- Unidad Clínica de Diagnóstico por Imagen, Hospital Universitario Puerta del Mar, Cádiz, España
| | - I Marín León
- Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España. CIBERESP-IBIS, Fundación Enebro.
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Castilla-Peón MF, Ramírez-Sandoval JC, Reyes-Morales H, Reyes-López A. [Clinical research design and causality: does oral rotavirus vaccine cause intussusception?]. Bol Med Hosp Infant Mex 2015; 72:346-352. [PMID: 29421534 DOI: 10.1016/j.bmhimx.2015.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 10/22/2022] Open
Abstract
Design of clinical research whose purpose is to answer questions about causality can be classified in relation to four axes: the number of study groups, the implementation of an experimental maneuver, cause-effect directionality and source from which the data are collected. The basic designs used in epidemiology are the clinical trial, the cohort study, the case-control study and the cross-sectional survey. This text aims to facilitate the identification and understanding of each of these designs through examples related to the association between rotavirus vaccination and intussusception.
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Affiliation(s)
| | - Juan C Ramírez-Sandoval
- Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México D.F., México
| | | | - Alfonso Reyes-López
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, México D.F., México
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