Background: On December 31, 2019, one of the most serious pandemics in recent times made its appe... more Background: On December 31, 2019, one of the most serious pandemics in recent times made its appearance. Certain health conditions, such as obesity and diabetes mellitus, have been described to be related to COVID-19 unfavorable outcomes. Objective: To identify factors associated with mortality in patients with COVID-19. Material and methods: Retrospective cohort of 998,639 patients. Patient sociodemographic and clinical characteristics were analyzed, with survivors being compared with the deceased individuals. Cox proportional hazards model was used to identify variables predictive of COVID-19-associated mortality. Results: Among the deceased patients, men accounted for 64.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Antecedentes: El 31 de diciembre de 2019, se inició una de las pandemias más graves de los último... more Antecedentes: El 31 de diciembre de 2019, se inició una de las pandemias más graves de los últimos tiempos. Se ha descrito que ciertas condiciones de salud, como la obesidad y la diabetes mellitus, están relacionadas con desenlaces desfavorables por COVID-19. Objetivo: Identificar factores asociados a mortalidad en pacientes con COVID-19. Material y métodos: Cohorte retrospectiva de 998 639 pacientes. Se analizaron las características sociodemográficas y clínicas de los pacientes, y se compararon supervivientes con fallecidos. Se utilizó el modelo de riesgos proporcionales de Cox para la identificación de variables predictivas de defunción por COVID-19. Resultados: Entre los fallecidos, los hombres representaron 64.3 % y las mujeres 35.7 %, diferencia que resultó estadísticamente significativa. Las personas con más de 80 años presentaron un riesgo 13 veces mayor de morir por COVID-19
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
COVID-19 has produced more than 176 million infected individuals and almost 3.2 million deaths wo... more COVID-19 has produced more than 176 million infected individuals and almost 3.2 million deaths worldwide. The infection results in a dysregulated systemic inflammation, multi-organ dysfunction, and critical illness. Cells of the central nervous system (CNS) are also affected triggering a dysregulated neuroinflammatory response.Low doses of glucocorticoids (GCs) orally or intravenously administered has been proved to reduce mortality of moderate and severe COVID-19 patients. However, low doses administered by those routes do not reach therapeutic levels in the CNS. In contrast, if dexamethasone is administered by the intranasal route can result in therapeutic doses in the CNS even at low doses of the GC. Methods: This is an approved multicentric randomized controlled protocol to compare the effectiveness of low doses of intranasal dexamethasone versus intravenous administered in adult moderate and severe COVID-19 patients. The protocol is conducted in five health institutions in Mexi...
Pediatric Infectious Disease Journal, Jun 22, 2023
Purpose: To evaluate the clinical and epidemiological characteristics of children with ocular tra... more Purpose: To evaluate the clinical and epidemiological characteristics of children with ocular trauma. Materials and Methods: We retrospectively reviewed the medical records of 278 children (aged 15 years or less) hospitalized with ocular injuries and treated as inpatients at a tertiary referral center in Shiraz, Iran, from 2005 to 2008. Nominal variables were evaluated with a Chi-square test. A P-value less than 0.05 indicated statistical significance. Results: The cohort was comprised of 205 (74%) males, outnumbering females by a ratio of 2.81/1. The mean age was 7.6 ± 3.96 years. Rural residents comprised 125 (45%) of the cohort. Sharp objects caused ocular injury in 211 (76%) cases, and 207 (74%) cases had open-globe injuries. The lens was injured in 62 (30%) cases at initial examination and 89 (43%) patients according to ultrasound examination (P = 0.006). Twenty-eight cases (10%) developed posttraumatic endophthalmitis. Endophthalmitis was associated with needle injury [odd ratio (OR) = 19.25] and presence of intraocular foreign body (OR = 3.48). Visual acuity of patients with closed-globe injuries was 20/200 or better on both initial and final examinations. Visual acuity of patients with open-globe injuries were in the range of light perception to 20/200. Conclusions: Trauma is an important cause of childhood ocular morbidity in southern Iran. Playing with sharp objects is an important cause of ocular trauma in children, and most injuries can be prevented by careful supervision.
International Journal of Surgery Case Reports, 2019
INTRODUCTION: Necrotizing fasciitis (NF) is a severe infectious condition associated with signifi... more INTRODUCTION: Necrotizing fasciitis (NF) is a severe infectious condition associated with significant morbidity and mortality and characteristically has a higher incidence in adults; pediatric cases are very rare. In this case report we describe, the clinical presentation, management and outcome of a patient with necrotizing fasciitis of the neck and head complicated with chronic osteomyelitis. PRESENTATION OF THE CASE: An 18 month-old, latin, male, diagnosed with rickets and Crouzon syndrome, twenty-four hours post-craniofacial remodeling surgery presented tissue edema, indurated skin and violaceous and well delimited lesions in the neck and head. The patient developed septic shock, acute osteomyelitis and infection of the cranial grafts. Multiple surgical lavages, debridation of the necrotic tissue and resection of the affected bone, in combination with multiple antibiotics, laboratory test methods, VAC therapy and hyperbaric oxygen were required for successful treatment and full recovery of the patient. DISCUSSION: Although early antibiotic therapy and critical care are basic for the treatment of patients with NF, early aggressive surgical treatment is crucial for an adequate outcome. Adjuvant treatment for NF such as the Vacuum-assisted closure and the hyperbaric oxygen therapy are very useful to accelerate wound healing. Moreover, special laboratory test methods such as the checkerboard can be used to determine the adequate antimicrobial combination of drugs in the case of multi resistant organisms. CONCLUSIONS: Early diagnosis, adequate antibiotic therapy and aggressive surgical debridement of the necrotic tissue combined with VAC and hyperbaric oxygen therapy played an important role in the successful treatment of NF.
Background: Pneumonia caused 704,000 deaths in children younger than 5 years in 2015. Zinc is an ... more Background: Pneumonia caused 704,000 deaths in children younger than 5 years in 2015. Zinc is an important micronutrient due to its role in immune function. Since 2004, WHO recommends zinc supplementation for children with diarrhea to shorten the duration and decrease severity. Zinc supplementation for children with pneumonia is controversial. Methods: A randomized controlled clinical trial was conducted, and 103 children 1 month to 5 years old with pneumonia were included. Zinc or placebo was given during hospitalization. Clinical symptoms were recorded, and a blood draw was obtained to determine serum zinc levels, lymphoproliferation, and cytokines at hospitalization and at discharge of the patient; a nasal wash was obtained to detect viral or bacterial pathogens by multiplex RT-PCR. Results: Zinc supplementation improved in fewer hours the clinical status (76 ± 7 vs. 105 ± 8, p = 0.01), the respiratory rate (37 ± 6 vs. 57 ± 7, p = 0.04), and the oxygen saturation (53 ± 7 vs. 87 ± 9, p = 0.007) compared to the placebo group. An increase in IFNγ and IL-2 after treatment in the zinc group was observed. Conclusions: Zinc supplementation improved some clinical symptoms in children with pneumonia in fewer hours and induced a cellular immune response. Clinical Trial Registration: The trial was retrospectively registered in ClinicalTrials.gov, identifier NCT03690583, URL https://clinicaltrials.gov/ct2/show/NCT03690583?term= zinc+children&cond=Pneumonia&draw=2&rank=1.
The presence of any comorbidity more than doubled the odds ratio, with hypertensiondiabetes as th... more The presence of any comorbidity more than doubled the odds ratio, with hypertensiondiabetes as the riskiest combination. While the wave peaks increased over time, the odds ratios for developing severe disease (waves , , and to wave) decreased to. (% CI: .-.) in the fourth wave. Conclusion: The health policy promoted by the Mexican government decreased hospitalizations and deaths, particularly among older adults with the highest risk of admission and death. Comorbidities augment the risk of developing severe illness, which is shown to rise by double in the Mexican population, particularly for those reported with hypertension-diabetes. Factors such as the decrease in the severity of the SARS-CoV variants, changes in symptomatology, and advances in the management of patients, vaccination, and treatments influenced the decrease in mortality and hospitalizations.
The objective of this study was to characterize the kinetics of the cellular and humoral immune r... more The objective of this study was to characterize the kinetics of the cellular and humoral immune responses elicited by measles vaccine given to previously immune adults. The cellular and humoral immune responses to measles were measured in seven healthy adults, before vaccination and at 1, 2, 3, and 4 weeks and 3 months after vaccination, using measles-specific T-cell proliferation and plaque reduction neutralization assays. All study subjects had detectable measles antibodies, but only six (85%) showed protective titers, defined as >1:120, before immunization. However measles-specific T-cell proliferation was not detectable before vaccination in any of the subjects. The six subjects with protective titers showed a positive stimulation index (SI) of >3.0 within the first 4 weeks after vaccination, an SI of 5 at the 4th week, and an SI of 3 at 3 months after vaccination. The subject with a low antibody titer (1:99) before vaccination developed a high SI at 3 months after vaccination. This subject was the only participant whose neutralizing antibody titers increased more than 4-fold by 3 months after vaccination. No significant increases in geometric mean titers were detected in the other six subjects during the follow-up period. These data suggest that high measles antibody titers interfere with the humoral response in subjects who receive a booster immunization, whereas the cellular response is boosted at least transiently, after revaccination.
Anales De Pediatría (english Edition), Aug 1, 2022
Introduction In the paediatric population, coronavirus disease (COVID-19) is usually asymptomatic... more Introduction In the paediatric population, coronavirus disease (COVID-19) is usually asymptomatic or mild, but there are also severe and fatal cases. Methods We analysed data on COVID-19 cases from the national and state-level databases of the Federal Ministry of Health of Mexico and the Department of Health of Mexico City to determine the clinical characteristics and risk factors for mortality in children. We used Cox proportional hazards regression analysis to calculate the risk of death. Results The national and Mexico City databases had recorded a total of 18,465 (2.8%) and 5,733 (4.2%) confirmed cases of COVID-19, respectively, in individuals aged less than 18 years as of September 2020. The median age at diagnosis was 12 years (range: 0–17). The differences between cases in the national vs Mexico City databases were: 12.5% vs 8.2% of patients were hospitalised; 6% vs 3.5% had pneumonia; 2.4% vs 1.9% were admitted to the intensive care unit (ICU), and 1.3% vs 0.7% died. The independent risk factors significantly associated with a higher probability of death were pneumonia, hypertension, obesity, immunosuppression and intubation. Conclusion In Mexico, 2.8% of all confirmed cases of COVID-19 occurred in individuals under 18 years, with a median age of 12 years and a mortality of 1.3%. The identified predictors of mortality were pneumonia, admission to the ICU, obesity, hypertension, immunosuppression, diabetes, chronic lung disease and renal disease.
Frecuencia de virus respiratorios y características clínicas de niños que acuden a un hospital en... more Frecuencia de virus respiratorios y características clínicas de niños que acuden a un hospital en México.
Background. A 30-second aerosol measles vaccination successfully primes children 12 months of age... more Background. A 30-second aerosol measles vaccination successfully primes children 12 months of age and older but is poorly immunogenic when given to 9-month-old children. We examined the immune responses when increasing the duration to aerosol exposure in 9-month-olds. Methods. One hundred and thirteen healthy 9-month-old children from Mexico City were enrolled; 58 received aerosol EZ measles vaccine for 2.5 minutes and 55 subcutaneously. Measles-specific neutralizing antibodies and cellular responses were measured before and at 3 and 6 months postimmunization. Results. Adaptive immunity was induced in 97% after aerosol and 98% after subcutaneous administration. Seroconversion rates and GMCs were 95% and 373 mIU/mL (95% confidence interval [CI], 441-843) following aerosol vaccination and 91% and 306 mIU/mL (95% CI, 367-597) after subcutaneous administration at 3 months. The percentage of children with a measles-specific stimulation index R3 was 45% and 60% in the aerosol versus 55% and 59% in the subcutaneous group at 3 and 6 months, respectively. CD8 memory cell frequencies were higher in the aerosol group at 3 months compared with the subcutaneous group. Adverse reactions were comparable in both groups. Conclusions. Increasing exposure time to aerosol measles vaccine elicits immune responses that are comparable to those seen when an equivalent dose is administered by the subcutaneous route in 9-month-old infants.
The emergence and rapid increase of the B.1.1.7 (Alpha) lineage of severe acute respiratory syndr... more The emergence and rapid increase of the B.1.1.7 (Alpha) lineage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) throughout the world were due to its increased transmissibility. However, it did not displace cocirculating lineages in most of Mexico, particularly B.1.1.519, which dominated the country from February to May 2021.
Human rhinovirus (HRV) affects the lower and upper respiratory tract, however, some studies sugge... more Human rhinovirus (HRV) affects the lower and upper respiratory tract, however, some studies suggest that HRV infection can lead to extrapulmonary complications in critical illness. Moreover, some reports have shown the presence of HRV in patients with Central Nervous System (CNS) disease. During a CNS infection, the microglia cells are the first line of defense against pathogens. In this study, the susceptibility of the human microglial clone 3 cell line (HMC3) to HRV infection was analyzed. Our findings demonstrate for the first time that HRV is capable of completing the entire viral cycle in microglial cells.
We report the complete genome sequence of the first Mexican human coronavirus (HCoV) OC43, obtain... more We report the complete genome sequence of the first Mexican human coronavirus (HCoV) OC43, obtained by new-generation sequencing and a metagenomic approach, isolated from a child hospitalized with pneumonia. The genome is closely related to the other OC43 genome sequences available, ranging from 99.8% to 98.2% nucleotide sequence identity.
Malnutrition in children younger than 5 years old has persisted in time (13.5% in 1988 to 12.3% i... more Malnutrition in children younger than 5 years old has persisted in time (13.5% in 1988 to 12.3% in 2012) in Mexico City. A quasi-experimental study was performed. An educational intervention was given twice a month for 6 months to mothers of mild to moderate malnourished children 1 to 5 years old. Weight, height, and body mass index of the children were obtained at the beginning and 3 and 6 months after the intervention. Thirteen mothers and 15 children were included. The baseline mean weight/age in Z score was −1.49 ± 0.65, which improved to −1.19 ± 0.60 (P = 0.001; per protocol analysis). Linear regression analysis showed a P of 0.006 of the mothers' adherence to improve children's weight. The educational intervention decreased the weight deficit after 6 months with the same economic resources of the family; hence, the adherence of the mothers to the educational intervention is relevant to improve the nutritional status of their children.
Human respiratory syncytial virus (hRSV) is the leading cause of acute lower respiratory tract in... more Human respiratory syncytial virus (hRSV) is the leading cause of acute lower respiratory tract infections in children under five years of age and older adults worldwide. During hRSV infection, host cells undergo changes in endomembrane organelles, including mitochondria. This organelle is responsible for energy production in the cell and plays an important role in the antiviral response. The present study focuses on characterizing the ultrastructural and functional changes during hRSV infection using thin-section transmission electron microscopy and RT-qPCR. Here we report that hRSV infection alters mitochondrial morphodynamics by regulating the expression of key genes in the antiviral response process, such as Mfn1, VDAC2, and PINK1. Our results suggest that hRSV alters mitochondrial morphology during infection, producing a mitochondrial phenotype with shortened cristae, swollen matrix, and damaged membrane. We also observed that hRSV infection modulates the expression of the afore...
Background: On December 31, 2019, one of the most serious pandemics in recent times made its appe... more Background: On December 31, 2019, one of the most serious pandemics in recent times made its appearance. Certain health conditions, such as obesity and diabetes mellitus, have been described to be related to COVID-19 unfavorable outcomes. Objective: To identify factors associated with mortality in patients with COVID-19. Material and methods: Retrospective cohort of 998,639 patients. Patient sociodemographic and clinical characteristics were analyzed, with survivors being compared with the deceased individuals. Cox proportional hazards model was used to identify variables predictive of COVID-19-associated mortality. Results: Among the deceased patients, men accounted for 64.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Antecedentes: El 31 de diciembre de 2019, se inició una de las pandemias más graves de los último... more Antecedentes: El 31 de diciembre de 2019, se inició una de las pandemias más graves de los últimos tiempos. Se ha descrito que ciertas condiciones de salud, como la obesidad y la diabetes mellitus, están relacionadas con desenlaces desfavorables por COVID-19. Objetivo: Identificar factores asociados a mortalidad en pacientes con COVID-19. Material y métodos: Cohorte retrospectiva de 998 639 pacientes. Se analizaron las características sociodemográficas y clínicas de los pacientes, y se compararon supervivientes con fallecidos. Se utilizó el modelo de riesgos proporcionales de Cox para la identificación de variables predictivas de defunción por COVID-19. Resultados: Entre los fallecidos, los hombres representaron 64.3 % y las mujeres 35.7 %, diferencia que resultó estadísticamente significativa. Las personas con más de 80 años presentaron un riesgo 13 veces mayor de morir por COVID-19
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
COVID-19 has produced more than 176 million infected individuals and almost 3.2 million deaths wo... more COVID-19 has produced more than 176 million infected individuals and almost 3.2 million deaths worldwide. The infection results in a dysregulated systemic inflammation, multi-organ dysfunction, and critical illness. Cells of the central nervous system (CNS) are also affected triggering a dysregulated neuroinflammatory response.Low doses of glucocorticoids (GCs) orally or intravenously administered has been proved to reduce mortality of moderate and severe COVID-19 patients. However, low doses administered by those routes do not reach therapeutic levels in the CNS. In contrast, if dexamethasone is administered by the intranasal route can result in therapeutic doses in the CNS even at low doses of the GC. Methods: This is an approved multicentric randomized controlled protocol to compare the effectiveness of low doses of intranasal dexamethasone versus intravenous administered in adult moderate and severe COVID-19 patients. The protocol is conducted in five health institutions in Mexi...
Pediatric Infectious Disease Journal, Jun 22, 2023
Purpose: To evaluate the clinical and epidemiological characteristics of children with ocular tra... more Purpose: To evaluate the clinical and epidemiological characteristics of children with ocular trauma. Materials and Methods: We retrospectively reviewed the medical records of 278 children (aged 15 years or less) hospitalized with ocular injuries and treated as inpatients at a tertiary referral center in Shiraz, Iran, from 2005 to 2008. Nominal variables were evaluated with a Chi-square test. A P-value less than 0.05 indicated statistical significance. Results: The cohort was comprised of 205 (74%) males, outnumbering females by a ratio of 2.81/1. The mean age was 7.6 ± 3.96 years. Rural residents comprised 125 (45%) of the cohort. Sharp objects caused ocular injury in 211 (76%) cases, and 207 (74%) cases had open-globe injuries. The lens was injured in 62 (30%) cases at initial examination and 89 (43%) patients according to ultrasound examination (P = 0.006). Twenty-eight cases (10%) developed posttraumatic endophthalmitis. Endophthalmitis was associated with needle injury [odd ratio (OR) = 19.25] and presence of intraocular foreign body (OR = 3.48). Visual acuity of patients with closed-globe injuries was 20/200 or better on both initial and final examinations. Visual acuity of patients with open-globe injuries were in the range of light perception to 20/200. Conclusions: Trauma is an important cause of childhood ocular morbidity in southern Iran. Playing with sharp objects is an important cause of ocular trauma in children, and most injuries can be prevented by careful supervision.
International Journal of Surgery Case Reports, 2019
INTRODUCTION: Necrotizing fasciitis (NF) is a severe infectious condition associated with signifi... more INTRODUCTION: Necrotizing fasciitis (NF) is a severe infectious condition associated with significant morbidity and mortality and characteristically has a higher incidence in adults; pediatric cases are very rare. In this case report we describe, the clinical presentation, management and outcome of a patient with necrotizing fasciitis of the neck and head complicated with chronic osteomyelitis. PRESENTATION OF THE CASE: An 18 month-old, latin, male, diagnosed with rickets and Crouzon syndrome, twenty-four hours post-craniofacial remodeling surgery presented tissue edema, indurated skin and violaceous and well delimited lesions in the neck and head. The patient developed septic shock, acute osteomyelitis and infection of the cranial grafts. Multiple surgical lavages, debridation of the necrotic tissue and resection of the affected bone, in combination with multiple antibiotics, laboratory test methods, VAC therapy and hyperbaric oxygen were required for successful treatment and full recovery of the patient. DISCUSSION: Although early antibiotic therapy and critical care are basic for the treatment of patients with NF, early aggressive surgical treatment is crucial for an adequate outcome. Adjuvant treatment for NF such as the Vacuum-assisted closure and the hyperbaric oxygen therapy are very useful to accelerate wound healing. Moreover, special laboratory test methods such as the checkerboard can be used to determine the adequate antimicrobial combination of drugs in the case of multi resistant organisms. CONCLUSIONS: Early diagnosis, adequate antibiotic therapy and aggressive surgical debridement of the necrotic tissue combined with VAC and hyperbaric oxygen therapy played an important role in the successful treatment of NF.
Background: Pneumonia caused 704,000 deaths in children younger than 5 years in 2015. Zinc is an ... more Background: Pneumonia caused 704,000 deaths in children younger than 5 years in 2015. Zinc is an important micronutrient due to its role in immune function. Since 2004, WHO recommends zinc supplementation for children with diarrhea to shorten the duration and decrease severity. Zinc supplementation for children with pneumonia is controversial. Methods: A randomized controlled clinical trial was conducted, and 103 children 1 month to 5 years old with pneumonia were included. Zinc or placebo was given during hospitalization. Clinical symptoms were recorded, and a blood draw was obtained to determine serum zinc levels, lymphoproliferation, and cytokines at hospitalization and at discharge of the patient; a nasal wash was obtained to detect viral or bacterial pathogens by multiplex RT-PCR. Results: Zinc supplementation improved in fewer hours the clinical status (76 ± 7 vs. 105 ± 8, p = 0.01), the respiratory rate (37 ± 6 vs. 57 ± 7, p = 0.04), and the oxygen saturation (53 ± 7 vs. 87 ± 9, p = 0.007) compared to the placebo group. An increase in IFNγ and IL-2 after treatment in the zinc group was observed. Conclusions: Zinc supplementation improved some clinical symptoms in children with pneumonia in fewer hours and induced a cellular immune response. Clinical Trial Registration: The trial was retrospectively registered in ClinicalTrials.gov, identifier NCT03690583, URL https://clinicaltrials.gov/ct2/show/NCT03690583?term= zinc+children&cond=Pneumonia&draw=2&rank=1.
The presence of any comorbidity more than doubled the odds ratio, with hypertensiondiabetes as th... more The presence of any comorbidity more than doubled the odds ratio, with hypertensiondiabetes as the riskiest combination. While the wave peaks increased over time, the odds ratios for developing severe disease (waves , , and to wave) decreased to. (% CI: .-.) in the fourth wave. Conclusion: The health policy promoted by the Mexican government decreased hospitalizations and deaths, particularly among older adults with the highest risk of admission and death. Comorbidities augment the risk of developing severe illness, which is shown to rise by double in the Mexican population, particularly for those reported with hypertension-diabetes. Factors such as the decrease in the severity of the SARS-CoV variants, changes in symptomatology, and advances in the management of patients, vaccination, and treatments influenced the decrease in mortality and hospitalizations.
The objective of this study was to characterize the kinetics of the cellular and humoral immune r... more The objective of this study was to characterize the kinetics of the cellular and humoral immune responses elicited by measles vaccine given to previously immune adults. The cellular and humoral immune responses to measles were measured in seven healthy adults, before vaccination and at 1, 2, 3, and 4 weeks and 3 months after vaccination, using measles-specific T-cell proliferation and plaque reduction neutralization assays. All study subjects had detectable measles antibodies, but only six (85%) showed protective titers, defined as >1:120, before immunization. However measles-specific T-cell proliferation was not detectable before vaccination in any of the subjects. The six subjects with protective titers showed a positive stimulation index (SI) of >3.0 within the first 4 weeks after vaccination, an SI of 5 at the 4th week, and an SI of 3 at 3 months after vaccination. The subject with a low antibody titer (1:99) before vaccination developed a high SI at 3 months after vaccination. This subject was the only participant whose neutralizing antibody titers increased more than 4-fold by 3 months after vaccination. No significant increases in geometric mean titers were detected in the other six subjects during the follow-up period. These data suggest that high measles antibody titers interfere with the humoral response in subjects who receive a booster immunization, whereas the cellular response is boosted at least transiently, after revaccination.
Anales De Pediatría (english Edition), Aug 1, 2022
Introduction In the paediatric population, coronavirus disease (COVID-19) is usually asymptomatic... more Introduction In the paediatric population, coronavirus disease (COVID-19) is usually asymptomatic or mild, but there are also severe and fatal cases. Methods We analysed data on COVID-19 cases from the national and state-level databases of the Federal Ministry of Health of Mexico and the Department of Health of Mexico City to determine the clinical characteristics and risk factors for mortality in children. We used Cox proportional hazards regression analysis to calculate the risk of death. Results The national and Mexico City databases had recorded a total of 18,465 (2.8%) and 5,733 (4.2%) confirmed cases of COVID-19, respectively, in individuals aged less than 18 years as of September 2020. The median age at diagnosis was 12 years (range: 0–17). The differences between cases in the national vs Mexico City databases were: 12.5% vs 8.2% of patients were hospitalised; 6% vs 3.5% had pneumonia; 2.4% vs 1.9% were admitted to the intensive care unit (ICU), and 1.3% vs 0.7% died. The independent risk factors significantly associated with a higher probability of death were pneumonia, hypertension, obesity, immunosuppression and intubation. Conclusion In Mexico, 2.8% of all confirmed cases of COVID-19 occurred in individuals under 18 years, with a median age of 12 years and a mortality of 1.3%. The identified predictors of mortality were pneumonia, admission to the ICU, obesity, hypertension, immunosuppression, diabetes, chronic lung disease and renal disease.
Frecuencia de virus respiratorios y características clínicas de niños que acuden a un hospital en... more Frecuencia de virus respiratorios y características clínicas de niños que acuden a un hospital en México.
Background. A 30-second aerosol measles vaccination successfully primes children 12 months of age... more Background. A 30-second aerosol measles vaccination successfully primes children 12 months of age and older but is poorly immunogenic when given to 9-month-old children. We examined the immune responses when increasing the duration to aerosol exposure in 9-month-olds. Methods. One hundred and thirteen healthy 9-month-old children from Mexico City were enrolled; 58 received aerosol EZ measles vaccine for 2.5 minutes and 55 subcutaneously. Measles-specific neutralizing antibodies and cellular responses were measured before and at 3 and 6 months postimmunization. Results. Adaptive immunity was induced in 97% after aerosol and 98% after subcutaneous administration. Seroconversion rates and GMCs were 95% and 373 mIU/mL (95% confidence interval [CI], 441-843) following aerosol vaccination and 91% and 306 mIU/mL (95% CI, 367-597) after subcutaneous administration at 3 months. The percentage of children with a measles-specific stimulation index R3 was 45% and 60% in the aerosol versus 55% and 59% in the subcutaneous group at 3 and 6 months, respectively. CD8 memory cell frequencies were higher in the aerosol group at 3 months compared with the subcutaneous group. Adverse reactions were comparable in both groups. Conclusions. Increasing exposure time to aerosol measles vaccine elicits immune responses that are comparable to those seen when an equivalent dose is administered by the subcutaneous route in 9-month-old infants.
The emergence and rapid increase of the B.1.1.7 (Alpha) lineage of severe acute respiratory syndr... more The emergence and rapid increase of the B.1.1.7 (Alpha) lineage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) throughout the world were due to its increased transmissibility. However, it did not displace cocirculating lineages in most of Mexico, particularly B.1.1.519, which dominated the country from February to May 2021.
Human rhinovirus (HRV) affects the lower and upper respiratory tract, however, some studies sugge... more Human rhinovirus (HRV) affects the lower and upper respiratory tract, however, some studies suggest that HRV infection can lead to extrapulmonary complications in critical illness. Moreover, some reports have shown the presence of HRV in patients with Central Nervous System (CNS) disease. During a CNS infection, the microglia cells are the first line of defense against pathogens. In this study, the susceptibility of the human microglial clone 3 cell line (HMC3) to HRV infection was analyzed. Our findings demonstrate for the first time that HRV is capable of completing the entire viral cycle in microglial cells.
We report the complete genome sequence of the first Mexican human coronavirus (HCoV) OC43, obtain... more We report the complete genome sequence of the first Mexican human coronavirus (HCoV) OC43, obtained by new-generation sequencing and a metagenomic approach, isolated from a child hospitalized with pneumonia. The genome is closely related to the other OC43 genome sequences available, ranging from 99.8% to 98.2% nucleotide sequence identity.
Malnutrition in children younger than 5 years old has persisted in time (13.5% in 1988 to 12.3% i... more Malnutrition in children younger than 5 years old has persisted in time (13.5% in 1988 to 12.3% in 2012) in Mexico City. A quasi-experimental study was performed. An educational intervention was given twice a month for 6 months to mothers of mild to moderate malnourished children 1 to 5 years old. Weight, height, and body mass index of the children were obtained at the beginning and 3 and 6 months after the intervention. Thirteen mothers and 15 children were included. The baseline mean weight/age in Z score was −1.49 ± 0.65, which improved to −1.19 ± 0.60 (P = 0.001; per protocol analysis). Linear regression analysis showed a P of 0.006 of the mothers' adherence to improve children's weight. The educational intervention decreased the weight deficit after 6 months with the same economic resources of the family; hence, the adherence of the mothers to the educational intervention is relevant to improve the nutritional status of their children.
Human respiratory syncytial virus (hRSV) is the leading cause of acute lower respiratory tract in... more Human respiratory syncytial virus (hRSV) is the leading cause of acute lower respiratory tract infections in children under five years of age and older adults worldwide. During hRSV infection, host cells undergo changes in endomembrane organelles, including mitochondria. This organelle is responsible for energy production in the cell and plays an important role in the antiviral response. The present study focuses on characterizing the ultrastructural and functional changes during hRSV infection using thin-section transmission electron microscopy and RT-qPCR. Here we report that hRSV infection alters mitochondrial morphodynamics by regulating the expression of key genes in the antiviral response process, such as Mfn1, VDAC2, and PINK1. Our results suggest that hRSV alters mitochondrial morphology during infection, producing a mitochondrial phenotype with shortened cristae, swollen matrix, and damaged membrane. We also observed that hRSV infection modulates the expression of the afore...
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