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COVID-19 fatality in Mexico's indigenous populations

OBJECTIVE: The aim of the study was to explore the factors that could explain the differences in fatality rates among indigenous groups with COVID-19 diagnosis compared with the rest of the population in Mexico. STUDY DESIGN: We analyzed the public data of COVID-19 surveillance, of the Mexican Minis...

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Autores principales: Argoty-Pantoja, A.D., Robles-Rivera, K., Rivera-Paredez, B., Salmerón, J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Royal Society for Public Health. Published by Elsevier Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877204/
https://www.ncbi.nlm.nih.gov/pubmed/33743216
http://dx.doi.org/10.1016/j.puhe.2021.01.023
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author Argoty-Pantoja, A.D.
Robles-Rivera, K.
Rivera-Paredez, B.
Salmerón, J.
author_facet Argoty-Pantoja, A.D.
Robles-Rivera, K.
Rivera-Paredez, B.
Salmerón, J.
author_sort Argoty-Pantoja, A.D.
collection PubMed
description OBJECTIVE: The aim of the study was to explore the factors that could explain the differences in fatality rates among indigenous groups with COVID-19 diagnosis compared with the rest of the population in Mexico. STUDY DESIGN: We analyzed the public data of COVID-19 surveillance, of the Mexican Ministry of Health, to estimate COVID-19 fatality rates by ethnicity. METHODS: We explored associated factors using Cox proportional hazards models stratified by outpatient and hospital management at diagnosis; analysis was conducted in three scenarios: national level, states with 89% of the indigenous population, and South Pacific region. RESULTS: A total of 412,017 COVID-19 cases were included, with 1.1% of the indigenous population. The crude fatality rate per 1000 person-weeks was 64.8% higher among indigenous than among non-indigenous people (29.97 vs. 18.18, respectively), and it increased more than twice within outpatients (5.99 vs. 2.64, respectively). Cox analysis revealed that indigenous people who received outpatient management had higher fatality rate than non-indigenous outpatients, at the national level (hazard ratio [HR] = 1.63; 95% confidence interval [CI] = 1.34–1.98), within the subgroup of 13 states (HR = 1.66; 95% CI = 1.33–2.07), and in the South Pacific region (HR = 2.35; 95% CI = 1.49–3.69). Factors associated with higher fatality rates among non-indigenous and indigenous outpatients were age, sex, and comorbidities. CONCLUSIONS: COVID-19 fatality is higher among indigenous populations, particularly within cases managed as outpatients.
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spelling pubmed-78772042021-02-11 COVID-19 fatality in Mexico's indigenous populations Argoty-Pantoja, A.D. Robles-Rivera, K. Rivera-Paredez, B. Salmerón, J. Public Health Original Research OBJECTIVE: The aim of the study was to explore the factors that could explain the differences in fatality rates among indigenous groups with COVID-19 diagnosis compared with the rest of the population in Mexico. STUDY DESIGN: We analyzed the public data of COVID-19 surveillance, of the Mexican Ministry of Health, to estimate COVID-19 fatality rates by ethnicity. METHODS: We explored associated factors using Cox proportional hazards models stratified by outpatient and hospital management at diagnosis; analysis was conducted in three scenarios: national level, states with 89% of the indigenous population, and South Pacific region. RESULTS: A total of 412,017 COVID-19 cases were included, with 1.1% of the indigenous population. The crude fatality rate per 1000 person-weeks was 64.8% higher among indigenous than among non-indigenous people (29.97 vs. 18.18, respectively), and it increased more than twice within outpatients (5.99 vs. 2.64, respectively). Cox analysis revealed that indigenous people who received outpatient management had higher fatality rate than non-indigenous outpatients, at the national level (hazard ratio [HR] = 1.63; 95% confidence interval [CI] = 1.34–1.98), within the subgroup of 13 states (HR = 1.66; 95% CI = 1.33–2.07), and in the South Pacific region (HR = 2.35; 95% CI = 1.49–3.69). Factors associated with higher fatality rates among non-indigenous and indigenous outpatients were age, sex, and comorbidities. CONCLUSIONS: COVID-19 fatality is higher among indigenous populations, particularly within cases managed as outpatients. The Royal Society for Public Health. Published by Elsevier Ltd. 2021-04 2021-02-11 /pmc/articles/PMC7877204/ /pubmed/33743216 http://dx.doi.org/10.1016/j.puhe.2021.01.023 Text en © 2021 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Research
Argoty-Pantoja, A.D.
Robles-Rivera, K.
Rivera-Paredez, B.
Salmerón, J.
COVID-19 fatality in Mexico's indigenous populations
title COVID-19 fatality in Mexico's indigenous populations
title_full COVID-19 fatality in Mexico's indigenous populations
title_fullStr COVID-19 fatality in Mexico's indigenous populations
title_full_unstemmed COVID-19 fatality in Mexico's indigenous populations
title_short COVID-19 fatality in Mexico's indigenous populations
title_sort covid-19 fatality in mexico's indigenous populations
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877204/
https://www.ncbi.nlm.nih.gov/pubmed/33743216
http://dx.doi.org/10.1016/j.puhe.2021.01.023
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