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Héctor Gallardo-Rincón,1,2 Julieta Lomelin-Gascon,2 Luis Alberto Martinez-Juarez,2 Alejandra Montoya,2 Janinne Ortega-Montiel,2 Victoria Galicia-Hernandez,2 Diego-Abelardo Álvarez-Hernández,2 Rosangela Ávila-Domínguez,2 Enrique Reyes-Muñoz,3 Lucía Marcela Illescas-Correa,4 Daniel Alberto Diaz Martinez,5 Francisco Javier Magos Vázquez,5 Edwin Oswaldo Vargas Ávila,5 Alejandro Efraín Benitez-Herrera,6 Diana Reyes-Gómez,6 María Concepción Carmona-Ramos,6 Laura Hernández-González,6 Oscar Romero-Islas,6 Ricardo Mújica-Rosales,2 Roberto Tapia-Conyer7 1University of Guadalajara, Health Sciences University Center, Guadalajara, Jalisco, Mexico; 2Carlos Slim Foundation, Mexico City, Mexico; 3Coordination of Gynecological and Perinatal Endocrinology, National Institute of Perinatology, Mexico City, Mexico; 4Maternal and Childhood Research Center (CIMIGEN), Mexico City, Mexico; 5Ministry of Health of the State of Guanajuato, Guanajuato, Mexico; 6Ministry of Health of the State of Hidalgo, Pachuca, Hidalgo, Mexico; 7National Autonomous University of Mexico, School of Medicine, Mexico City, MexicoCorrespondence: Luis Alberto Martinez-Juarez, Carlos Slim Foundation, Lago Zurich 245, Presa Falcon Building (Floor 20), Miguel Hidalgo, Mexico City, 11529, Mexico, Tel +52 55 53 39 17 70, Fax +52 55 53 39 17 70, Email mjuarezl@fundacioncarlosslim.orgPurpose: Few pregnant women in low-resource settings are screened for gestational diabetes mellitus (GDM) using the gold standard oral glucose tolerance test (OGTT). This study compared capillary blood glucose testing with 2-h plasma glucose measurements obtained using the 75-g OGTT to screen for GDM at primary healthcare clinics in Mexico.Patients and Methods: Pregnant women who participated in a previous prospective multicenter longitudinal cohort study and who had not been previously diagnosed with diabetes were included. Participants were evaluated using the plasmatic 2-h 75-g OGTT with simultaneous capillary blood glucose measurements using a glucometer. The study endpoint was the comparability of the glucometer results to the gold standard OGTT when collected simultaneously. Sensitivity, specificity, and area under the curve of the glucose measurements obtained for capillary blood compared with venous plasma (gold standard) were calculated to determine diagnostic accuracy.Results: The study included 947 pregnant women who had simultaneous glucose measurements available (blood capillary [glucometer] and venous blood OGTT). Overall, capillary blood glucose testing was very sensitive (89.47%); the specificity was 66.58% and the area under the curve (95% confidence interval) was 0.78 (0.74– 0.81). The sensitivity, specificity and area under the curve of each capillary measurement were: 89.47%, 66.58% and 0.78 (0.74– 0.82) for the fasting measurement, 91.53%, 93.24% and 0.92 (0.88– 0.96) for the one-hour measurement, and 89.80%, 93.32%, 0.91 (0.87– 0.95) for the second-hour measurement, respectively. No adverse events were reported.Conclusion: Capillary OGTT is a valid alternative to the gold standard OGTT for screening of GDM in low-resource situations or in situations where there are other limitations to performing the OGTT as part of primary healthcare services.Keywords: capillary blood glucose, gestational diabetes mellitus, low-resource, Mexico, oral glucose tolerance test, screening

Background. COVID-19 has caused 244,830 deaths in Mexico. Evaluating the severity of this contingency is possible if the hospital fatality rate of COVID-19 is described because hospitalized patients present more severe conditions. Objective. To analyze the fatality of COVID-19 in hospitalized patients. Methods. A quantitative, descriptive, analytical, cross-sectional, and retrospective study was conducted using open database from Ministry of Health in Mexico. Results. The analysis included 71,189 discharges from patients diagnosed with COVID-19 in the Mexican Ministry of Health Hospitals during 2020. Of them, 27,403 were due to death, predominantly in men and age groups from 50 to 69 years. The general hospital fatality due to COVID-19 was 38.49%, a hospital fatality of 40.75% in men and 35.03% in women. The 55-to-99-year-old age groups, Baja California, Puebla, and Coahuila had a higher hospital fatality than the general fatality. Conclusion. Besides the deaths caused directly by COVID-19 (those that occurred due to respiratory failures), many deaths were indirect in persons with comorbidities exacerbated by this disease. Access to health services, social changes derived from job loss, home protection, and changes in social dynamics, facts expressed in the general mortality excess, cannot be quantified in our study. There are similar patterns with other persons infected worldwide: this disease is more severe for males and older age subjects.

In late 2019, pneumonia cases from unknown origin were detected in Wuhan, China. The cause was a new coronavirus. The World Health Organization (WHO) named the virus SARS-CoV-2 and COVID-19 the associated disease. In the first months of 2020, this disease became a pandemic with a high lethality reported. Since then, the search for treatments began. We started by searching among treatments previously approved for human use that were not designed for COVID-19 and were considered to treat this condition. We continued searching on the therapeutics guidelines published by the WHO for the management of infection by SARS-CoV-2. Based on these results, we searched for the literature in PubMed to obtain further evidence on the drugs against SARS-CoV-2. The treatments presented in this chapter are Ivermectin, Hydroxychloroquine, Nitazoxanide, Azithromycin, Molnupiravir, Casirivimab-Imdevimab, Ritonavir-Nirmatrelvir, Ritonavir-Lopinavir, Remdesivir, and Favipiravir. Two years ahead of the start of the COVID-19 pandemic, a plenty of options for treatment have been investigated. Only a few of them have been shown to be efficient and safe. According to the WHO, Ritonavir-Nirmatrelvir outperforms other proposed therapeutics.

Aims: The objective was to analyze the clinical data in population from Mexican Guanajuato state as a suspected case of COVID-19 and with result positive of rRT-PCR, reported until October 2, 2020. Study Design: It is a cross-sectional based in data from National Epidemiological Surveillance System from General Epidemiological Directorate, Secretary of Health in Mexico. Place and Duration of Study: Sample: All registries from confirmed and discarded cases of COVID-19 in database until October 2, 2020. Methodology: It was included 100,919 registries, and from them, 810 were excluded by missing the result of rRT-PCR test. A suspected case was one with a clinical finding considered greater (cough, fever, headache or dyspnea and accompanied by at least one of the following: myalgia, arthralgia, odynophagia, chills, chest pain, rhinorrhea, anosmia, dysgeusia or conjunctivitis); a confirmed case of COVID-19 is a person with a positive rRT-PCR test for SARS-CoV-2, regardless of the clinical data presented. We included age, sex, and clinical data registered and result of rRT-PCR for SARS-CoV-2. It was used logistic regression to analyze the effect of clinical data on positive rRT-PCR. Results: It was analyzed 100,109 registries. From them, 41,734 were positive for SARS-CoV-2. Fever (OR 1.72, CI95% 1.68 to 1.77), cough (OR 1.70, CI95% 1.66 to 1.74), and odynophagia (OR 1.71, CI95% 1.66 to 1.75) shown a stronger effect on positive rRT-PCR test. Cyanosis did not have any effect on the result of the rRT-PCR test. Conclusion: There are not pathognomonic clinical data for COVID-19. All clinical data in confirmed cases are similar to another respiratory viral infections.