A Comprehensive Analysis of COVID-19 Impact in Latin America

Abstract

Background: Latin America has now become the epicenter of the global coronavirus disease 2019 (COVID-19) pandemic. In the ongoing COVID -19 pandemic, a profound burden of SARS-COV-2 infection has been reported in Latin America. In the present study, we aim to determine the profiles that are associated with this disease in Latin America. We analyzed symptoms, morbidities and gastrointestinal (GI) manifestations by country.Methods: We analyzed data from SARS-CoV-2 positive patients evaluated at healthcare centers and hospitals of 8 Latin American countries including Brazil, Peru, Mexico, Argentina, Colombia, Venezuela, Ecuador, and Bolivia between March 1 and July 30, 2020. These countries consist of a total population that exceeds 519 million. Demographics, comorbidities and clinical symptoms were collected. Statistical descriptive analysis and correlation analyses of symptoms, comorbidities and lethality were performed.Results: A total of 728,282 patients tested positive for COVID-19 across all the 8 Latin American countries. Of these, 52.6% were female. The average age was 48.4 years. Peru had the oldest cohort with 56.8 years old and highest rate of females (56.8%) while Chile had the youngest cohort (39 years old). Venezuela had the highest male prevalence (56.7%). Most common symptoms were cough with 60.1% (Bolivia had the highest rate 78%), fatigue/tiredness with 52.0%, sore throat with 50.3%, and fever with 44.2%. Bolivia had fever as the top symptom (83.3%). GI symptoms including diarrhea (highest in Mexico with 22.9%), nausea, vomiting, and abdominal pain were not associated with higher mortality. Hypertension was among the top (12.1%) comorbidities followed by diabetes with 8.3% and obesity 4.5%. In multivariable analyses, the leading and significant comorbidities were hypertension (r=0.83, p=0.02), diabetes (r=0.91, p=0.01), and obesity (r=0.86, p=0.03). Asthma (r=0.37, p=0.54) and increasing age (0.13 p=0.81) were not independently associated with higher mortality. Lethality was highest in Mexico (16.6%) and lowest in Venezuela (0.9%) among the analyzed cohorts.Conclusion: Nearly, 10.5%–53% of patients with COVID-19 have GI manifestations. Differential clinical symptoms were associated with COVID-19 in Latin America countries. Metabolic syndrome components were the main comorbidities associated with poor outcome. Country-specific management and prevention plans are needed. Country-specific management and prevention plans can be established from this meta-analysis.

Effects of the COVID-19 Pandemic on Mental Health in Peru: Psychological Distress

“…The percentage of women's participation (56.2%) was lower here than in the study carried out in Spain, with psychological distress was also lower in women in Peru than in Spain, and, similar to most countries investigated, higher psychological distress was found among women than in men [17,18]. It is known that sex is a variable that influences the level of COVID-19 contagion and, in a study on people assisted with COVID-19 conducted in eight Latin American countries, Peru presented a higher percentage of women [4]. In the present study, higher psychological distress has also been found among younger people, but, on the contrary, higher psychological distress was found among those with the lowest level of education.…”

“…Moreover, the level of compliance and differences between population groups according to socioeconomic, educational, and working conditions are variables that are known to determine physical and mental health. This requires reliable sources of information, something that has been highly questioned as seen in previous studies [4].…”

“…In Latin America, in the first phase of the pandemic, COVID-19 diagnostic methods were developed and used in a short period of time and with many limitations, which generated wrong results and insufficient diagnosis, thus increasing the level of uncertainty and making it difficult to estimate the total number of cases, and even to initiate control measures, resource planning, or benchmarking with neighboring countries [4]. However, over time, new tools have been developed for a rapid identification of the infected that allow their isolation and treatment, aiming to enhance their use through artificial intelligence and machine learning that integrate clinical and laboratory data [62].…”

“…Its spread continued, and, on 12 March, the WHO declared the status of international pandemic [3]. Latin America has overcome major recent health challenges such as Zika, but they were not as lethal as the current COVID-19, the Coronavirus Disease 2019 caused by SARS-CoV-2, with high rates of subclinical infections and inconsistent and insufficient diagnostic tests detected, making it difficult to know the actual number of people infected [4]. Analyzing deaths during 2020 in Peru, Ecuador, Mexico, and Spain, there were significantly greater excess deaths than the ones recorded for COVID-19, something that has not happened in Denmark, Germany, or Norway [5].…”

“…Peru, similar to other countries, has shown an exponential increase in tendencies [39]. It has been suggested that the country's precarious health system and poverty rates prior to the pandemic may justify higher mortality figures in Peru than in other Latin American countries, despite prompt action for its containment and with Peruvian citizens being more compliant with the measures imposed by the government than other Latin American populations [4,15].…”