Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador

Abstract

Background:The SARS-CoV-2 virus has spread rapidly around the globe. Nevertheless, there is limited information describing the characteristics and outcomes of COVID-19 patients in Latin America. Methods:We conducted a cross-sectional analysis of 9,468 confirmed COVID-19 cases reported in Ecuador. We calculated overall incidence, mortality, case fatality rates, disability adjusted life years, attack and crude mortality rates, as well as relative risk and relative odds of death, adjusted for age, sex and presence of comorbidities.Results: A total of 9,468 positive COVID-19 cases and 474 deaths were included in the analysis. Men accounted for 55.4% (n = 5, 247) of cases and women for 44.6% (n = 4, 221).We found the presence of comorbidities, being male and older than 65 years were important determinants of mortality. Coastal regions were most affected by COVID-19, with higher mortality rates than the highlands. Fatigue was reported in 53.2% of the patients, followed by headache (43%), dry cough (41.7%), ageusia (37.1%) and anosmia (36.1%). Conclusion:We present the first analysis of the burden of COVID-19 in Ecuador. Our findings show that men are at higher risk of dying from COVID-19 than women, and risk increases with age and the presence of comorbidities. We also found that blue-collar workers and the unemployed are at greater risk of dying. These early observations offer clinical insights for the medical community to help improve patient care and for public health officials to strengthen Ecuador's response to the outbreak.

Behavioral and sociodemographic predictors of anxiety and depression in patients under epidemiological surveillance for COVID-19 in Ecuador

“…Participants from Coastal region were more affected emotionally, and this makes sense given the progression of the disease in the country. Coastal areas, particularly Guayaquil, presented a higher number of cases and higher mortality rates in comparison to the other regions during April 2020 as result of the COVID-19 pandemic [23].…”

“…This study was conducted in Ecuador, a country located in South America split in four main regions: 1) the Coastal region, 2) the Highland or Sierra region, 3) the Amazon region and 4) the Insular region. Coastal region presented higher mortality rates than the other regions as consequences of late implementing restrictive measures of social distancing and limited capacity of health services [23]. The population of Ecuador was estimated to be 17,510,643 inhabitants based on the latest available projections for 2020 [24].…”

“…According to the Ecuadorian law and international good clinical and research practices observational studies that do not put in risk patients' rights are exempted to obtain full ethical approval. This study presents a secondary data analysis of Ortiz-Prado et al 2020 [23], which received ethical exemption from the Universidad de Las Américas Ethics Committee (CEISH) because it used only anonymized, un-identifiable information of the patients. Follow-up phone calls and the information retrieved was obtained by health professionals who offer standard care treatment for confirmed and suspected patients with COVID-19.…”

Anxiety and depression in patients with confirmed and suspected COVID‐19 in Ecuador

“…For instance, Ecuador was one of the most affected countries by the pandemic, reported hundreds of deaths each day during the last weeks of March and the first weeks of April 2020. 2 The mortality rates were high during these months due to late implementation of restrictive measures of social distancing and limited capacity of health services (testing capacities and contact tracing). In this scenario, the Ecuadorian Ministry of Public Health (MoPH) established an epidemiological surveillance program for COVID-19 confirmed and suspected patients.…”

“…All participants included in the analyses were adults who had provided informed consent during data collection. We present here a secondary data analysis of the study conducted by Ortiz-Prado et al 2 which received an exemption from the Universidad de las Américas Ethics Committee.…”