Testing and isolation have been crucial for controlling the COVID-19 pandemic. Venezuela has one of the weakest testing infrastructures in Latin America and the low number of reported cases in the country has been attributed to substantial underreporting. However, the Venezuelan epidemic seems to have lagged behind other countries in the region, with most cases occurring within the capital region and four border states. Here, we describe the spatial epidemiology of COVID-19 in Venezuela and its relation to the population mobility, migration patterns, non-pharmaceutical interventions and fuel availability that impact population movement. Using a metapopulation model of SARS-CoV-2 transmission dynamics, we explore how movement patterns could have driven the observed distribution of cases. Low within-country connectivity most likely delayed the onset of the epidemic in most states, except for those bordering Colombia and Brazil, where high immigration seeded outbreaks. NPIs slowed early epidemic growth and subsequent fuel shortages appeared to be responsible for limiting the spread of COVID-19 across the country.
The coronavirus disease 2019 (COVID‐19) pandemic has particularly affected countries with weakened health services in Latin America, where proper patient management could be a critical step to address the epidemic. In this study, we aimed to characterize and identify which epidemiological, clinical, and paraclinical risk factors defined COVID‐19 infection from the first confirmed cases through the first epidemic wave in Venezuela. A retrospective analysis of consecutive suspected cases of COVID‐19 admitted to a sentinel hospital was carried out, including 576 patient cases subsequently confirmed for severe acute respiratory syndrome coronavirus 2 infection. Of these, 162 (28.1%) patients met the definition criteria for severe/critical disease, and 414 (71.2%) were classified as mild/moderate disease. The mean age was 47 (SD 16) years, the majority of which were men (59.5%), and the most frequent comorbidity was arterial hypertension (23.3%). The most common symptoms included fever (88.7%), headache (65.6%), and dry cough (63.9%). Severe/critical disease affected mostly older males with low schooling (p < 0.001). Similarly, higher levels of glycemia, urea, aminotransferases, total bilirubin, lactate dehydrogenase, and erythrocyte sedimentation rate were observed in severe/critical disease patients compared to those with mild/moderate disease. Overall mortality was 7.6% (44/576), with 41.7% (28/68) dying in hospital. We identified risk factors related to COVID‐19 infection, which could help healthcare providers take appropriate measures and prevent severe clinical outcomes. Our results suggest that the mortality registered by this disease in Venezuela during the first epidemic wave was underestimated. An increase in fatalities is expected to occur in the coming months unless measures that are more effective are implemented to mitigate the epidemic while the vaccination process is ongoing.
Malaria cases in Latin America reached ~1 million in 2017 and 2018, with 53% and 51% reported from Venezuela, respectively. In this study, we characterized the spatiotemporal dynamics of malaria transmission between 2007-2017 in southern Venezuela, the main endemic area of the country. We found that disease transmission was focal and more prevalent in the southeast of southern Venezuela where two persistent hotspots of Plasmodium vivax (76%) and P. falciparum (18%) linked to deforestation for illegal gold mining accounted for ~60% of the country-wide number of cases. Incidence has increased nearly tenfold in the last decade, showing an explosive epidemic growth due to a significant lack of disease control. We suggest that a source-sink pattern of Plasmodium sp . dispersal account for the re-emergence and progression of malaria transmission in the last 4 years across the country due to the internal migration of infected people to and from the hotspots and other malaria-prone ecosystems. We observe a similar pattern explaining the spillover of cases across international borders affecting neighboring countries. This study provides baseline epidemiological data and guidance for malaria control to further assess the dynamics of cross-border malaria, the role of asymptomatic carriers, drug-resistant evolution, and innovative control efforts in the Latin America region.
COVID-19 vaccines prevented severe disease outcomes worldwide. As part of a vaccine effectiveness study, the authors summarized demographic and health profiles, vaccination data, SARS-CoV-2 variants, and disease outcomes from patients hospitalized due to COVID-19-like symptoms in Latin America between February and December 2022. LIVE was an observational-prospective study with a test-negative case-control design (NCT05282017). Adults admitted with COVID-19-like symptoms were recruited across five Latin American countries. Patients were tested for SARS-CoV-2, and variants were identified through sequencing. Data were collected from medical records and interviews. Participants recruited (536 cases, 250 controls) had a mean age of 60.5 years. COVID-19 cases (63.7, SD = 19.1) were slightly older than controls (53.8, SD = 20.4). Disorders of the cardiovascular system were the most prevalent comorbidities, and most participants (73.0 %) reported at least one comorbidity. COVID-19 cases mostly presented with moderate (51.1 %) disease. Overall, 50.6 % of participants were unvaccinated against COVID-19, with a higher percentage in cases (56.3 %) than in controls (38.2 %). Viral genomic analysis identified the most prevalent SARS-CoV-2 lineages, BQ.1.1 (11.9 %) among Omicron BA.5 and XBB.1.15 (2.5 %) among recombinant variants. The study was underpowered to estimate vaccine effectiveness due to the low number of COVID-19 hospitalization cases. The present study revealed key demographic and clinical characteristics of patients hospitalized due to COVID-19. Notably, an older age among confirmed cases, a substantial proportion of unvaccinated individuals, and the decrease in hospitalizations emphasize the complexity of the COVID-19 landscape in Latin America and the need for continued research to inform public health strategies.
Introduction Lower respiratory tract infections represent a major public health burden, but adult data on respiratory viruses except influenza and COVID-19 are limited. Most European surveillance systems report aggregate data lacking patient-level detail. Methods We utilised the multicountry id.DRIVE surveillance study data to describe the epidemiology, clinical characteristics, and outcomes of adults hospitalised with pathogen-specific severe acute respiratory infections (SARI) during 2024–2025. Adults (≥ 18 years) hospitalised with SARI across 17 hospitals in Spain, Italy, and Germany between 1 September 2024 and 31 August 2025 were included. All participants were tested using reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), and influenza A/B (testing additional respiratory pathogens varied by hospital). Descriptive analyses were stratified by pathogen. Results Of 8730 included participants (median age, 77 years), 14.3% (n = 1249) tested positive for influenza A, 6.9% (n = 606) SARS-CoV-2, 6.4% (n = 554) RSV, and 0.8% (n = 74) for influenza B. Positivity peaked for influenza and RSV in December–January, and for SARS-CoV-2 in July. Comorbidity burden was substantial: 51.9% of all SARI participants had ≥ 3 chronic conditions, reaching 62.3% in those with RSV. RSV-positive SARI patients were older (median age, 80 years); oxygen therapy was required in 72.0%, non-invasive ventilation in 12.3%, and in-hospital mortality was 9.4%. Over 75.0% of SARI cases positive for a respiratory virus received antibiotics during hospitalisation. Conclusion Viral pathogens remain a major cause of adult SARI hospitalisations in Europe. Our findings highlight the continued burden and seasonal diversity of viral respiratory pathogens, supporting the value of integrated, pathogen-specific SARI surveillance guiding prevention strategies.
Testing and isolation have been crucial for controlling the COVID-19 pandemic. Venezuela has one of the weakest testing infrastructures in Latin America and the low number of reported cases in the country has been attributed to substantial underreporting. However, the Venezuelan epidemic seems to have lagged behind other countries in the region, with most cases occurring within the capital region and four border states. Here, we describe the spatial epidemiology of COVID-19 in Venezuela and its relation to population mobility, migration patterns, non-pharmaceutical interventions and fuel availability. Using an SEI metapopulation model, we explore how movement patterns could have driven the observed distribution of cases. Low within-country connectivity most likely delayed the epidemic in most states, except for those bordering Colombia and Brazil where high immigration seeded outbreaks. NPIs slowed early epidemic growth and subsequent fuel shortages appeared to be responsible for limiting the spread of COVID-19 across the country.