Objectives: To describe the prevalence and distribution of anxiety and depression among Mexican population, and to examine its association with internet addiction during the COVID-19 outbreak. Design: A web-based cross-sectional study. Setting: General population in Mexico. Participants: 561 subjects were recruited (71% female, mean age of was 30.7 ± 10.6 years). Interventions: An online survey to assess personal attitudes and perceptions towards COVID-19, sleep-disorders related, the Mexican version of the Hospital Anxiety and Depression Scale (HADS) and the Internet Addiction Test (IAT) was applied. Primary and secondary outcome measures: Prevalence of anxiety, depression, internet addiction and sleep disorders and associated factors. Also, prevalence for anxiety and depression were compared to an historic control group. Results: During the initial phase of the COVID-19 pandemic the prevalence for anxiety and depression was 50% (95% CI, 45.6% to 54.1%) and 27.6%, (95% CI 23.8% to 31.4%), respectively. We found a 51% (33% to 50%) increase in anxiety and up to 86% increase in depression uring the initial weeks of the lock-down compared to the control group. According to the IAT questionnaire, 62.7% (95% CI 58.6% to 68.8%) of our population had some degree of internet addiction. Odds ratio for development of anxiety symptoms was 2.02 (95% CI1.56-2.1, p=0.0001) and for depression was 2.15 (95% CI 1.59-2.9, p=0.0001). In the multivariate analysis, younger age (p=0.006), sleep problems (p=0.000), and internet addiction ( p=0.000) were associated with anxiety and depression. Conclusions: Our study provides valuable information on the psychological impact that the COVID-19 pandemic has had on the Mexican population. As in other parts of the globe, in Mexico, fear of SARS-CoV-2 infection has had devastating consequences on mental health, such as anxiety, depression and sleeping disturbances. Internet abuse and the consequent overexposure to rapidly spreading misinformation (infodemia) are associated to anxiety and depression.

Objective A minimum of physical activity and low liquid intake are factors that have been associated with constipation. The health emergency brought on by the COVID-19 pandemic has resulted in adopting behaviour, such as sheltering-in-place (less mobility) and dietary changes, creating a scenario we believe to be an adequate model for examining the appearance of symptoms of constipation and its associated factors. Design A cross-sectional and descriptive study was conducted on an open population, applying an electronic survey (4 weeks after lockdown due to COVID-19 in Mexico) to evaluate demographic characteristics, physical activity, water and fibre intake, appearance of constipation symptoms (including stool consistency), and quality of life. Results Out of 678 subjects evaluated, 170 (25%, 95% CI: 21.7 to 28.4) developed symptoms of ‘new-onset’ constipation, with a significant decrease in the number of daily bowel movements (p<0.05) and stool consistency (p<0.05) during lockdown. Furthermore, in the ‘new-onset’ constipation population there was a higher proportion of subjects (79 (47%) of 170) who stopped exercising during the pandemic compared with the subjects who did not develop constipation symptoms (187 (37%) of 508, p=0.03, OR: 1.49, 95% CI: 1.0 to 2.1). The multivariate analysis (logistic regression) showed that female sex (p=0.001), water intake (p=0.039), and physical activity (p=0.012) were associated with ‘new-onset’ constipation. Conclusions In our study on an open population in Mexico, we found that one-fourth of the population developed ‘new-onset’ constipation symptoms during the lockdown imposed due to the COVID-19 pandemic. A reduction of physical activity and less water consumption were associated factors.

Irritable Bowel Syndrome (IBS) is usually a lifelong state that disturbs the digestive system. IBS has been linked to low-grade inflammation and the release of inflammatory mediators into the bloodstream. This could be associated with the degree of obesity presented by patients with IBS. Reports imply that IBS is more frequent in obese patients than in the overall population, with a prevalence of up to 31%. Here, we evaluated the serum levels of immunological and inflammation molecules and their correlation with Body Mass Index in IBS patients and the healthy control (HC). Seventy-nine serum samples of the IBS patients and thirty-five of the HC group were analyzed to determine the levels of each molecule and compare them with their BMI. Serum levels of C3 and C4 were significantly increased in IBS patients. C3 and C4 levels were higher in IBS-M and IBS-D subtypes compared with the HC group. When patients were grouped by BMI, a positive correlation between serum C3 (r = 0.49, p < 0.0001) and CRP (r = 0.40, p < 0.001) levels was found. Our results show, for the first time, a correlation between immunological molecules and BMI in IBS patients, suggesting that the inflammatory nature of obesity could contribute to the development of the symptoms in IBS through the stimulation and release of proteins as complement components and CRP.

Increasing evidence suggests a microbial pathogenesis in irritable bowel syndrome (IBS) but the relationship remains elusive. Fecal DNA samples from 120 patients with IBS, 82 Mexican (IBS-C: n = 33, IBS-D: n = 24, IBS-M: n = 25) and 38 British (IBS-C: n = 6, IBS-D: n = 27, IBS-M: n = 5), were available for analysis using 16S rRNA gene sequencing. Firmicutes (mean: 82.1%), Actinobacteria (10.2%), and Bacteroidetes (4.4%) were the most abundant taxa. The analysis of all samples (n = 120), and females (n = 94) only, showed no significant differences in bacterial microbiota, but the analysis of Mexican patients (n = 82) showed several differences in key taxa (e.g., Faecalibacterium) among the different IBS subtypes. In IBS-D there were significantly higher Bacteroidetes in British patients (n = 27) than in Mexican patients (n = 24), suggesting unique fecal microbiota signatures within the same IBS subtype. These differences in IBS-D were also observed at lower phylogenetic levels (e.g., higher Enterobacteriaceae and Streptococcus in Mexican patients) and were accompanied by differences in several alpha diversity metrics. Beta diversity was not different among IBS subtypes when using all samples, but the analysis of IBS-D patients revealed consistent differences between Mexican and British patients. This study suggests that fecal microbiota is different between IBS subtypes and also within each subtype depending on geographical location.