Background: The impact of the coronavirus disease 2019 (COVID-19) pandemic in Mexico City has been sharp, as several social inequalities at all levels coexist. Here we conducted an in-depth evaluation of the impact of individual and municipal-level social inequalities on the COVID-19 pandemic in Mexico City. Methods: We analyzed suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases, from the Mexico City Epidemiological Surveillance System from 24 February 2020 to 31 March 2021. COVID-19 outcomes included rates of hospitalization, severe COVID-19, invasive mechanical ventilation, and mortality. We evaluated socioeconomic occupation as an individual risk, and social lag, which captures municipal-level social vulnerability, and urban population density as proxies of structural risk factors. Impact of reductions in vehicular mobility on COVID-19 rates and the influence of risk factors were also assessed. Finally, we assessed discrepancies in COVID-19 and non-COVID-19 excess mortality using death certificates from the general civil registry. Results: We detected vulnerable groups who belonged to economically unfavored sectors and experienced increased risk of COVID-19 outcomes. Cases living in marginalized municipalities with high population density experienced greater risk for COVID-19 outcomes. Additionally, policies to reduce vehicular mobility had differential impacts modified by social lag and urban population density. Finally, we report an under-registry of COVID-19 deaths along with an excess mortality closely related to marginalized and densely populated communities in an ambulatory setting. This could be attributable to a negative impact of modified hospital admission criteria during the pandemic. Conclusions: Socioeconomic occupation and municipality-wide factors played a significant role in shaping the course of the COVID-19 pandemic in Mexico City.

The coronavirus disease 2019 outbreak is a significant challenge for health-care systems around the world. The objective of the study was to assess the impact of comorbidities on the case fatality rate (CFR) and the development of adverse events in patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the Mexican population. We analyzed the data from 13,842 laboratory-confirmed SARS-CoV-2 patients in Mexico between January 1, 2020, and April 25, 2020. We investigated the risk of death and the development of adverse events (hospitalization, pneumonia, orotracheal intubation, and intensive care unit [ICU] admission), comparing the number of comorbidities of each patient. The patient mean age was 46.6 ± 15.6 years, 42.3% (n = 5853) of the cases were women, 38.8% of patients were hospitalized, 4.4% were intubated, 29.6% developed pneumonia, and 4.4% had critical illness. The CFR was 9.4%. The risk of hospitalization (odds ratio [OR] = 3.1, 95% confidence interval [CI]: 2.7-3.7), pneumonia (OR = 3.02, 95% CI: 2.6-3.5), ICU admission (OR = 2, 95% CI: 1.5-2.7), and CFR (hazard ratio = 3.5, 95% CI: 2.9-4.2) was higher in patients with three or more comorbidities than in patients with 1, 2, or with no comorbidities. The number of comorbidities may be a determining factor in the clinical course and its outcomes in SARS-CoV-2-positive patients.

Background: The awake prone positioning strategy for patients with acute respiratory distress syndrome is a safe, simple and cost-effective technique used to improve hypoxaemia. We aimed to evaluate intubation and mortality risk in patients with coronavirus disease 2019 (COVID-19) who underwent awake prone positioning during hospitalisation.Methods: In this retrospective, multicentre observational study conducted between 1 May 2020 and 12 June 2020 in 27 hospitals in Mexico and Ecuador, nonintubated patients with COVID-19 managed with awake prone or awake supine positioning were included to evaluate intubation and mortality risk through logistic regression models; multivariable and centre adjustment, propensity score analyses, and E-values were calculated to limit confounding.Results: 827 nonintubated patients with COVID-19 in the awake prone (n=505) and awake supine (n=322) groups were included for analysis. Fewer patients in the awake prone group required endotracheal intubation (23.6%versus40.4%) or died (19.8%versus37.3%). Awake prone positioning was a protective factor for intubation even after multivariable adjustment (OR 0.35, 95% CI 0.24–0.52; p<0.0001, E=2.12), which prevailed after propensity score analysis (OR 0.41, 95% CI 0.27–0.62; p<0.0001, E=1.86) and mortality (adjusted OR 0.38, 95% CI 0.26–0.55; p<0.0001, E=2.03). The main variables associated with intubation among awake prone patients were increasing age, lower baseline peripheral arterial oxygen saturation/inspiratory oxygen fraction ratio (PaO₂/FIO₂) and management with a nonrebreather mask.Conclusions: Awake prone positioning in hospitalised nonintubated patients with COVID-19 is associated with a lower risk of intubation and mortality.

The consumption of fruits and vegetables involves the disposal of the inedible parts, conveying challenges such as waste management and environment pollution. In recent years, there have been multiple studies aimed at finding alternatives that reduce the negative impact of food/agricultural waste. Since most studies done with by-products recommend their careful selection, the aim of this study was to verify if discarded banana peels could be disinfected until microbiologically safe and to determine if they could still provide nutrients to formulate food products with sensory characteristics acceptable to a consumer market after disinfection. Banana peels were collected from markets, restaurants, and greengrocers. They were disinfected, dried, and pulverized to obtain a flour which was subjected to microbiological and proximal analysis. Once its microbial safety was assured, this flour was incorporated into bakery and pasta products, replacing wheat flour with 5–20% banana peel flour (BPF). The sensory evaluation of the different products was carried out and, after verifying that the products were sensory acceptable, the proximal analysis was implemented. The formulated products were suitable for the addition of BPF up to 10%, in which the Acceptability Index was higher than 80% and significant increases in fiber and fat were achieved. We conclude that waste banana peel flour can be incorporated into bread and pasta products for human consumption to provide nutrients which might contribute to reduce this type of waste and to recover nutrients from otherwise disposed banana peels.

Many studies suggest that probiotic, prebiotic and symbiotic foods may be beneficial in the prevention and management of nutrition and health, the objective of this work was to develop a symbiotic drink based on coconut water. Fermentation was performed using lyophilized Lactobacillus rhamnosus SP1 and inulin as a source of soluble fiber. Different formulations were developed, determining the concentrations of fiber and probiotics. The growth of the probiotic in MRS broth was evaluated, using the plate counting technique in different periods of time. The fermentation time of the drink was 8 h and the shelf life in refrigeration was 14 days evaluated by pH and hedonic scale. The pH of the final drink was 3.48 and the probiotic content was 82 × 10 8 CFU/ml. It is concluded that coconut water can be processed by adding probiotic and prebiotic characteristics with sensory acceptance and adequate preservation characteristics.

The aim of this cross-sectional study was to evaluate the use and application of the atherogenic index of plasma (AIP) in the prediction of cardiovascular risk factors including mixed hyperlipidemia, hypertension, hyperuricemia, and metabolic syndrome in a population of young Mexican adults. Values were obtained for metabolic parameters, such as glucose, triglycerides, cholesterol (total, high-density, low-density, and very low density), systolic and diastolic blood pressure, and uric acid. Through univariate and multivariate analysis, parametric comparisons were applied and receiver operating characteristic curves were plotted. Logistic regression analysis was used to assess the risk of hyperuricemia, hypertension, mixed hyperlipidemia, and metabolic syndrome from a high AIP. Metabolic parameters and AIP had a significant correlation, with higher rates observed with increased AIP. As a set, metabolic parameters increased with an AIP >0.21 (λ Wilks = 0.58, F(14,344) = 7.7, P < 0.0001). The area under the curve was statistically significant for prediction of hyperuricemia (0.6), mixed hyperlipidemia (0.9), hypertension (0.8), and metabolic syndrome (0.95). In conclusion, in a sample of young Mexican adults, AIP was strongly associated with cardiovascular risk factors and could serve as a useful marker for the prediction of metabolic alterations related to cardiovascular disease.