Revista Biomédica Revisada Por Pares
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Palabras clave: COVID-19, risk factors, social determinants of health, Latin America, review
La pandemia de la enfermedad por coronavirus 2019 (COVID-19), producida por el virus SARS-CoV-2, se ha diseminado rápidamente a través del mundo. Los países de Latinoamérica y el Caribe han sido afectados duramente por la pandemia principalmente debido a falta de preparación de sus sistemas de salud y debido al fragmentado sistema de seguridad social. Además, en la región, el estado de salud de la población muestra peores indicadores de salud comparado con los países de la Organización para la Cooperación y el Desarrollo Económico. Evidencia reciente sugiere que la progresión y severidad de la COVID-19 están asociadas con el estado de salud basal del individuo, y algunos estudios han mostrado que la letalidad está altamente estratificada entre diferentes poblaciones. El objetivo de esta revisión narrativa es describir los factores asociados con peor evolución de la COVID-19 en el contexto de los determinantes sociales de la salud en los países de Latinoamérica y el Caribe. En esta revisión, se indica que los factores biológicos y genéticos interactúan de una manera sofisticada con los determinantes sociales de la salud, impactando la rápida diseminación de la COVID-19 en los países de Latinoamérica y el Caribe. Factores del comportamiento, como la inactividad física, fumar, y una dieta poco saludable, están relacionadas con una inflamación sistémica crónica. Además, la contaminación ambiental puede prolonger la inflamación y la hiperactivación del sistema inmune. Las partículas contaminantes del aire pueden facilitar la dispersión del virus. Finalmente, el síndrome de fragilidad y las comorbilidades están asociadas con severidad de la COVID-19, aumentando la vulnerabilidad ante factores estresantes y provocando síntomas más graves de la enfermedad COVID-19, aumentando el riesgo de mortalidad. Todos los factores mencionados, contribuyen a aumentar el impacto de la pandemia por COVID-19 en los países de Latinoamérica y el Caribe. Destacamos la relevancia de considerar los determinantes sociales de la salud en los países de Latinoamérica y el Caribe, no sólo para controlar el riesgo de contagio, sino también la progresión y severidad de la enfermedad. Los determinantes sociales pueden guiar el diseño y la implementación de intervenciones para promover los estilos de vida saludable, que puede contribuir a reducir la diseminación de la enfermedad, su severidad y letalidad.
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The coronavirus disease 2019 (COVID-19) pandemic, produced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly throughout the world. Latin American and the Caribbean countries have been harshly affected by the pandemic mainly due to less prepared healthcare systems and fragmented social safety nets. In the region, health status population-based indicators are worse than compared to the Organization for Economic Cooperation and Development. Recent evidence suggests that the progression and severity of COVID-19 are associated with the prior health status of individuals, and studies have shown that the case fatality rate is highly stratified among different populations. This narrative review aims to describe factors associated with adverse outcomes of COVID-19 in the context of social determinants of health in Latin American and Caribbean countries. In this review, we state that genetic and biological factors interact in a sophisticated way with social determinants of health, impacting the rapid spread of COVID-19 in Latin American and Caribbean countries. Behavioral factors, such as physical inactivity, smoking, and unhealthy diets, are related to chronic systemic inflammation. Also, air pollution can prolong inflammation and the hyper-activation of the immune system. Air pollutants could facilitate the spread of the virus. Finally, frailty and comorbidities can be associated with COVID-19 severity through increasing vulnerability to stressors and leading to more severe symptoms of COVID-19 disease, including a higher mortality risk. All these factors contribute to increasing the impact of COVID-19 in Latin American and Caribbean countries. We highlight the relevance of considering social determinants of health in Latin American and the Caribbean countries, not only in controlling the likelihood of getting the disease but also its progression and severity. All these social determinants can guide the design and implementation of tailored interventions promoting healthy lifestyle behaviors, which should lower the spread of the disease, its severity, and lethality.
Autores:
Teresa Balboa-Castillo[1,2], Omar Andrade-Mayorga[1,3], Gabriel Nasri Marzuca-Nassr[1,4], Gladys Morales Illanes[1,2], Manuel Ortiz[1,5], Ingrid Schiferlli[1,2], Nicolas Aguilar-Farias[1,6], Álvaro Soto[1,7], Jorge Sapunar[1,4]
Citación: Balboa-Castillo T, Andrade-Mayorga O, Marzuca-Nassr GN, Morales Illanes G, Ortiz M, Schiferlli I, et al. Pre-existing conditions in Latin America and factors associated with adverse outcomes of COVID-19: A review. Medwave 2021;21(04):e8180 doi: 10.5867/medwave.2021.04.8180
Fecha de envío: 23/9/2020
Fecha de aceptación: 2/3/2021
Fecha de publicación: 4/5/2021
Origen: No solicitado
Tipo de revisión: Con revisión por pares externa, por cuatro árbitros a doble ciego
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