Mexico
Mexico (México)
You cannot have a World Cup without Mexico. The Mexican national football team has been present since the beginning of the tournament for a total of 16 appearances in the history of the FIFA World Cup. They hosted the tournament in 1986 which was also the closest they have ever been to winning the World Cup: 6th place in the quarterfinals (Audio 1). Mexico hopes to surpass this feat in the present tournament, and the following one in 2026 when they return as co-hosts along with Canada and the United States. Some of the players that have marked the history of Mexico in the World Cup are Rafael Marquez and goalkeeper Antonio Carbajal who have appeared five times in the tournament. Top goal scorers are Javier Hernandez and Luis Hernandez. Together, their mixture of courage and tenacity makes them a top contender.
Audio 1: Theme song from the 1986 Mexico-hosted World Cup
Figure 1: Risk factors for heart disease in patients with COVID-19 | Presented at the 2020 European Society of Cardiology annual meeting | Courtesy of Dr. Vass Vassilliou (zoom in for details)
For the NephroWorldCup the Mexican team present an equally strong paper, one that marks one the most important events in modern medical history: COVID-19. In Mexico, a country with a high prevalence in obesity, it is paramount to understand the interaction between the virus and metabolic disease (Figure 1).
In this study, the authors tapped into the collective knowledge of the national registry of the Mexican Ministry of Health crossing different factors associated with COVID-19 mortality. The idea was to identify the impact obesity and diabetes had into the viral illness.
As with any good registry, power is in the numbers. The Mexican Health registry had those numbers: 177133 subjects → total of 51633 cases of Covid-19 → 5332 deaths (by May 2020). The risk factors that were associated with COVID-19 lethality included: early onset diabetes, COPD, being elderly, hypertension, use of immunosuppressants, and chronic kidney disease.
Not surprisingly, nearly half of the cases of COVID-19 mortality were strongly mediated by obesity. While early onset diabetes increased the risk of hospitalization, obesity increased the risk for ICU admission and intubation (Figure 2) Elegantly the researchers developed a predictive score for COVID-19 lethality which included several variables and were able to discriminate from lethal to non-lethal COVID-19 cases with a c-statistic of 0.823 (Figure 4). Mortality was higher in obesity versus diabetes (13.5% vs 9.4%).
Figure 3: COVID-19 related outcomes in all patients with SARS-CoV2 positivity for admission to ICU (A), mechanical ventilation (B) and hospital admission risk (C).
The findings come as no shock in the current state of affairs. Let's remember how difficult it was to conduct research during the midst of the pandemic and how little we knew. This study was conducted in May 2020: two months into the official start of the pandemic. Findings such as those helped cement what now is common knowledge regarding COVID-19 and one of its prominent risk factors.
Whether or not Mexico will reach the glory in the FIFA World Cup Tournament is to hope for as the team continues to growth and is yearning for success Similarly, one can expect a lot of supporters for this team in the NephroWorldCup given their important contributions to the pool of knowledge of the most impactful healthcare challenge of our era.
Figure 4: Predictor variables and clinical score for COVID-19 lethality
