Person: Rubilar, Paola
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Publication Seroprevalence and estimation of the impact of SARS-CoV-2 infection in older adults residing in Long-term Care Facilities in Chile(2022) Rubilar, Paola; Hirmas Adauy, Macarena; Matute, María Isabel; Browne, Jorge; Little, Cedric; Ruz, Gonzalo; Aguilera, Ximena; Avila, Carlos; Vial, Pablo; Gutknecht Mackenzie, TaniaIntroduction Older adults are at a higher risk of severe illness and death from COVID-19. This vulnera bility increases in those who live in long-term care facilities due to overcrowding, greater physical dependence, and contact with health workers. Evidence on the impact of the pan demic on these establishments in low- and middle-income countries has been scant. This study aims to determine the seroprevalence of SARS-CoV-2 in older people residing in long-term care facilities and estimate the impact of infection after the first wave of the pandemic. Methods A cross-sectional design with 2099 residents in three regions of Chile was carried out be tween September and November 2020. Measurement of antibodies was performed with a rapid test. The impact of SARS-CoV-2 infection was estimated with seropositive residents, those who had a history of positive polymerase chain reaction tests, and those who died from COVID-19. Bivariate analysis with the region, sex, age, history of COVID-19, physical dependence, and serological results were performed. In addition, we performed a correla tion analysis between the seroprevalence of the centers by the municipality and the rate of confirmed cases. Results The seroprevalence of SARS-CoV-2 antibodies in the three regions was 14.7% (95% confi dence interval: 13.2 to 16.3%), the infection impact was 46.4%, and the fatality rate was 19.6%. A significant correlation was found between the seroprevalence of older adults re siding in long-term care facilities and the cumulative incidence by municipalities. Conclusions The seroprevalence of older adults residing in long-term care facilities was higher than the general population. The high impact of infection among this population at the end of the first wave of the COVID-19 pandemic is similar to other countries. The centers' environ ment is directly related to COVID-19 infection. Morbidity and mortality monitoring sys tems should be implemented promptly to establish prevention and control measurPublication Factors influencing neutralizing antibody response to the original SARS-CoV-2 virus and the Omicron variant in a high vaccination coverage country, a population-based study(2023) Hormazabal, Juan; Nuñez-Franz, Loreto; Rubilar, Paola; Apablaza, Mauricio; Vial Cox, María Cecilia; Cortes Salinas, Lina Jimena; González, Natalia; Vial, Pablo; Said, Macarena; Gonzalez Wiedmaier, Claudia; Olivares, Kathya; Aguilera, Ximena; Ramírez-Santana, MurielThe study compared immunity to the original SARS-CoV-2 virus (Wuhan) and the Omicron variant using neutralizing antibodies (NAbs), that provide a good approximation of protective immunity. The results might help determine immunization strategies. Design and methods: Unlike previous studies, we analyzed NAbs in a random sample of 110 IgG positive sera from individuals who participated in a population-based seroprevalence transversal study, carried out in May 2022 in two Chilean cities, a country with high vaccination coverage. Results: Our findings indicate that 98.2% of individuals had NAbs against Wuhan, 65.5% against Omicron, and 32.7% tested positive for Wuhan but not Omicron. Factors influencing protective immunity included a prior natural infection and the number of vaccines received. NAbs titers against the original virus were high, demonstrating vaccine effectiveness in the population. However, the level of antibodies decreased when measuring NAbs against Omicron, particularly among older individuals, indicating a decline in vaccine protection. Previous COVID-19 episodes acted as a natural booster, increasing NAbs titers against both virus strains. Conclusions: Protective immunity against the original Wuhan SARS-CoV-2 virus is reduced when compared to Omicron variant. Updating vaccine to target emerging variants and continued monitoring of effectiveness at the population level are necessary.Publication Overcoming Health Inequities: Spatial Analysis of Seroprevalence and Vaccination Against COVID-19 in Chile(2024) Muriel Ramírez-Santana , Juan Hormazábal, Luis Canales, Pablo Vial, and Ximena Aguilera; Correa, Juan; Núñez Franz, Loreto; Apablaza, Mauricio; Rubilar, Paola; Vial Cox, María Cecilia; Cortes, Lina Jimena; Hormazabal, Juan; Canales, Luis; Vial, Pablo; Aguilera, XimenaBackground: In unequal economies, the spread of the first waves of the COVID-19 was usually associated withlow socioeconomic status of individuals and their families. Chile exemplified this. By mid-2020, Chile had one ofthe highest SARS-CoV-2 infection rates in the world predominantly in poorer areas. A year later, the countrylaunched a universal vaccination campaign based on the national strategy of immunization established in1975. By 2022, Chile presented one of the highest COVID-19 vaccination coverages globally, reaching 94.3%of the population with the primary scheme by the end of 2022.Objective: This study analyzes the spatial distribution of SARS-CoV-2 seroprevalence at the beginning of the pan-demic (2020) compared with the seroprevalence after 2 years of ongoing epidemic and COVID-19 vaccinationcampaigns (2022).Methods: Two population-based random samples of individuals aged 7 years and older from two Chilean citieswere studied. Utilizing an enzyme-linked immunosorbent assay test, IgG antibodies were measured in serum of1061 participants in 2020, and 853 in 2022.Results: Using the Global Moran’s Index, the seroprevalence distribution pattern for the year 2020 showed clus-tering in the two cities. Conversely, seroprevalence and vaccinations were homogeneously distributed in 2022.These results show the success of the vaccination campaign in Chile, not only in coverage but also because itwidely reached all individuals.Conclusions: The uptake of this preventive measure is high, regardless of the social and economic factors,achieving broad population immunity. The extensive deployment of the primary health care network contrib-uted to reducing health inequities and promoting to universal health access.Publication Preventive behaviors for COVID-19 in Chile: Lessons from a population follow-up for 2021 and 2022(2024) Rubilar, Paola; Núñez-Franz, Loreto; Apablaza, Mauricio; Ramírez-Santana, Muriel; Molina, Xaviera; Canales, LuisINTRODUCTION The rapid emergence of COVID-19 urged policy responses worldwide, focusing on vaccination and mobility restrictions. Chile represents a unique scenario for analyzing personal preventive measures amid intensive communication and vaccination campaigns. This study aims to explore changes in population adherence to non-pharmacological preventive measures during the pandemic and the factors that explain this adherence each year. METHODS 386 individuals who participated in two population-based studies (2021 and 2022) were considered. An interview was conducted to measure adherence to self-care practices, and case and contact tracing by the health authorities. The Wilcoxon signedrank test was performed to measure change between 2021 and 2022, bivariate analysis, and a linear regression model for each year were performed. RESULTS Mask-wearing in public places was the most commonly used measure (95.9% in 2021, 89.9% in 2022). Follow-up of cases and cases contacts by the health authority had high coverage in 2021 (94.3% and 83% respectively). A greater decrease was observed in contact tracing in 2022 totaling 33.3%. An increase in the score of adherence to preventive practices was observed in 2022 (p < 0.00). The regression model showed in 2021 that women were more likely to adopt preventive behaviors (95% confidence interval: 0.27 to 1.13) and the overweight/obese had higher adherence compared to normal body mass index (95% confidence interval: 0.06 to 0.98). In 2022 being a young adult (30 to 49 years) predicted the adoption of behavioral precautions (95% confidence interval: 0.00 to 1.32). CONCLUSIONS Adherence to preventive measures increased even with high vaccination coverage, likely due to the epidemiological situation with the Omicron variant circulating in 2022.