<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112021000400009</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2020.04.001</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Letalidad de la COVID-19: ausencia de patrón epidemiológico]]></article-title>
<article-title xml:lang="en"><![CDATA[Case fatality rate of COVID-19: absence of epidemiological pattern]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Figueiredo]]></surname>
<given-names><![CDATA[Alexandre Medeiros de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Daponte]]></surname>
<given-names><![CDATA[Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Figueiredo]]></surname>
<given-names><![CDATA[Daniela Cristina Moreira Marculino de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gil-García]]></surname>
<given-names><![CDATA[Eugenia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Kalache]]></surname>
<given-names><![CDATA[Alexandre]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidade Federal da Paraíba Departamento de Promoción de la Salud ]]></institution>
<addr-line><![CDATA[João Pessoa ]]></addr-line>
<country>Brasil</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidade Federal do Rio Grande do Norte Programa de Posgrado en Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Natal ]]></addr-line>
<country>Brasil</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,CIBER de Epidemiología y Salud Pública (CIBERESP)  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Escuela Andaluza de Salud Pública Observatorio de Salud y Medio Ambiente de Andalucía (OSMAN) ]]></institution>
<addr-line><![CDATA[Granada ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidade Federal da Paraíba Departamento de Estadística Programa de Posgrado en Modelos de Decisión y Salud]]></institution>
<addr-line><![CDATA[João Pessoa ]]></addr-line>
<country>Brasil</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Universidad de Sevilla Departamento de Enfermería, Fisioterapia y Podología ]]></institution>
<addr-line><![CDATA[Sevilla ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,International Longevity Centre-Brazil WHO Department of Ageing and Life Course ]]></institution>
<addr-line><![CDATA[Río de Janeiro ]]></addr-line>
<country>Brasil</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2021</year>
</pub-date>
<volume>35</volume>
<numero>4</numero>
<fpage>355</fpage>
<lpage>357</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112021000400009&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112021000400009&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112021000400009&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo  Analizar un conjunto de indicadores para comprender la variabilidad de la evolución y el impacto de la epidemia de COVID-19.  Método  Estudio ecológico de países con más de 200 casos notificados. Se han analizado variables demográficas, de gasto sanitario y de características de los servicios sanitarios como variables explicativas, y las tasas de incidencia, mortalidad y letalidad como variables respuesta. Se ha creado un índice de letalidad relativa. Los datos proceden de organismos internacionales. La magnitud de las asociaciones se ha estimado mediante el coeficiente de correlación de Spearman.  Resultados  El número de pruebas y el número de profesionales de medicina se asocian a una mayor incidencia. La mortalidad y la letalidad no se asocian con variables demográficas, de gasto sanitario ni de los servicios sanitarios.  Conclusión  Las diferencias sugieren una subestimación generalizada de la magnitud de la epidemia. Es necesario mejorar la identificación de casos y la eficacia de los sistemas de vigilancia epidemiológica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective  Analyze a set of indicators to understand the variability of the evolution and impact of the COVID-19 epidemic in a set of selected countries.  Method  Ecological study of a group of countries with more than 200 reported cases. Demographic variables, health expenditure variables, and variables about characteristics of health services were included as explanatory variables. and incidence, mortality and fatality rates have been analyzed as response variables. In addition, a relative fatality index has been created. Data are from international organizations. Spearman's correlation coefficient was used to estimate the magnitude of the associations.  Results  Number of tests and of medical professionals are associated with a higher incidence rate. Mortality and case fatality rate are not associated with demographic, health expenditure, or health services variables.  Conclusion  Differences suggest a general underestimation of the magnitude of the epidemic. Improvement of case identification and effectiveness of epidemiological surveillance systems is necessary.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Epidemias]]></kwd>
<kwd lng="es"><![CDATA[Coronavirus]]></kwd>
<kwd lng="es"><![CDATA[Epidemiología]]></kwd>
<kwd lng="es"><![CDATA[Enfermedades transmisibles]]></kwd>
<kwd lng="es"><![CDATA[Monitoreo epidemiológico]]></kwd>
<kwd lng="en"><![CDATA[Epidemics]]></kwd>
<kwd lng="en"><![CDATA[Coronavirus]]></kwd>
<kwd lng="en"><![CDATA[Epidemiology]]></kwd>
<kwd lng="en"><![CDATA[Communicable diseases]]></kwd>
<kwd lng="en"><![CDATA[Epidemiological monitoring]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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