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At the close of yesterday, April 21, 3,425 patients are admitted to hospitals for epidemiological clinical surveillance. Another 5 thousand 497 people are watched in their homes, from the Primary Health Care.

For COVID-19, 1,860 cases were studied, resulting in 52 positive samples. The country accumulates 32 thousand 276 samples and thousand 189 positive (3.7%). Therefore, at the close of yesterday, 52 new cases are confirmed, for a cumulative of 1,189 in the country.

The 52 new confirmed cases were Cuban. Of these, 43 were contacts of confirmed cases and 9 did not specify the source of infection.

Of the 52 diagnosed cases, 31 (59.6%) were men and 21 (40.4%) were women. Of the total number of diagnosed cases, the most affected age groups were: under 40 years of age with 26 cases (50%), followed by the group of 40 to 60 years with 20 cases (38.4%). 63.4% (33) of the positive cases were asymptomatic.

The residence by provinces and municipalities of the 52 confirmed cases is:

Havana: 44 (12 from the Centro Habana municipality, 7 from San Miguel del Padrón; 4 from Diez de Octubre; Cotorro, Habana del Este and Playa with 3 each; Guanabacoa, La Lisa, Marianao, Boyeros and Plaza de la Revolución; Old Havana and Cerro with one each)
Mayabeque: 1 (from the municipality of San José de las Lajas)
Matanzas: 1 (from the Cárdenas municipality)
Villa Clara: 1 (from the municipality of Santa Clara)
Cienfuegos: 1 (from the Cienfuegos municipality)
Las Tunas: 1 (from Puerto Padre municipality)
Holguín: 1 (from Holguín municipality)
Santiago de Cuba: 1 (from the municipality of Santiago de Cuba)
Guantánamo: 1 (from the Guantánamo municipality)

Details of the 52 confirmed cases:

Havana

19-year-old Cuban citizen, resident in the Playa municipality, Havana province. Previously confirmed case contact. 12 contacts are kept under surveillance.
56-year-old Cuban citizen, resident in the Playa municipality, Havana province. Previously confirmed case contact. 19 contacts are kept under surveillance.
74-year-old Cuban citizen, resident in the Cotorro municipality, Havana province. Infection source investigated. 12 contacts are kept under surveillance.
45-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. Infection source investigated. 11 contacts are kept under surveillance.
47-year-old Cuban citizen, resident in the Cotorro municipality, Havana province. Previously confirmed case contact. 17 contacts are kept under surveillance.
12-year-old Cuban citizen, resident in the Cotorro municipality, Havana province. Previously confirmed case contact. 17 contacts are kept under surveillance.
47-year-old Cuban citizen, resident in the municipality of Diez de Octubre, province of Havana. Previously confirmed case contact. 13 contacts are kept under surveillance.
29-year-old Cuban citizen, resident in the municipality of Diez de Octubre, province of Havana. Previously confirmed case contact. 13 contacts are kept under surveillance.
59-year-old Cuban citizen, resident in the municipality of Diez de Octubre, province of Havana. The source of infection is investigated. 11 contacts are kept under surveillance.
54-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. Previously confirmed case contact. 12 contacts are kept under surveillance.
54-year-old Cuban citizen, resident in the Boyeros municipality, Havana province. Previously confirmed case contact. 14 contacts are kept under surveillance.
25-year-old Cuban citizen, resident in the Habana Vieja municipality, Havana province. Previously confirmed case contact. 11 contacts are kept under surveillance.
18-year-old Cuban citizen, resident in the municipality of Habana del Este, province of Havana. Related to the event that occurred in the Guiteras neighborhood of this municipality. 10 contacts are kept under surveillance.
10-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. Previously confirmed case contact. 10 contacts are kept under surveillance.
10-year-old Cuban citizen, resident in the Playa municipality, Havana province. Previously confirmed case contact. 15 contacts are kept under surveillance.
17-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. Previously confirmed case contact. 15 contacts are kept under surveillance.
20-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. Infection source investigated. 19 contacts are kept under surveillance.
42-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. Previously confirmed case contact. 12 contacts are kept under surveillance.
26-year-old Cuban citizen, resident in the municipality of Diez de Octubre, province of Havana. Previously confirmed case contact. 12 contacts are kept under surveillance.
47-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. Previously confirmed case contact. 13 contacts are kept under surveillance.
61-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. Previously confirmed case contact. 11 contacts are kept under surveillance.
26-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. The source of infection is investigated. 17 contacts are kept under surveillance.
44-year-old Cuban citizen, resident in the San Miguel del Padrón municipality, Havana province. Previously confirmed case contact. 12 contacts are kept under surveillance.
61-year-old Cuban citizen, resident in the San Miguel del Padrón municipality, Havana province. Previously confirmed case contact. 16 contacts are kept under surveillance.
24-year-old Cuban citizen, resident in the San Miguel del Padrón municipality, Havana province. Previously confirmed case contact. 17 contacts are kept under surveillance.

20-year-old Cuban citizen, resident in the San Miguel del Padrón municipality, Havana province. Previously confirmed case contact. 17 contacts are kept under surveillance.

50-year-old Cuban citizen, resident in the Marianao municipality, Havana province. Contact of previously confirmed cases. 16 contacts are kept under surveillance.
26-year-old Cuban citizen, resident in the Plaza municipality, Havana province. Previously confirmed case contact. 17 contacts are kept under surveillance.
43-year-old Cuban citizen, resident in the San Miguel del Padrón municipality, Havana province. Contact of previously confirmed cases. 15 contacts are kept under surveillance.
30-year-old Cuban citizen, resident in the Cerro municipality, Havana province. The source of infection is investigated. 15 contacts are kept under surveillance.
8-year-old Cuban citizen, resident in the Guanabacoa municipality, Havana province. Previously confirmed case contact. 15 contacts are kept under surveillance.
33-year-old Cuban citizen, resident in the Guanabacoa municipality, Havana province. Previously confirmed case contact. 15 contacts are kept under surveillance.
24-year-old Cuban citizen, resident in the Boyeros municipality, Havana province. Previously confirmed case contact. 16 contacts are kept under surveillance.
Cuban citizen of 54 years of age, resident in the Plaza de la Revolución municipality, Havana province. Previously confirmed case contact. 25 contacts are kept under surveillance.
21-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. Contact of previously confirmed cases. 12 contacts are kept under surveillance.
25-year-old Cuban citizen, resident in the San Miguel del Padrón municipality, Havana province. Contact of previously confirmed cases. 12 contacts are kept under surveillance.
25-year-old Cuban citizen, resident in the San Miguel del Padrón municipality, Havana province. Contact of previously confirmed cases. 12 contacts are kept under surveillance.
56-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. Contact of previously confirmed cases. 15 contacts are kept under surveillance.
66-year-old Cuban citizen, resident in the Habana del Este municipality, Havana province. The source of infection is investigated. 1 contacts are kept under surveillance.
42-year-old Cuban citizen, resident in the municipality of Habana del Este, province of Havana. Contact of previously confirmed cases. 12 contacts are kept under surveillance.
22-year-old Cuban citizen, resident in the Centro Habana municipality, Havana province. The source of infection is investigated. 10 contacts are kept under surveillance.
44-year-old Cuban citizen, resident in the municipality of La Lisa, province of Havana. Contact of previously confirmed cases. 17 contacts are kept under surveillance.
29-year-old Cuban citizen, resident in the municipality of La Lisa, province of Havana. Contact of previously confirmed cases. 17 contacts are kept under surveillance.
60-year-old Cuban citizen, resident in the Marianao municipality, Havana province. The source of infection is investigated. 16 contacts are kept under surveillance.

Mayabeque

51-year-old Cuban citizen, resident in the San José de las Lajas municipality, Mayabeque province. Contact of previously confirmed cases. 27 contacts are kept under surveillance.

Killings

58-year-old Cuban citizen, resident in the Cárdenas municipality, Havana province. Previously confirmed case contact. 12 contacts are kept under surveillance.

Villa Clara

84-year-old Cuban citizen, resident in the Santa Clara municipality, Villa Clara province. Previously confirmed case contact. 14 contacts are kept under surveillance.

Hundred fires

67-year-old Cuban citizen, resident in the Cienfuegos municipality, Cienfuegos province. Previously confirmed case contact. 13 contacts are kept under surveillance.

Las Tunas

23-year-old Cuban citizen, resident in the Puerto Padre municipality, Las Tunas province. Previously confirmed case contact. 40 contacts are kept under surveillance.

Holguin

48-year-old Cuban citizen, resident in the Holguín municipality, province of the same name. Contact of previously confirmed cases. 17 contacts are kept under surveillance.

Santiago de Cuba

30-year-old Cuban citizen, resident in the Santiago de Cuba municipality, province of the same name. Previously confirmed case contact. 25 contacts are kept under surveillance.

Guantanamo

33-year-old Cuban citizen, resident in the Guantánamo municipality, province of the same name. Previously confirmed case contact. 17 contacts are kept under surveillance.

Of the 1,189 patients diagnosed with the disease, 790 have stable clinical evolution, 40 deaths are reported (two in the day), two evacuated and 341 discharges (32 more yesterday). Nine critically ill patients and seven critically ill patients are reported.

Critically ill patients reported:

41-year-old Cuban citizen, resident in Havana. He has a history of Diabetes Mellitus, Hypertension, Obesity, Cushing's Syndrome. She is admitted to the Luis Díaz Soto Hospital. He underwent a tracheostomy, he maintained an ischemic arterial lesion of the left lower limb without changes, hemodynamically stable. It is still reported in critical condition.
67-year-old Cuban citizen, resident in Centro Habana, Havana. She is admitted to the Salvador Allende Hospital. It is found with mechanical ventilation, moderate respiratory distress. Hemodynamically unstable. Rx. Chest radiological worsening, significant inflammatory infiltrate in the lower 2/3 of both hemithorax. It is still reported in critical condition.
62-year-old Cuban citizen, resident in Havana. He has a history of high blood pressure, diabetes mellitus and psoriasis. With mechanical ventilation, severe respiratory distress. Hemodynamically stable, Rx. chest with inflammatory lesions in the lower 2/3 with a predominance of right hemithorax. Still reported in critical condition.
84-year-old Cuban citizen, resident in the Plaza de la Revolución municipality. It is found with abundant bronchial secretions, ventilated, moderate respiratory distress. Hemodynamically stable. Rx. Inflammatory thorax lesions in the right hemithorax and lower 2/3 of the left hemithorax. It is still reported in critical condition.
86-year-old Cuban citizen. History of bronchial asthma and senile dementia. He performed a cardio-respiratory arrest event at 10.00 pm on April 20, this oliguric, hyperglycemic and with hypotension. Mechanical ventilation was started and she presented moderate respiratory distress. Hemodynamically unstable, drop in diuretic rhythm. Rx thorax signs of pulmonary emphysema, fibrosis and inflammatory lesions predominantly 1/3 lower right. It is reported in critical condition.
60-year-old Cuban citizen residing in Marianao, Havana. He has a history of Diabetes Mellitus and Morbid Obesity. He is admitted to the Salvador Allende Hospital with dyspnea, which increases during the early morning, it is necessary to intubate and ventilate, being transferred to Intensive Care. It is in mechanical ventilation, with moderate respiratory distress. Hemodynamically unstable, he made several pictures of hyperglycemia yesterday. Rx thorax. inflammatory lesions disseminated in both lung fields. It is still reported in critical condition.
Cuban citizen, 54 years old. He resides in the Plaza de la Revolución municipality, Havana. History of hypertension. He was admitted to Intermediate Care with symptoms of cough, fever, decay, and progressive shortness of breath, was ventilated, and was transferred to Intensive Care. He is ventilated with moderate respiratory distress. Hemodynamically stable. Chest x-ray with bilateral inflammatory lesions. It is reported in critical condition.

59-year-old Cuban citizen, resides in Havana. History of Bronchial Asthma and morbid obesity. He presented cough, decay and progressive dyspnea, he was transferred to Intensive Care due to an increase in symptoms. She is ventilated with moderate respiratory distress, hemodynamically stable, chest X-ray with predominantly right inflammatory lesions. It is reported in critical condition.

73-year-old Cuban citizen, resident in the Santa Clara municipality, Villa Clara province. History of Hypertension, Diabetes Mellitus, Ischemic Heart Disease and Ischemic Stroke, with motor sequelae of Right Hemiplegia. Patient who made a suicide attempt, incomplete hanging, for which he was admitted to the Arnaldo Milián Hospital, where he began with respiratory symptoms, a positive PCR sample was taken and he was transferred to the Manuel Fajardo Hospital. He is mechanically ventilated through a tracheostomy, hemodynamically stable. Rx thorax. interstitial opacities in the infraclavicular vertex and for the right hilar, as well as in the external region of the left hemithorax. Still reported in critical condition.

Patients reported in serious condition:

Cuban citizen, 66, resides in Havana. History of Bronchial Asthma, Arterial Hypertension and Obesity. He is hemodynamically stable, chest X-ray with radiological improvement. It is reported in serious condition.
Cuban citizen, 80 years old. Plaza de la Revolución Municipality. History of high blood pressure, chronic ibstructive pulmonary disease and ischemic heart disease. He presented fever, symptoms of abdominal pain and vomiting, was evaluated by surgery, an abdominal ultrasound was performed, and an acute surgical abdomen was proposed, and he was transferred to the operating room. Hemodynamically stable, Rx thorax signs of pulmonary emphysema, fibrosis and inflammatory predominance of the left vertex and the entire right hemithorax. It is reported in serious condition.
66-year-old Cuban citizen, resident in the Matanzas municipality. Personal Pathological Background. Hypothyroidism, High Blood Pressure, Diabetes Mellitus and Chronic Kidney Failure (CRI). She moved to therapy for presenting an exacerbation of her IRC picture to subject her to a dialysis regimen. Ventilate spontaneously, hemodynamically stable. It is reported in serious condition.
55-year-old Cuban citizen, Colón municipality, Matanzas province. Personal Pathological Background. Bronchial asthma. She was admitted to the ICU ward in Colón due to cough, expectoration, and marked dyspnea. She underwent a PCR and, as a result, she was transferred to therapy at the Mario Muñoz Hospital. He is without dyspnea, spontaneously ventilates, hemodynamically stable. It is reported in serious condition.

Cuban citizen of 53 years. With a history of Diabetes Mellitus. It is found with clinical and gasometric improvement, afebrile, spontaneously ventilating, hemodynamically stable. Culture of bronchial secretions with Klebsiella. It is reported in serious condition.

49-year-old Cuban citizen, resident in the Santiago de Cuba municipality. With a history of high blood pressure. It is found with spontaneous ventilation, hemodynamically stable, Rx thorax disseminated inflammatory lesions persist in both hemithorax. It is reported in serious condition.
9-month-old Cuban citizen, resident in the municipality of Venezuela, Ciego de Ávila. Infant who is admitted due to a seizure crisis, is placed on treatment and the next day returns to seizure, taking general condition, ventilatory compromise, and is transferred to the Pediatric Intensive Care Unit, so it is ventilated, a CT scan of the skull is performed. simple which reports imaging signs of cerebritis, and is interpreted as a viral Meningoencephalitis. Without having respiratory symptoms on admission but taking into account the behavior of the clinic, it was decided to take a sample for PCR, due to the suspicion of cerebral manifestations due to the virus. It is reported on April 18 positive to the COVID.19 It is stable, it presented a focal seizure in the lower limbs at night, it presents a decreased cough that has decreased, it spontaneously ventilates, Rx of normal thorax, a CT scan of the skull was performed where there is no cerebral edema. Diagnosis of secondary epilepsy. It is reported in serious condition.

Unfortunately two deaths occurred:

Cuban citizen, 84 years old, from the Cárdenas municipality, Matanzas. He had a history of Vascular Dementia and Respiratory Sepsis. It started with a picture of progressive respiratory failure. On his 4th day in Intensive Care, he encountered polypnea, Rx. chest with inflammatory lesions in both lung bases, reported severe. He presented clinical worsening with symptoms of acute respiratory failure and cardio-respiratory arrest, not responding to the measures taken. We deeply regret what happened and we convey to your family and friends our deepest condolences.
86-year-old Cuban citizen from the Santa Clara Nursing Home No. 3. History of High Blood Pressure, Heart Failure and Diverticular Disease of the Colon. Admitted to the Manuel Fajardo Hospital. On her 3rd day in Intensive Care, she was maintained with mechanical ventilation, acute respiratory distress, hemodynamically unstable, metabolic acidosis, and chest X-ray with interstitial infiltrate that covered the entire left hemithorax and the apex of the right lung. He presented clinical worsening, hypothermia, septic shock with multiple organ dysfunction (respiratory, cardiovascular, and renal). We deeply regret what happened and we convey to your family and friends our deepest condolences.

As of April 21, 182 countries with cases of COVID-19 are reported with 2 million 431 thousand 890 confirmed cases (+ 76 thousand 037) and 169 thousand 859 deaths (+ 5 thousand 200) for a fatality of 6.98%.

In the Americas region, 934 thousand 355 confirmed cases (+ 35 thousand 304) are reported, 38.4% of the total reported cases in the world, with 49 thousand 605 deaths (+ 2 thousand 236) for a lethality of 5, 31% (+0.05). Courtesy: https://salud.msp.gob.cu/?p=4917