medRxiv PreprintsInternational12 November 2026
Delayed first contact in a universally insured population: time to care and COVID-19 outcomes in Mexican primary care
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Time from symptom onset to first care may be a modifiable determinant of COVID-19 outcomes, but it is rarely quantified in primary care. This retrospective cohort study included all 5,248 confirmed SARS-CoV-2 cases (RT-PCR or certified rapid antigen test) notified to the national surveillance system (SINOLAVE) by a large family medicine unit of the Mexican Social Security Institute (IMSS) in Leon, Mexico, between April 2020 and April 2021. Pandemic waves were classified using the official IMSS definition. Wave profiles were compared with chi-square tests and Bonferroni correction, and predicto
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