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Fig 1.

Location of Durán as a satellite city of Guayaquil, and the 5 sites where the blood tests and surveys were applied.

Sites were selected to capture urban neighborhoods diversity and logistic feasibility.

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Fig 2.

Diagram of the process from registration (1), informed consent (2), app installation to monitor risks (3), survey (4), and serologic samples for COVID-19 test (5), and results notification (6) during the field campaign in Durán Study.

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Fig 3.

Diagram of the multi-hazard vulnerability framework, should consider multiple dimensions.

Exposure refers to the degree to which populations, such as children and elders, are affected by climate-related disasters or viral outbreaks. Sensitivity is shaped by individual factors like age, disabilities, or pre-existing health conditions, urban factors such as access to basic services, housing conditions, and infrastructure. Adaptive capacity, or the ability to respond and recover, is influenced by levels of education, the presence of community organization, and the availability and quality of health and municipal services.

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Table 1.

Sociodemographic and health characteristics stratified by sex.

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Table 2.

Associations between sociodemographic, health, and environmental factors with stress and depression levels during the COVID-19 pandemic.

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Table 3.

Multivariable logistic regression of stress level predictors.

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Table 4.

Multivariable logistic regression of mild and moderate depression level predictors by vulnerability dimension.

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