Risk factors for critical illness and death among adult Brazilians with COVID-19

Abstract

Introduction: Severe acute respiratory syndrome coronavirus 2 has infected more than 9,834,513 Brazilians up to February 2021. Knowledge of risk factors of coronavirus disease among Brazilians remains scarce, especially in the adult population. This study verified the risk factors for intensive care unit admission and mortality for coronavirus disease among 20-59-year-old Brazilians. Methods: A Brazilian database on respiratory illness was analyzed on October 9, 2020, to gather data on age, sex, ethnicity, education, housing area, and comorbidities (cardiovascular disease, diabetes, and obesity). Multivariate logistic regression analysis was performed to identify the risk factors for coronavirus disease. Results: Overall, 1,048,575 persons were tested for coronavirus disease; among them, 43,662 were admitted to the intensive care unit, and 34,704 patients died. Male sex (odds ratio=1.235 and 1.193), obesity (odds ratio=1.941 and 1.889), living in rural areas (odds ratio=0.855 and 1.337), and peri-urban areas (odds ratio=1.253 and 1.577) were predictors of intensive care unit admission and mortality, respectively. Cardiovascular disease (odds ratio=1.552) was a risk factor for intensive care unit admission. Indigenous people had reduced chances (odds ratio=0.724) for intensive care unit admission, and black, mixed, East Asian, and indigenous ethnicity (odds ratio=1.756, 1.564, 1.679, and 1.613, respectively) were risk factors for mortality. Conclusions: Risk factors for intensive care unit admission and mortality among adult Brazilians were higher in men, obese individuals, and non-urban areas. Obesity was the strongest risk factor for intensive care unit admission and mortality.

Specific Risk Factors for Fatal Outcome in Critically Ill COVID-19 Patients: Results from a European Multicenter Study

“…Others concentrate on demographic factors such as gender [9], ethnicity [10], or BMI [11]. A third branch of research invests risk factors for specific groups: pregnant women [12], the elderly population [13,14], or specific regions [15][16][17], to name a few examples. While in the beginning, identifying risk factors was of primary interest, there are now also some attempts to understand possible mechanisms [18][19][20].…”

COVID-19's intra-urban inequalities and social vulnerability in a medium-sized city

“…It was hypothesized that regional inequalities, with higher mortality in the North and Northeast of the country, would be related to a greater burden of comorbidities in regions with lower socioeconomic development, while ethnic-racial inequalities, with higher mortality of black and brown people , would be related to less access to health services 17 . In another study carried out with adults admitted for COVID-19 until the beginning of October 2020, a higher risk of death was also identified in black and brown people, in addition to indigenous people 18 .…”

Identifying obesity and COVID-19 overlapping risk-factors: Protocol for a systematic review and meta-analysis

“…2,3 On one hand, obesity has been identified as a risk factor for more severe cases of COVID-19, and higher rates of mortality are observed precisely among individuals with overweight and obesity. [4][5][6][7] On the other hand, being infected by the virus that causes COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and needing intensive care for a long period of time, also might contribute to higher adiposity through sarcopenia, high levels of stress and anxiety, sleep disturbances and more sedentary time, among other effects increasing the risk of obesity. 8 Also, mobility restriction measures, such as lockdowns, implemented in several countries to prevent the dissemination of COVID-19, have contributed to weight gain in the overall population.…”