Association between Obesity and COVID-19 Mortality in Peru: An Ecological Study

Ramírez-Soto, Max Carlos; Alarcón-Arroyo, Miluska; Chilcon-Vitor, Yajaira; Chirinos-Pérez, Yelibeth; Quispe-Vargas, Gabriela; Solsol-Jacome, Kelly; Quintana-Zavaleta, Elizabeth

doi:10.3390/tropicalmed6040182

Cited by 8 publications

(10 citation statements)

References 18 publications

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“…In our study, the ORs for excess mortality occurred in a wider range of age groups for men (40–79 years old); this may be related to the high prevalence of chronic diseases in adult men, which increases the likelihood of death due to COVID-19 32 33. Thus, a recent study showed that as obesity prevalence increases, the COVID-19 MR increases in the Peruvian population ≥15 years 34. These factors may have contributed to a higher estimated excess all-cause death rate in men than women in the ≥60 years age group in Peru.…”

Section: Discussionmentioning

confidence: 48%

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Excess all-cause deaths stratified by sex and age in Peru: a time series analysis during the COVID-19 pandemic

2022

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BackgroundIn this study, we estimated excess all-cause deaths and excess death rates during the COVID-19 pandemic in 25 Peruvian regions, stratified by sex and age group.DesignCross-sectional study.SettingTwenty-five Peruvian regions with complete mortality data.ParticipantsAnnual all-cause official mortality data set from SINADEF (Sistema Informático Nacional de Defunciones) at the Ministry of Health of Peru for 2017–2020, disaggregated by age and sex.Main outcome measuresExcess deaths and excess death rates (observed deaths vs expected deaths) in 2020 by sex and age (0–29, 30–39, 40–49, 50–59, 60–69, 70–79 and ≥80 years) were estimated using P-score. The ORs for excess mortality were summarised with a random-effects meta-analysis.ResultsIn the period between January and December 2020, we estimated an excess of 68 608 (117%) deaths in men and 34 742 (69%) deaths in women, corresponding to an excess death rate of 424 per 100 000 men and 211 per 100 000 women compared with the expected mortality rate. The number of excess deaths increased with age and was higher in men aged 60–69 years (217%) compared with women (121%). Men between the ages of 40 and 79 years experienced twice the rate of excess deaths compared with the expected rate. In eight regions, excess deaths were higher than 100% in men, and in seven regions excess deaths were higher than 70% in women. Men in eight regions and women in one region had two times increased odds of excess death than the expected mortality. There were differences in excess mortality according to temporal distribution by epidemiological week.ConclusionApproximately 100 000 excess all-cause deaths occurred in 2020 in Peru. Age-stratified excess death rates were higher in men than in women. There was strong excess in geographical and temporal mortality patterns according to region.

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Section: Discussionmentioning

confidence: 48%

“…32 33 Thus, a recent study showed that as obesity prevalence increases, the COVID-19 MR increases in the Peruvian population ≥15 years. 34 These factors may have contributed to a higher estimated excess all-cause death rate in men than women in the ≥60 years age group in Peru.…”

Section: Main Findingsmentioning

confidence: 99%

Excess all-cause deaths stratified by sex and age in Peru: a time series analysis during the COVID-19 pandemic

2022

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“…The factors that may have contributed to the causal relationship between all-cause excess mortality and COVID-19 mortality in Peru and the large differences in excess mortality from one region of Peru to another could have several explanations. First, mortality rates depend on social factors such as demographic and socio-economic characteristics, including age, population structure, population size, lifestyles, obesity prevalence, ethnicity, and the mobility of populations across between regions, as was observed in several countries, including Peru [ 2 , 12 , 22 , 23 ]. Second, mortality rates also depend on the probability of being infected, prevalence and incidence rates, and mortality among the infected population, since worldwide, Peru was the country with the highest number of COVID-19 deaths per 100,000 population [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Excess All-Cause Mortality and COVID-19 Mortality in Peru: Observational Study

Ramírez-Soto

Ortega-Cáceres

2022

TropicalMed

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During the COVID-19 pandemic, an excess of all-cause mortality has been recorded in several countries, including Peru. Most excess deaths were likely attributable to COVID-19. In this study, we compared the excess all-cause mortality and COVID-19 mortality in 25 Peruvian regions to determine whether most of the excess deaths in 2020 were attributable to COVID-19. Excess deaths were calculated as the difference between the number of observed deaths from all causes during the COVID-19 pandemic (in 2020) and the number of expected deaths in 2020 based on a historical from recent years (2017–2019). Death data were retrieved from the Sistema Informatico Nacional de Defunciones (SINADEF) at the Ministry of Health of Peru from January 2017 to December 2020. Population counts were obtained from projections from Peru’s Instituto Nacional de Estadística e Informática (INEI). All-cause excess mortality and COVID-19 mortality were calculated by region per 100,000 population. Spearman’s test and linear and multiple regression models were used to estimate the correlation between excess all-cause mortality and COVID-19 mortality per 100,000 population. Excess all-cause death rates varied widely among regions (range: 115.1 to 519.8 per 100,000 population), and COVID-19 mortality ranged between 83.8 and 464.6 per 100,000 population. There was a correlation between the all-cause excess mortality and COVID-19 mortality (r = 0.90; p = 0.00001; y = 0.8729x + 90.808; R2 = 0.84). Adjusted for confounding factors (mean age in the region, gender balance, and number of intensive care unit (ICU) beds), the all-cause excess mortality rate was correlated with COVID-19 mortality rate (β = 0.921; p = 0.0001). These findings suggest that most of the excess deaths in Peru are related to COVID-19. Therefore, these findings can help decision-makers to understand the high COVID-19 mortality rates in Peru.

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“…Confounding factors included the mean age in the region (cases or deaths), mean income and gender balance (cases or deaths), and the number of intensive care unit (ICU) beds. These confounding factors were used in a previous observational study [ 12 ]. We also used COVID-19 vaccination coverage rates in individuals ≥ 18 years in 2021 as a confounding factor.…”

Section: Methodsmentioning

confidence: 99%

“…This excess mortality can be explained by social factors, individual factors, the health care system, and other direct and indirect factors related to COVID-19 infection. Several Peruvian studies have shown an association between obesity and COVID-19 mortality, both in the overall population and in patients infected with SARS-CoV-2 [ 12 , 13 ]. To control the COVID-19 pandemic and mitigate mortality associated with its complications, Peru launched the COVID-19 vaccination on 9 February 2021, which initially included immunization of health workers and subsequently encompassed the overall population [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19, Non-Communicable Diseases, and Behavioral Factors in the Peruvian Population ≥ 15 Years: An Ecological Study during the First and Second Year of the COVID-19 Pandemic

Canorio

Sánchez

Ramírez-Soto

2022

IJERPH

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A range of health-related and behavioral risk factors are associated with COVID-19 incidence and mortality. In the present study, we assess the association between incidence, mortality, and case fatality rate due to COVID-19 and the prevalence of hypertension, obesity, overweight, tobacco and alcohol use in the Peruvian population aged ≥15 years during the first and second year of the COVID-19 pandemic. In this ecological study, we used the prevalence rates of hypertension, overweight, obesity, tobacco, and alcohol use obtained from the Encuesta Demográfica y de Salud Familiar (ENDES) 2020 and 2021. We estimated the crude incidence and mortality rates (per 100,000 habitants) and case fatality rate (%) of COVID-19 in 25 Peruvian regions using data from the Peruvian Ministry of Health that were accurate as of 31 December 2021. Spearman correlation and lineal regression analysis was applied to assess the correlations between the study variables as well as multivariable regression analysis adjusted by confounding factors affecting the incidence and mortality rate and case fatality rate of COVID-19. In 2020, adjusted by confounding factors, the prevalence rate of obesity (β = 0.582; p = 0.037) was found to be associated with the COVID-19 mortality rate (per 100,000 habitants). There was also an association between obesity and the COVID-19 case fatality rate (β = 0.993; p = 0.014). In 2021, the prevalence of obesity was also found to be associated with the COVID-19 mortality rate (β = 0.713; p = 0.028); however, adjusted by confounding factors, including COVID-19 vaccination coverage rates, no association was found between the obesity prevalence and the COVID-19 mortality rate (β = 0.031; p = 0.895). In summary, Peruvian regions with higher obesity prevalence rates had higher COVID-19 mortality and case fatality rates during the first year of the COVID-19 pandemic. However, adjusted by the COVID-19 vaccination coverage, no association between the obesity prevalence rate and the COVID-19 mortality rate was found during the second year of the COVID-19 pandemic.

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Association between Obesity and COVID-19 Mortality in Peru: An Ecological Study

Cited by 8 publications

References 18 publications

Excess all-cause deaths stratified by sex and age in Peru: a time series analysis during the COVID-19 pandemic

Excess all-cause deaths stratified by sex and age in Peru: a time series analysis during the COVID-19 pandemic

Analysis of Excess All-Cause Mortality and COVID-19 Mortality in Peru: Observational Study

COVID-19, Non-Communicable Diseases, and Behavioral Factors in the Peruvian Population ≥ 15 Years: An Ecological Study during the First and Second Year of the COVID-19 Pandemic

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