Chronic kidney disease is a very significant comorbidity for high risk of death in patients with <scp>COVID</scp>‐19 in Mexico

Parra‐Bracamonte, Gaspar Manuel; Parra-Bracamonte, Francisco E.; López‐Villalobos, N.; Lara-Rivera, Ana Laura

doi:10.1111/nep.13827

Cited by 16 publications

(12 citation statements)

References 6 publications

(14 reference statements)

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“…We were not able assess the effect of recent use of systemic corticosteroids in asthmatic patients, which has been shown to be a significant risk factor for adverse outcomes in patients with COVID-19 rather than history of asthma alone [27, 31]. CKD alone did not increase mortality risk, which could be due to the low number of patients with only CKD included in our study since CKD has been found to be a risk factor in others [27, 32]. However, the role of CKD as an individual risk factor for adverse outcomes in COVID-19 should be explored since CKD is often present in combination with DM and hypertension [33], which were individual risk factors in our study.…”

Section: Discussionmentioning

confidence: 94%

Obesity is a strong risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: a national observational study

et al. 2021

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Conflicting results have been obtained through meta-analyses for the role of obesity as a risk factor for adverse outcomes in patients with coronavirus disease-2019 (COVID-19), possibly due to the inclusion of predominantly multimorbid patients with severe COVID-19. Here, we aimed to study obesity alone or in combination with other comorbidities as a risk factor for short-term all-cause mortality and other adverse outcomes in Mexican patients evaluated for suspected COVID-19 in ambulatory units and hospitals in Mexico. We performed a retrospective observational analysis in a national cohort of 71 103 patients from all 32 states of Mexico from the National COVID-19 Epidemiological Surveillance Study. Two statistical models were applied through Cox regression to create survival models and logistic regression models to determine risk of death, hospitalisation, invasive mechanical ventilation, pneumonia and admission to an intensive care unit, conferred by obesity and other comorbidities (diabetes mellitus (DM), chronic obstructive pulmonary disease, asthma, immunosuppression, hypertension, cardiovascular disease and chronic kidney disease). Models were adjusted for other risk factors. From 24 February to 26 April 2020, 71 103 patients were evaluated for suspected COVID-19; 15 529 (21.8%) had a positive test for SARS-CoV-2; 46 960 (66.1%), negative and 8614 (12.1%), pending results. Obesity alone increased adjusted mortality risk in positive patients (hazard ratio (HR) = 2.7, 95% confidence interval (CI) 2.04–2.98), but not in negative and pending-result patients. Obesity combined with other comorbidities further increased risk of death (DM: HR = 2.79, 95% CI 2.04–3.80; immunosuppression: HR = 5.06, 95% CI 2.26–11.41; hypertension: HR = 2.30, 95% CI 1.77–3.01) and other adverse outcomes. In conclusion, obesity is a strong risk factor for short-term mortality and critical illness in Mexican patients with COVID-19; risk increases when obesity is present with other comorbidities.

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Section: Discussionmentioning

confidence: 94%

Obesity is a strong risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: a national observational study

et al. 2021

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“…The certainty of evidence was moderate for at least a large increase in mortality from COVID-19 for people aged 60-69 years versus <60 years (11 studies, n=517,217) [24, 48, 63, 68, 71, 84, 92, 93, 98, 101, 106, 113], people with two or more versus no comorbidities (4 studies, n=189,608) [48, 59, 101, 105], and for people with (versus without): Down syndrome (1 study, n>8 million) [35], type 1 and 2 diabetes (1 study, n>8 million) [35], end-stage kidney disease (1 study, n>8 million) [35]; epilepsy (1 study, n>8 million) [35]; motor neuron disease, multiple sclerosis, myasthenia gravis, or Huntington’s disease (as a grouping; 1 study, n>8 million) [35]. The magnitude of association with mortality is probably (moderate certainty) very large for Down syndrome, and may (low certainty) be very large for age 60-69 years, and diabetes.…”

Section: Resultsmentioning

confidence: 99%

Risk factors associated with severe outcomes of COVID-19: A systematic rapid review to inform national guidance on vaccine prioritization in Canada

Gates

Pillay

Wingert

et al. 2021

Preprint

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BackgroundTo inform vaccine prioritization guidance by the National Advisory Committee on Immunization (NACI), we reviewed evidence on the magnitude of association between risk factors and severe outcomes of COVID-19.MethodsWe updated our existing review by searching online databases and websites for cohort studies providing multivariate adjusted associations. One author screened studies and extracted data. Two authors estimated the magnitude of association between exposures and outcomes as little-to-no (odds, risk, or hazard ratio <2.0, or >0.50 for reduction), large (2.0-3.9, or 0.50-0.26 for reduction), or very large (≥4.0, or ≤0.25 for reduction), and rated the evidence certainty using GRADE.ResultsOf 7,819 unique records we included 111 reports. There is probably (moderate certainty) at least a large increase in mortality from COVID-19 among people aged 60-69 vs. <60 years (11 studies, n=517,217), with ≥2 vs. no comorbidities (4 studies, n=189,608), and for people with (vs. without): Down syndrome (1 study, n>8 million), type 1 and 2 diabetes (1 study, n>8 million), end-stage kidney disease (1 study, n>8 million), epilepsy (1 study, n>8 million), motor neuron disease, multiple sclerosis, myasthenia gravis, or Huntington’s disease (as a grouping; 1 study, n>8 million). The magnitude of association with mortality is probably very large for Down syndrome and may (low certainty) be very large for age 60-69 years, and diabetes. There is probably little-to-no increase in severe outcomes with several cardiovascular and respiratory conditions, and for adult males vs. females.InterpretationFuture research should focus on risk factors where evidence is low quality (e.g., social factors) or non-existent (e.g., rare conditions), the pediatric population, combinations of comorbidities that may increase risk, and long-term outcomes.Systematic review registrationPROSPERO #CRD42021230185.

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“…We were not able assess the effect of recent use of systemic corticosteroids in asthmatic patients, which has been shown to be a significant risk factor for adverse outcomes in patients with COVID-19 rather than history of asthma alone [16,20]. CKD alone did not increase mortality risk, which could be due to the low number of patients included in our study since CKD has been found to be a risk factor in others [16,21]. However, the role of CKD as an individual risk factor for adverse outcomes in COVID-19 should be explored since CKD is often present in combination with DM and hypertension [22], which were individual risk factors in our study.…”

Section: Sars-mentioning

confidence: 88%

Obesity is a strong independent risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: A national observational study

Kammar-García

Vera-Zertuche

Mancilla-Galindo

et al. 2021

Preprint

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We aimed to study obesity alone or in combination with other comorbidities as a risk factor for short-term all-cause mortality and other adverse outcomes in Mexican patients evaluated for suspected COVID-19. We performed a retrospective observational analysis in a national cohort of 71,103 patients. Multivariate logistic regression models were applied to determine risk of death, hospitalisation, invasive mechanical ventilation, pneumonia, and admission to an intensive care unit, conferred by obesity and other comorbidities From February 24 to April 26, 2020, 71,103 patients were evaluated for suspected COVID-19; 15,529 (21.8%) had a positive test for SARS-CoV-2; 46,960 (66.1%), negative, and 8,614 (12.1%), pending results. Obesity alone increased adjusted mortality risk in positive patients (HR=2.37, 95%CI:1.96-2.86), but not in negative and pending-result patients. In conclusion, obesity is a strong independent risk factor for short-term mortality and critical illness in Mexican patients with COVID-19; risk increases when obesity is present with other comorbidities.

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Chronic kidney disease is a very significant comorbidity for high risk of death in patients with COVID‐19 in Mexico

Cited by 16 publications

References 6 publications

Obesity is a strong risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: a national observational study

Obesity is a strong risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: a national observational study

Risk factors associated with severe outcomes of COVID-19: A systematic rapid review to inform national guidance on vaccine prioritization in Canada

Obesity is a strong independent risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: A national observational study

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