Impact of Comorbidities in Mexican SARS-CoV-2-Positive Patients: A Retrospective Analysis in a National Cohort

Abstract

Background:The coronavirus disease 2019 outbreak is a significant challenge for health-care systems around the world. Objective: The objective of the study was to assess the impact of comorbidities on the case fatality rate (CFR) and the development of adverse events in patients positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the Mexican population. Materials and methods: We analyzed the data from 13,842 laboratory-confirmed SARS-CoV-2 patients in Mexico between January 1, 2020, and April 25, 2020. We investigated the risk of death and the development of adverse events (hospitalization, pneumonia, orotracheal intubation, and intensive care unit [ICU] admission), comparing the number of comorbidities of each patient. Results: The patient mean age was 46.6 ± 15.6 years, 42.3% (n = 5853) of the cases were women, 38.8% of patients were hospitalized, 4.4% were intubated, 29.6% developed pneumonia, and 4.4% had critical illness. The CFR was 9.4%. The risk of hospitalization (odds ratio [OR] = 3.1, 95% confidence interval [CI]: 2.7-3.7), pneumonia (OR = 3.02, 95% CI: 2.6-3.5), ICU admission (OR = 2, 95% CI: 1.5-2.7), and CFR (hazard ratio = 3.5, 95% CI: 2.9-4.2) was higher in patients with three or more comorbidities than in patients with 1, 2, or with no comorbidities. Conclusions: The number of comorbidities may be a determining factor in the clinical course and its outcomes in SARS-CoV-2-positive patients. (REV INVEST CLIN.

Development and Validation of the Patient History COVID-19 (PH-Covid19) Scoring System: A Multivariable Prediction Model of Death in Mexican Patients with COVID-19

“…Similar to other studies, we found that older age is the main risk factor for dying from COVID-19, with every 10-year increase associated with the largest increases in hazard ratio [2,5,15]; in the PH-Covid19 score, 10-year increases added two points, starting from 30 years, and being <20 years subtracted 2 points. Sex (men), which increases two points in our score, was correlated with death in our study and others [2,3,5,6,15].…”

“…The coronavirus disease (COVID-19) pandemic is the global phenomenon which is shaping modern societies in the year 2020, a reason why the severe acute respiratory coronavirus 2 (SARS-CoV-2) has been named the once-in-a-century pathogen that scientists and global leaders had been worrying for [1]. Demographic and patient history risk factors for fatal outcomes in patients with COVID-19 have been characterized in large national cohorts [2][3][4][5], and broadly include old age, sex (men), comorbidities, deprivation (a correlate of poverty), and belonging to certain ethnic groups. Other clinical, radiological, and laboratory parameters at presentation have also been studied as risk factors for disease progression and death [5,6].…”

“…Adjusted risk of death by obesity occurred with gradual increases in higher obesity classes 2 and no evident or clear risk was identified in another study for class I and II obesity, whereas class III obesity was significantly correlated with death[5]. This last study, however, included only patients admitted to ICUs who had a high prevalence of comorbidities, which are independent risk factors for ICU admission[3].COVID-19 patients included in a meta-analysis[23]. Chest X-ray, on the other hand, may be normal in up to 63% of patients with early COVID-19 pneumonia[24].Nonetheless, the low proportion of pneumonia in non-survivors suggests non-optimal diagnosis of pneumonia may be occurring in Mexico.…”

Revisión sobre obesidad como factor de riesgo para mortalidad por COVID-19

“…De otro lado, Hajifathalian et al [18] reportaron un RR: 1,58 (IC 95%: 1,18-2,13) de desarrollar distrés respiratorio comparado con no obesos en Estados Unidos y Qianqxian et al [22] indicaron un OR: 3,42 (IC 95%: 1,42-8,27) para el mismo desenlace en población China. Además, Simmonet et al [23] reportaron un OR: 7,36 (1,14) de necesidad de ventilación mecánica en personas obesas comparadas con personas con peso normal.…”

“…Luego de la lectura por títulos y resúmenes se excluyeron 124 estudios por no abordar los criterios de nuestra pregunta PICO (del inglés: patient, intervention, comparison, outcome); quedando 29 artículos para lectura a texto completo. Tras la lectura se excluyeron ocho artículos [8][9][10][11][12][13][14][15] por reportar únicamente obesidad como característica de la población general del estudio y 11 [15][16][17][18][19][20][21][22][23][24][25] artículos que por no reportar frecuencias o medidas de asociación entre obesidad y mortalidad (Figura 1). Al final, quedaron 10 artículos para esta revisión.…”