Sex, Age, and Comorbidities Are Associated with SARS-CoV-2 Infection, COVID-19 Severity, and Fatal Outcome in a Mexican Population: A Retrospective Multi-Hospital Study

Abstract

People with comorbidities and the male sex are at a higher risk of developing severe COVID-19. In the present study, we aim to investigate the associated factors for infection, severity, and death due to COVID-19 in a population from Nuevo León, México. Epidemiological COVID-19 data were collected from 65 hospitals from December 2020 to May 2022. A total of 75,232 cases were compiled from which 25,722 cases were positive for SARS-CoV-2. Male sex, older age, diabetes, obesity, and hypertension were associated with infection. In addition to the above-mentioned factors, renal disease, cardiovascular disease, and immunosuppression were found to be associated with increased COVID-19 severity. These factors, as well as neurological diseases, are also associated with death due to COVID-19. When comparing the different variants of SARs-CoV-2, the variant B1.1.519 increased the probability of death by 2.23 times compared to the AY.20 variant. Male sex, older age, diabetes, obesity, and hypertension are associated with SARS-CoV-2 infection, severity, and death. Along with the aforementioned comorbidities, renal disease, cardiovascular disease, and immunosuppression are also associated with severity and death. Another factor associated with death is the presence of neurological disease. The SARS-CoV-2 B1.1.519 variant increases the odds of death compared to the SARS-CoV-2 AY.20 variant.

Modeling mortality risk in patients with severe COVID-19 from Mexico

“…High pulse oximetry saturation values at admission and high platelet counts at admission were protective of mortality, while increases in age, dNLR, and the need for invasive mechanical ventilation increased the odds of death. These findings support the findings of Camacho-Moll et al ( 38 ), whose final logistic model included respiratory and organ-injured routine biomarkers ( 38 ). Even though some studies have shown that CRP and D-dimer can be a prognosticator in morbidity and mortality in those with COVID-19 ( 13 , 17 , 18 ), the concentrations were similarly high in both groups, so they did not present as essential predictors in mortality outcome in this study.…”

Comparison between Neutralization Capacity of Antibodies Elicited by COVID-19 Natural Infection and Vaccination in Indonesia: A Prospective Cohort

“…Finally, there are several limitations of this study: (1) it merely investigated the neutralization activity of the original Wuhan-Hu strain, (2) there were no baseline data for both the infection and vaccine groups; we assumed that the antibodies were at the expected level, (3) we did not analyze the variables of the subjects, such as age, gender, disease severity, body mass index, and exposure-related work that may affect the antibody response and their neutralization capacity, as conducted by a prior study by Kodde et al, due to limited sample size [ 51 , 52 ]. It was reported that an increase in age decreases the neutralizing antibody [ 51 , 53 ].…”

The impact of comorbidity status in COVID-19 vaccines effectiveness before and after SARS-CoV-2 omicron variant in northeastern Mexico: a retrospective multi-hospital study

“…Stepwise multivariate logistic regression models were adjusted for age, sex, and tobacco smoking, which is described in table footnotes. Tobacco smoking has been previously shown to decrease infection, severity, and death predisposition in COVID-19 positive patient ( 1 ). Categorical variables were described in frequencies.…”

“…Coronavirus disease 2019 (COVID-19) has represented a milestone in epidemiological surveillance systems worldwide. Particularly, monitoring the clinical manifestations of the disease, as well as the outcome, have revealed key information about the predisposing factors for complications in different populations, including those observed in Mexicans ( 1 ). In previous studies several comorbidities have been associated with an increased risk of severe COVID-19 such as diabetes mellitus ( 2–5 ), hypertension ( 3 , 6 , 7 ), chronic kidney disease ( 3 , 8–10 ), chronic obstructive pulmonary ( 3 , 11–15 ), rheumatic and autoimmune diseases ( 16 , 17 ), cancer ( 18 ), and obesity ( 19 ).…”

“…In previous studies several comorbidities have been associated with an increased risk of severe COVID-19 such as diabetes mellitus ( 2–5 ), hypertension ( 3 , 6 , 7 ), chronic kidney disease ( 3 , 8–10 ), chronic obstructive pulmonary ( 3 , 11–15 ), rheumatic and autoimmune diseases ( 16 , 17 ), cancer ( 18 ), and obesity ( 19 ). Demographic factors such as sex and age have also been associated with severe COVID-19 ( 1 , 20 ). To reduce the effects led by the causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ( 21 ), several vaccines have been approved to be used during COVID-19 emergency ( 22 ).…”