Abstract
Several risk factors are associated with COVID-19 severity and death, such as advanced age, male sex, and the presence of comorbidities. To study the effect of these risk factors and socioeconomic variables on the outcome of Chilean patients admitted with COVID-19 to a Chilean public hospital. Review of medical records of patients admitted to a Chilean public hospital with a positive PCR test for COVID-19, Chile from March to June 2020. The outcome variable was severity (ICU admission or death). The exposure variables were age, sex, socioeconomic level, and comorbidities. A multivariable logistic regression analysis was performed. Of 1,141 confirmed cases, 266 cases had a severe evolution (23.3%), including 147 deaths (fatality 12.9%). Advanced age and low socioeconomic status were the variables most strongly associated with severity. An age of 80 years or over had an odds ratio (OR) = 11.1 [95% confidence intervals (CI) 5.22-23.53]. The OR [95% CI] for a low socioeconomic level was 3.1 [1.1-8.5]. The figure for male sex was 2.13 [1.5-3.0], for chronic kidney disease was 2.65 [1.49-4.73], for obesity was 2.36 [1.65-3.39], and for diabetes 1.78 [1.22-2.61]. No significant association with severity was found for high blood pressure, chronic pulmonary disease, cardiovascular disease, or smoking. Following age, a low socioeconomic level was the factor with the higher association with a poor outcome or severe evolution of COVID-19.
Highlights
Several risk factors are associated with COVID-19 severity and death, such as advanced age, male sex, and the presence of comorbidities
De todas las muertes en el mundo, 25% se ha reportado solo en América del Sur[13], sin embargo, los datos de estudios provenientes de esta región son escasos siendo subrepresentada en los metaanálisis que evalúan factores de riesgo para evolución severa, y muchos de ellos no consideran el nivel socioeconómico como variable en sus estimaciones[4,5,6,7,8], lo que podría generar confusión en los resultados[14]
Los resultados de este estudio destacan la importancia de la obesidad independientemente del efecto mediador que producen otras enfermedades como la diabetes o la enfermedad renal crónica, de acuerdo con la literatura[24]
Summary
Several risk factors are associated with COVID-19 severity and death, such as advanced age, male sex, and the presence of comorbidities. Conclusions: Following age, a low socioeconomic level was the factor with the higher association with a poor outcome or severe evolution of COVID-19. De todas las muertes en el mundo, 25% se ha reportado solo en América del Sur[13], sin embargo, los datos de estudios provenientes de esta región son escasos siendo subrepresentada en los metaanálisis que evalúan factores de riesgo para evolución severa, y muchos de ellos no consideran el nivel socioeconómico como variable en sus estimaciones[4,5,6,7,8], lo que podría generar confusión en los resultados[14]. Los resultados contribuirán a aumentar la representación de Sudamérica en el análisis del panorama global y entregarán elementos para direccionar la toma de decisiones en Chile con información local
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