Risk factors for critical illness and death among adult Brazilians with COVID-19.

Isabela Silva,Natália Cristina De Faria,Lucilene Rezende Anastácio,Álida Rosária Silva Ferreira,Lívia Garcia Ferreira

doi:10.1590/0037-8682-0014-2021

Abstract

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 has infected more than 9,834,513 Brazilians up to February 2021. Knowledge of risk factors of coronavirus disease among Brazilians remains scarce, especially in the adult population. This study verified the risk factors for intensive care unit admission and mortality for coronavirus disease among 20-59-year-old Brazilians. METHODS: A Brazilian database on respiratory illness was analyzed on October 9, 2020, to gather data on age, sex, ethnicity, education, housing area, and comorbidities (cardiovascular disease, diabetes, and obesity). Multivariate logistic regression analysis was performed to identify the risk factors for coronavirus disease. RESULTS: Overall, 1,048,575 persons were tested for coronavirus disease; among them, 43,662 were admitted to the intensive care unit, and 34,704 patients died. Male sex (odds ratio=1.235 and 1.193), obesity (odds ratio=1.941 and 1.889), living in rural areas (odds ratio=0.855 and 1.337), and peri-urban areas (odds ratio=1.253 and 1.577) were predictors of intensive care unit admission and mortality, respectively. Cardiovascular disease (odds ratio=1.552) was a risk factor for intensive care unit admission. Indigenous people had reduced chances (odds ratio=0.724) for intensive care unit admission, and black, mixed, East Asian, and indigenous ethnicity (odds ratio=1.756, 1.564, 1.679, and 1.613, respectively) were risk factors for mortality. CONCLUSIONS: Risk factors for intensive care unit admission and mortality among adult Brazilians were higher in men, obese individuals, and non-urban areas. Obesity was the strongest risk factor for intensive care unit admission and mortality.

Highlights

Severe acute respiratory syndrome coronavirus 2 has infected more than 9,834,513 Brazilians up to February 2021
Patients were diagnosed with COVID-19, of which 159,704 (15.2%) were aged 20–59 years and their data contained information about mortality or intensive care units (ICU) admission
Among the comorbidities analyzed, obesity was the strongest and the only variable associated with the two study outcomes in the Brazilian adult population—it was positively associated with ICU admission and mortality

Summary

Introduction

Severe acute respiratory syndrome coronavirus 2 has infected more than 9,834,513 Brazilians up to February 2021. This study verified the risk factors for intensive care unit admission and mortality for coronavirus disease among 20–59-year-old Brazilians. Methods: A Brazilian database on respiratory illness was analyzed on October 9, 2020, to gather data on age, sex, ethnicity, education, housing area, and comorbidities (cardiovascular disease, diabetes, and obesity). Risk factors associated with the progression and worsening of the disease include older age, male sex, and presence of comorbid cardiovascular disease, diabetes, and obesity. These have emerged as risk factors for COVID-19-related ICU admission and mortality worldwide[6]. Ethnicity has been identified as a risk factor in some studies[7,8], including those conducted in Brazil[9]

Objectives

Methods

Results

Conclusion