Risk Factors For COVID-19 Mortality Research Articles

Predictors of mortality in hospitalised patients with COVID-19: a 1-year case–control study

BackgroundA paucity of predictive models assessing risk factors for COVID-19 mortality that extend beyond age and gender in Latino population is evident in the current academic literature.ObjectivesTo determine the associated...

Imagination and idealism after the COVID-19 pandemic: the science of healthy ageing.

On 5 May 2023, the World Health Organization declared that COVID-19 no longer constituted a public health emergency of international concern. Medical science must now consider how it ought to recalibrate its imagination and idealism in a post-COVID-19 pandemic world. The fact that advanced age was the largest risk factor for COVID-19 mortality and serious illness, as well as for the most prevalent chronic diseases, reveals the urgency and significance of shifting the focus from mitigating each specific pathology risk, one at a time, to targeting biological ageing itself. In his 1910 JAMA Address entitled 'Imagination and Idealism in the Medical Sciences', Christian Herter made an important distinction between two ways imagination and idealism can be invoked in the medical sciences: (i) humanitarian medicine, which emphasizes the obvious and direct paths of ameliorating human suffering; and (ii) a curiosity-oriented approach which explores pure science and the experimental laboratory. The latter examines the indirect ways of winning, in Herter's words, 'the citadel' of health promotion. Herter's reflections on these two contrasting approaches to medicine have significance for both the COVID-19 pandemic and the aspiration to promote the ideal of healthy ageing in the post-COVID-19 pandemic era.

492. Risk Factors for COVID-19 Mortality in ≥90 year old Inpatients: Retrospective Case Series

Abstract Background Despite what we know about COVID-19, current literature is still lacking on some aspects of the disease. This is probably because the disease continues to evolve and there is still much to discover. COVID-19 outcomes in the elderly is one aspect that has not been fully explored. This study investigated short-term outcomes of COVID-19 Infection on ≥90 year old patients in the context of COVID vaccination availability. We sought to identify risk factors for in-patient all-cause mortality during the peak of daily COVID-19 infections in this population. Methods 52 admitted patients aged ≥90 years old with SARS-CoV-2 RT-PCR positive observed from Nov 2021 to Mar 2022 at New Rochelle Hospital in NY, USA. We conducted a retrospective case study of ≥ 90 years old patients admitted at New Rochelle Hospital in NY, USA from Nov 2021 to Mar 2022. Electronic health records were reviewed. Logistic regression was used to determine odds ratio for risk factors that contribute to COVID-19 mortality. Univariate analysis was used to analyze patients’ comorbidities, symptoms, lab abnormalities, and imaging with mortality as the independent variable. Results The most frequent risk conditions for COVID-19 mortality are congestive heart failure (p< 0.048) and atrial fibrillation (p< 0.009). The odds of dying from COVID19 is 5 times greater for nursing home residents than those patients residing at home or already admitted in the hospital. Shortness of breath and fever were found to be statistically significant with COVID 19 mortality. Patients who had x-ray results typical for COVID (p< 0.004), leukocytosis (p< 0.039), acute kidney injury (p< 0.003), and elevated transaminases (p< 0.001) are more at risk for dying from COVID. Conclusion Managing elderly individuals with COVID-19 can be challenging due to increased risk of severe illness and complications associated with age. We found that certain risk factors such as co-morbidities, previous residence, presenting symptoms and laboratories are associated with increased mortality in patients ≥ 90 years old. Currently, limited guidelines and studies are available for the geriatric population. Further research can be done by stratifying severity of comorbidities, determining vaccination status, and increasing sample size. Disclosures All Authors: No reported disclosures

Asthma and clinical outcomes of COVID-19 in a community setting

ObjectivesThe association between asthma and COVID-19 mortality remains inconclusive. We examined the association between asthma and clinical outcomes of patients with COVID-19. Study designA case–control study based on a surveillance cohort in Harris County, Texas. MethodsUsing the data of 21,765 patients who reported having at least one chronic health condition, we investigated the association between asthma and COVID-19 severity, characterized primarily by hospitalization and death. Unconditional logistic regression models were used to estimate the multivariable odds ratio (mOR) and its 95 % confidence interval (CI) of COVID-19 severity associated with asthma and other chronic lung diseases, adjusting for demographic and other comorbidities. A P-value < 0.005 was considered statistically significant after correcting multiple testing. ResultsIn total, 3034 patients (13.9 %) had asthma, and 774 (3.56 %) had other chronic lung diseases. The case death rate among patients with asthma and other chronic lung diseases was 0.75 % and 19.0 %, respectively. Compared to patients without the respective conditions, patients with asthma had lower odds of death (mOR = 0.44, 95 % CI: 0.27–0.69), while patients with other chronic lung diseases had higher odds of hospitalization (mOR = 2.02, 95 % CI: 1.68–2.42) and death (mOR = 1.95, 95 % CI: 1.52–2.49) (P-values < 0.005). Risk factors for COVID-19 mortality included older age, male gender, diabetes, obesity, hypertension, cardiovascular disease, active cancer, and chronic kidney disease. ConclusionsThe public health surveillance data suggested that preexisting asthma was inversely associated with COVID-19 mortality.

Risk factors for COVID-19 mortality in hospitalized patients in Bolivia

ObjectivesThis study aimed to ascertain which factors are associated with higher risk of mortality among hospitalized COVID-19 Bolivian patients. MethodsThis retrospective observational study assessed risk factors associated with mortality in patients (n = 549) hospitalized for SARS-CoV-2 infection in a Bolivian hospital between April 6, 2020, and August 18, 2022. ResultsThe results provide evidence of association between male sex (odds ratio [OR] = 1.6, 95% confidence interval [CI] 1.06-2.6), older age, 51-61 years-old (OR = 5.2, 95% CI 2.2-12.6), 62-70 years-old (OR = 8.7, 95% CI 3.7-20.5), >70 years-old (OR = 16.9, 95% CI 7.1-39.9), and blood group A (OR = 1.9, 95% CI: 1.1-3.4) with higher mortality risk. The strong association between mortality and relatively young age, may be due to high frequency of undiagnosed comorbidities. Vaccination was associated with a reduction in mortality only when time period of hospitalization was not adjusted for. ConclusionAmong hospitalized patients in Bolivia male sex, older age, and blood group A are associated with higher mortality risk. Mortality risk increased markedly from a relatively young age and decreased in parallel to the uptake of the vaccination program. However, the gradual reduction in mortality can also be due to improved patient management and changes in natural immunity and virulence of circulating strains as the pandemic progressed.

Study on the Correlation of Elevated Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio With Covid-19 Mortality among Patients in a Hospital Isolation Ward in Baler, Aurora

Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) are inflammatory biomarkers known to assess several disease types effectively. With the surge of Coronavirus disease (COVID-19) cases, many patients manifested various systemic inflammatory conditions suggesting a possible relationship between the predictive values of NLR and PLR to COVID-19 mortality. The study aims to assess a correlation between elevated biomarker values of NLR and PLR with COVID-19 mortality. A single-center, cross-sectional study of COVID-19 patients, admitted to a hospital isolation ward in Baler, Aurora, between May to October 2021 was conducted. Secondary data, namely demographic profiles, complete blood count results, and comorbidities upon admission, were collected. The effect of NLR and PLR on the risk of mortality, along with the impact of covariate variables that may affect the study’s outcome, was determined using a multiple binary logistic regression model and the computation of the odds ratio. 264 COVID-19 patients were included in the study–202 were recovered and 62 were deceased. Multiple binary logistic regression demonstrated a higher mortality risk in patients with elevated NLR (OR=2.607; 95% CI: 1.276 to 5.324; p=.009). Other risk factors such as age (OR=1.053; 95% CI: 1.029 to 1.077; p&lt;.001) and diabetes mellitus (OR=3.537; 95% CI: 1.441 to 8.682; p=.006) are risk factors for COVID-19 mortality. Patients with elevated NLR values indicate poor clinical outcomes with a higher mortality risk compared to those with low NLR in COVID-19 patients. Moreover, age and diabetes must be considered in patient assessment upon admission due to their correlation to COVID-19 mortality. Keywords: COVID-19 mortality, inflammatory biomarker, Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR).

Impact of vaccination and risk factors on COVID-19 mortality amid delta wave in Libya: A single center cohort study.

The Delta variant has led to a surge in COVID-19 cases in Libya, making it crucial to investigate the impact of vaccination on mortality rates among hospitalized patients and the critically ill. This study aimed to explore the risk factors for COVID-19 mortality and the mortality rates among unvaccinated and vaccinated adults during the Delta wave who were admitted to a single COVID-19 care center in Tripoli, Libya. The study involved two independent cohorts (n = 341). One cohort was collected retrospectively from May 2021-August 2021 and the second cohort was prospectively collected from August 2021-October 2021. Most of the patients in the study became ill during the Delta wave. The two cohorts were merged and analysed as one group. Most patients were male (60.5%) and 53.3% were >60 years old. The vast majority of patients did not have a previous COVID-19 infection (98.9%) and were unvaccinated (90.3%). Among vaccinated patients, 30 had received one dose of vaccine and only 3 had received two doses. Among patients who received one dose, 58.1% (18/31) died and 41.9% (13/31) survived. Most patients (72.2%) had a pre-existing medical condition. A multivariable prediction model showed that age >60 years was significantly associated with death (odds ratio = 2.328, CI 1.5-3.7, p-value = <0.0001). Our results indicate that previous infection or full vaccination against COVID-19 significantly reduces hospitalization and death. However, a single vaccine dose may not be adequate, especially for older individuals and those with underlying medical conditions. High-risk older patients with comorbidities should be fully vaccinated and offered up to date bivalent COVID-19 booster doses.

Gender differences in comorbidities of patients with COVID-19: An Italian local register-based analysis

In the current COVID-19 pandemic scenario, it is still necessary to understand if differences exist between genders in terms of patients’ characteristics and clinical outcomes. For this reason, we retrospectively analyzed data obtained from a local register-based dataset of all SARS-CoV-2 positive patients diagnosed in the province of Catania (Italy). The main aim of this analysis was to understand any differences between genders in the distribution of previous medical conditions, and to evaluate which of them posed individuals at higher risk of death.With this purpose, we analyzed data from 1424 patients with at least one underlying medical condition, who were tested positive for SARS-CoV-2 infection from February 2020 to December 2021. Overall, males were 59.5% of the total population and significantly younger than females (median ages: 68 years vs. 72 years; p = 0.011). The age distribution of cases by gender confirms that individuals from 70 to 79 years were the most affected in both genders. The comparison of underlying comorbidities by gender shows significant differences for diabetes (p < 0.001), other metabolic diseases (p = 0.006), and obesity (p = 0.019). Accordingly, multivariable logistic regression analysis confirmed that diabetes was more likely to be present in males than in females (p = 0.001), while other metabolic diseases and obesity were less likely to be present (p = 0.003 and p = 0.005, respectively). Although no difference in mortality was evident between genders (p = 0.141), both male and female COVID-19 patients had a significantly higher risk of death if they had comorbidities such as CVDs, kidney diseases, or chronic neurological diseases. Moreover, diabetes and chronic respiratory diseases were significant risk factors for COVID-19 mortality among men, whereas cancer was a significant contributor among women. Our findings confirm gender-differences in pre-existing medical conditions of COVID-19 patients, which may influence the risk of death. Further studies, however, are needed to understand physiological and pathological mechanisms underpinning these differences.

Risk factors for COVID-19 mortality among telehealth patients in Bangladesh: A prospective cohort study.

Estimating the contribution of risk factors of mortality due to COVID-19 is particularly important in settings with low vaccination coverage and limited public health and clinical resources. Very few studies of risk factors of COVID-19 mortality used high-quality data at an individual level from low- and middle-income countries (LMICs). We examined the contribution of demographic, socioeconomic and clinical risk factors of COVID-19 mortality in Bangladesh, a lower middle-income country in South Asia. We used data from 290,488 lab-confirmed COVID-19 patients who participated in a telehealth service in Bangladesh between May 2020 and June 2021, linked with COVID-19 death data from a national database to study the risk factors associated with mortality. Multivariable logistic regression models were used to estimate the association between risk factors and mortality. We used classification and regression trees to identify the risk factors that are the most important for clinical decision-making. This study is one of the largest prospective cohort studies of COVID-19 mortality in a LMIC, covering 36% of all lab-confirmed COVID-19 cases in the country during the study period. We found that being male, being very young or elderly, having low socioeconomic status, chronic kidney and liver disease, and being infected during the latter pandemic period were significantly associated with a higher risk of mortality from COVID-19. Males had 1.15 times higher odds (95% Confidence Interval, CI: 1.09, 1.22) of death compared to females. Compared to the reference age group (20-24 years olds), the odds ratio of mortality increased monotonically with age, ranging from an odds ratio of 1.35 (95% CI: 1.05, 1.73) for ages 30-34 to an odds ratio of 21.6 (95% CI: 17.08, 27.38) for ages 75-79 year group. For children 0-4 years old the odds of mortality were 3.93 (95% CI: 2.74, 5.64) times higher than 20-24 years olds. Other significant predictors were severe symptoms of COVID-19 such as breathing difficulty, fever, and diarrhea. Patients who were assessed by a physician as having a severe episode of COVID-19 based on the telehealth interview had 12.43 (95% CI: 11.04, 13.99) times higher odds of mortality compared to those assessed to have a mild episode. The finding that the telehealth doctors' assessment of disease severity was highly predictive of subsequent COVID-19 mortality, underscores the feasibility and value of the telehealth services. Our findings confirm the universality of certain COVID-19 risk factors-such as gender and age-while highlighting other risk factors that appear to be more (or less) relevant in the context of Bangladesh. These findings on the demographic, socioeconomic, and clinical risk factors for COVID-19 mortality can help guide public health and clinical decision-making. Harnessing the benefits of the telehealth system and optimizing care for those most at risk of mortality, particularly in the context of a LMIC, are the key takeaways from this study.

Factors associated with COVID-19 inpatient mortality cases within 24-hours South Africa.

African countries with limited healthcare capacity are particularly vulnerable to the novel coronavirus. The pandemic has left health systems short on resources to safely manage patients and protect health care workers. South Africa is still battling the epidemic of HIV/AIDS and tuberculosis which have had their programme/services interrupted due to the effects of the pandemic. Lessons learned from the HIV/AIDS and TB programme have shown that South Africans delay seeking health services when a new disease presents itself. The study sought to investigate the risk factors for COVID-19 inpatients' mortality within 24-hours of hospital admission in Public health facilities in Limpopo Province, South Africa. The study used retrospective secondary data obtained from the 1 067 clinical records of patients admitted between March 2020 and June 2021 by the Limpopo Department of Health (LDoH). A multivariable logistic regression model, both adjusted and unadjusted, was used to assess the risk factors associated with COVID-19 mortality within 24 hours of admission. This study, which was conducted in Limpopo public hospitals, discovered that 411 (40%) of COVID-19 patients died within 24-hours of admission. The majority of the patients were 60 years or older, mostly of female gender and had co-morbidities. In terms of vital signs, most had body temperatures less than 38°C. Our study findings revealed that COVID-19 patients who present with fever and shortness of breath are 1.8 and 2.5 times more likely to die within 24-hours of admission to the hospital, than patients without fever and normal respiratory rate . Hypertension was independently associated with mortality in COVID-19 patients within 24-hours of admission, with a high odds ratio for hypertensive patients (OR = 1.451; 95% CI = 1.013; 2.078) compared to non-hypertensive patients. Assessing demographic and clinical risk factors for COVID-19 mortality within 24-hours of admission aids in understanding and prioritising patients with severe COVID-19 and hypertension. Finally, this will provide guidelines for planning and optimising the use of LDoH healthcare resources and also aid in public awareness endeavours.

Eosinophil recovery in hospitalized COVID-19 patients is associated with lower rates of ICU admission and in-hospital mortality: An observational cohort analysis

BackgroundAdmission eosinopenia (<100 cells/μL) is associated with poor clinical outcomes in hospitalized COVID-19 patients. However, the effects of eosinophil recovery (defined as reaching ≥50 eosinophils/μL) during hospitalization on COVID-19 outcomes have been inconsistent. MethodsThe study included 1,831 patients admitted to UCLA hospitals between February 2020 and February 2021 with PCR-confirmed COVID-19. Using competing risk regression and modeling eosinophil recovery as a time-dependent covariate, we evaluated the longitudinal relationship between eosinophil recovery and in-hospital outcomes including ICU admission, need for mechanical ventilation, and in-hospital mortality. All analyses were adjusted for covariates including age, BMI, tobacco smoke exposure, comorbidities known to be risk factors for COVID-19 mortality, and treatments including dexamethasone and remdesivir. ResultsEosinophil recovery was evaluated in patients with <50 eosinophils/μL on admission (n = 1282). These patients cumulatively amassed 11,633 hospital patient-days; 3,985 of those days qualified as eosinophil recovery events, which were represented by 781 patients achieving at least one instance of eosinophil recovery during hospitalization. Despite no significant difference in the rate of mechanical ventilation, eosinophil recoverers had significantly lower rates of in-hospital mortality (aHR: 0.44 [0.29, 0.65], P = 0.001) and ICU admission (aHR: 0.25 [0.11, 0.61], P = 0.002). ConclusionTrending eosinophil counts during hospitalization is simple and can be performed in resource-limited healthcare settings to track the inflammatory status of a patient. Lack of eosinophil recovery events can identify those at risk for future progression to severe COVID.

Cognitive Concerns are a Risk Factor for Mortality in People with Human Immunodeficiency Virus and COVID-19 (S21.003)

<h3>Objective:</h3> To assess the contribution of cognitive symptoms to risk of mortality from COVID-19 in people with HIV (PWH). <h3>Background:</h3> Despite higher prevalence of cognitive disorders in PWH and dementia being a risk factor for COVID-19 mortality, the association between cognitive impairment and adverse outcomes in PWH with COVID-19 has not been well established. <h3>Design/Methods:</h3> Matched case-control study (1:10) of PWH and without (PWoH) with documented SARS-CoV-2 PCR positivity from March 2020-March 2021 evaluated at a Boston-based healthcare system. Data were extracted from the electronic health record. Matching was on age, sex, race, and zip code. Primary exposures were dementia (ICD-10 code) and cognitive concerns (concern for impairment within 12 months pre-COVID-19, ascertained using a semi-automated chart annotation tool). VACS2.0 Index (including general and HIV-specific biomarkers) was calculated. VACS2.0 Index-adjusted logistic regression models assessed effect of dementia and cognitive concerns on odds of death (OR[95% confidence interval]). <h3>Results:</h3> Among 14,129 patients with COVID-19, 64 PWH were identified and matched to 463 PWoH. Among PWH, 89% were on antiretroviral therapy, 87% had an HIV-1 viral load &lt;200 copies/mL, and 19% had CD4 &lt;200 cells/μL. VACS2.0 score predicted level of care and mortality in both PWH and PWoH. PWH had higher prevalence of dementia (16% vs. 6%, p=0.01) and cognitive concerns (22% vs. 16%, p=0.04). Death was more frequent in PWH (17% vs. 6%, p&lt;0.01), at younger ages (58 vs. 66 years, p=0.03). VACS2.0-adjusted regression models found cognitive concerns (2.4[1.1–5.3], p=0.03) and dementia (2.4[1.0–5.8], p=0.05) significantly associated with odds of death in the overall group. Among PWH only, aOR for cognitive concern approached significance (3.9[0.81–20.19], p=0.09), while dementia (1.75[0.29–8.71], p=0.50) did not. <h3>Conclusions:</h3> Dementia and cognitive concerns were associated with mortality among people with COVID-19, and the magnitude of the effect of cognitive impairment may be greater in PWH. Assessment of cognitive status is an important component to care for PWH in the COVID-19 era. <b>Disclosure:</b> Ms. Rudmann has nothing to disclose. Dr. Wilcox has nothing to disclose. Elissa Ye has received personal compensation for serving as an employee of Massachusetts General Hospital. Mr. Noori has nothing to disclose. Colin Magdamo has received research support from National Institutes of Health. Aayushee Jain has nothing to disclose. Dr. Alabsi has received personal compensation for serving as an employee of Biogen. Virginia Triant has nothing to disclose. The institution of Gregory Robbins has received research support from Gilead Sciences. The institution of Gregory Robbins has received research support from Citius Pharm. The institution of Gregory Robbins has received research support from Emergent Biosolutions. The institution of Gregory Robbins has received research support from Pfizer. The institution of Gregory Robbins has received research support from Leonard Meron Biosciences. Dr. Westover has stock in Beacon Biosignals. The institution of Dr. Westover has received research support from NIH. Dr. Westover has received publishing royalties from a publication relating to health care. Dr. Westover has a non-compensated relationship as a cofounder with Beacon Biosignals that is relevant to AAN interests or activities. An immediate family member of Sudeshna Das has received personal compensation for serving as an employee of Alix Partners. An immediate family member of Sudeshna Das has received stock or an ownership interest from Alix Partners. The institution of Sudeshna Das has received research support from NIA. The institution of Sudeshna Das has received research support from Mass Life Sciences Center. The institution of Sudeshna Das has received research support from IOS Press. Dr. Mukerji has stock in Gilead Science. The institution of Dr. Mukerji has received research support from NIH. The institution of Dr. Mukerji has received research support from Massachusetts General Hospital.

Hospitalization and Mortality for Insured Patients in the United States with COVID-19 with and without Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is a neuropsychiatric condition that may be associated with negative health outcomes. This retrospective cohort study reveals the odds of hospitalization and mortality based on ASD for a population of insured patients with COVID-19. The odds of hospitalization and mortality for people with ASD were found to be greater than individuals without ASD when adjusted for sociodemographic characteristics. Hospitalization and mortality was associated with a dose-response increase to comorbidity counts (1 to 5+). Odds of mortality remained greater for those with ASD when adjusting for comorbid health conditions. ASD is a risk factor for COVID-19 mortality. Comorbid health conditions play a particular role in increasing the odds of COVID-19 related hospitalization and death for ASD patients.

COVID-19 Mortality in the Colorado Center for Personalized Medicine Biobank.

Over 6.37 million people have died from COVID-19 worldwide, but factors influencing COVID-19-related mortality remain understudied. We aimed to describe and identify risk factors for COVID-19 mortality in the Colorado Center for Personalized Medicine (CCPM) Biobank using integrated data sources, including Electronic Health Records (EHRs). We calculated cause-specific mortality and case-fatality rates for COVID-19 and common pre-existing health conditions defined by diagnostic phecodes and encounters in EHRs. We performed multivariable logistic regression analyses of the association between each pre-existing condition and COVID-19 mortality. Of the 155,859 Biobank participants enrolled as of July 2022, 20,797 had been diagnosed with COVID-19. Of 5334 Biobank participants who had died, 190 were attributed to COVID-19. The case-fatality rate was 0.91% and the COVID-19 mortality rate was 122 per 100,000 persons. The odds of dying from COVID-19 were significantly increased among older men, and those with 14 of the 61 pre-existing conditions tested, including hypertensive chronic kidney disease (OR: 10.14, 95% CI: 5.48, 19.16) and type 2 diabetes with renal manifestations (OR: 5.59, 95% CI: 3.42, 8.97). Male patients who are older and have pre-existing kidney diseases may be at higher risk for death from COVID-19 and may require special care.

Impact of comorbidity on patients with COVID-19 in India: A nationwide analysis.

The emergence of coronavirus disease (COVID-19) as a global pandemic has resulted in the loss of many lives and a significant decline in global economic losses. Thus, for a large country like India, there is a need to comprehend the dynamics of COVID-19 in a clustered way. To evaluate the clinical characteristics of patients with COVID-19 according to age, gender, and preexisting comorbidity. Patients with COVID-19 were categorized according to comorbidity, and the data over a 2-year period (1 January 2020 to 31 January 2022) were considered to analyze the impact of comorbidity on severe COVID-19 outcomes. For different age/gender groups, the distribution of COVID-19 positive, hospitalized, and mortality cases was estimated. The impact of comorbidity was assessed by computing incidence rate (IR), odds ratio (OR), and proportion analysis. The results indicated that COVID-19 caused an exponential growth in mortality. In patients over the age of 50, the mortality rate was found to be very high, ~80%. Moreover, based on the estimation of OR, it can be inferred that age and various preexisting comorbidities were found to be predictors of severe COVID-19 outcomes. The strongest risk factors for COVID-19 mortality were preexisting comorbidities like diabetes (OR: 2.39; 95% confidence interval (CI): 2.31-2.47; p < 0.0001), hypertension (OR: 2.31; 95% CI: 2.23-2.39; p < 0.0001), and heart disease (OR: 2.19; 95% CI: 2.08-2.30; p < 0.0001). The proportion of fatal cases among patients positive for COVID-19 increased with the number of comorbidities. This study concluded that elderly patients with preexisting comorbidities were at an increased risk of COVID-19 mortality. Patients in the elderly age group with underlying medical conditions are recommended for preventive medical care or medical resources and vaccination against COVID-19.

Association between long-term air pollution exposure and COVID-19 mortality in Latin America.

Recent studies have shown a relationship between air pollution and increased vulnerability and mortality due to COVID-19. Most of these studies have looked at developed countries. This study examines the relationship between long-term exposure to air pollution and COVID-19-related deaths in four countries of Latin America that have been highly affected by the pandemic: Brazil, Chile, Colombia, and Mexico. Our results suggest that an increase in long-term exposure of 1 μg/m3 of fine particles is associated with a 2.7 percent increase in the COVID-19 mortality rate. This relationship is found primarily in municipalities of metropolitan areas, where urban air pollution sources dominate, and air quality guidelines are usually exceeded. By focusing the analysis on Latin America, we provide a first glimpse on the role of air pollution as a risk factor for COVID-19 mortality within a context characterized by weak environmental institutions, limited health care capacity and high levels of inequality.

Worldwide Regional Differences in Obesity, Elderly, and COVID-19 Mortality: Do the Exceptions Prove the Rule?

Obesity and old age are commonly assumed to be risk factors for COVID-19 mortality. On a worldwide basis, we examine quantitative measures of obesity and elderly in the populations of individual countries and territories, and investigate whether these measures are predictive of COVID-19 mortality in those countries. In particular, we highlight regional differences relative to obesity and elderly metrics, and how these relate to COVID-19 mortality. In this retrospective, population-based study, we obtained data relating to percentages of obese or elderly individuals in 199 countries, as well as COVID-19 mortality rates in these countries. We used negative binomial regression analyses to assess associations between COVID-19 mortality rates and the putative risk factors, in six regions - Africa, Asia, Europe, North America, Oceania, and South America. We found significant differences between regions relative to COVID-19 mortality, as well as obesity and elderly population proportions. There were also substantial differences between countries within regions relative to proportions of obesity and elderly individuals, and COVID-19 mortality. There are significant differences both between regions and within regions relative to COVID-19 mortality rates, as well as proportions of obese or elderly individuals. A global pronouncement that obesity and elderly constitute definitive risk factors for COVID-19 mortality masks the subtleties engendered by these intra- and inter-regional differences.

Study Hypothesis: Age, Gender, Presence of Diabetes Mellitus or Hypertension, and Anti-Hypertensive Drugs Are Independent Risk Factors for COVID-19 Mortality

Study Hypothesis: Age, Gender, Presence of Diabetes Mellitus or Hypertension, and Anti-Hypertensive Drugs Are Independent Risk Factors for COVID-19 Mortality

Risk Factors for COVID-19 Mortality in Malaysia

Background: Understanding the risks of COVID-19 mortality helps in the planning and prevention of the disease. This study aimed to determine the risk factors for COVID-19 mortality in Malaysia. Methods: Secondary online data provided by the Ministry of Health, Malaysia and Malaysia’s national COVID-19 immunisation programme were used: i) COVID-19 deaths data; ii) vaccination coverage data and iii) population estimate data. Quasi-Poisson regression was performed to determine the risk factors for COVID-19 mortality. Results: Four risk factors were identified: i) vaccination status (partial versus unvaccinated, incidence rate ratio [IRR]: 0.59; 95% CI: 0.54, 0.64; complete versus unvaccinated, IRR: 0.50; 95% CI: 0.45, 0.56; booster versus unvaccinated, IRR: 0.13; 95% CI: 0.05, 0.26); ii) age group (19 years old–59 years old versus above 60 years old, IRR: 0.90; 95% CI: 0.84, 0.97; 13 years old–18 years old versus above 60 years old, IRR: 0.09; 95% CI: 0.04, 0.19; 6 years old–12 years old versus above 60 years old, IRR: 0.09; 95% CI: 0.03, 0.22; below 5 years old versus above 60 years old, IRR: 0.11; 95% CI: 0.04, 0.23); iii) gender (male versus female, IRR: 1.23; 95% CI: 1.14, 1.32) and iv) comorbidity (yes versus no, IRR: 2.13; 95% CI: 1.96, 2.32). Conclusion: This study highlighted the risk factors for COVID-19 mortality and the benefit of COVID-19 vaccination, especially of booster vaccination, in reducing the risk of COVID-19 mortality in Malaysia.

Comparative analysis of risk factors for COVID-19 mortality before, during and after the vaccination programme in Mexico

ObjectivesThe purpose of this study was to compare case fatality rates (CFRs) and odds for mortality by risk factors of patients with COVID-19 in Mexico, before, during and after the implementation of the national COVID-19 vaccination programme. Study designA large database including COVID-19 monitoring cases was used to perform an observational retrospective study. MethodsThe Chi-squared test and multivariate logistic regression analyses were applied to data from COVID-19-positive patients in Mexico. Data were analysed over 3 years, 2020, 2021 and 2022, corresponding with pre-, during and post-vaccination periods. The unadjusted odds ratios and 95% confidence interval were used to estimate the risk factors for COVID-19 mortality in each of the years. ResultsStatistically significant differences in CFR and odds ratio were found in the studied years, favouring postvaccination period. Significant changes in CFR by age, sex and main comorbidities indicated changes in the epidemic dynamics after the implementation of the COVID-19 vaccination campaign. The likelihood of death increased for hospitalised cases and for patients who were middle-aged or older in 2021 and 2022, whereas the odds of death associated with sex and comorbidities remained similar or reduced over the 3 years. ConclusionsImplementation of the COVID-19 vaccination programme during 2021 showed positive consequences on CFR. The increased odds of dying in hospitalised patients are likely to be due to the unvaccinated proportion of patients.