Early estimation of the risk factors for hospitalization and mortality by COVID-19 in Mexico

PLoS One. 2020 Sep 11;15(9):e0238905. doi: 10.1371/journal.pone.0238905. eCollection 2020.

Abstract

Background: Due to a high prevalence of chronic non-degenerative diseases, it is suspected that COVID 19 poses a high risk of fatal complications for the Mexican population. The present study aims to estimate the risk factors for hospitalization and death in the Mexican population infected by SARS-CoV-2.

Methods and findings: We used the publicly available data released by the Epidemiological Surveillance System for Viral Respiratory Diseases of the Mexican Ministry of Health (Secretaría de Salud, SSA). All records of positive SARS-CoV-2 cases were included. Two multiple logistic regression models were fitted to estimate the association between hospitalization and mortality, with other covariables. Data on 10,544 individuals (57.68% men), with mean age 46.47±15.62, were analyzed. Men were about 1.54 times more likely to be hospitalized than women (p<0.001, 95% C.I. 1.37-1.74); individuals aged 50-74 and ≥74 were more likely to be hospitalized than people aged 25-49 (OR 2.05, p<0.001, 95% C.I. 1.81-2.32, and OR 3.84, p<0.001, 95% C.I. 2.90-5.15, respectively). People with hypertension, obesity, and diabetes were more likely to be hospitalized than people without these comorbidities (p<0.01). Men had more risk of death in comparison to women (OR = 1.53, p<0.001, 95% C.I. 1.30-1.81) and individuals aged 50-74 and ≥75 were more likely to die than people aged 25-49 (OR 1.96, p<0.001, 95% C.I. 1.63-2.34, and OR 3.74, p<0.001, 95% C.I. 2.80-4.98, respectively). Hypertension, obesity, and diabetes presented in combination conveyed a higher risk of dying in comparison to not having these diseases (OR = 2.10; p<0.001, 95% C.I. 1.50-2.93). Hospitalization, intubation and pneumonia entail a higher risk of dying (OR 5.02, p<0.001, 95% C.I. 3.88-6.50; OR 4.27, p<0.001, 95% C.I. 3.26-5.59, and OR = 2.57; p<0.001, 95% C.I. 2.11-3.13, respectively). Our study's main limitation is the lack of information on mild (asymptomatic) or moderate cases of COVID-19.

Conclusions: The present study points out that in Mexico, where an important proportion of the population has two or more chronic conditions simultaneously, a high mortality rate is a serious risk for those infected by SARS-CoV-2.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • COVID-19
  • Comorbidity
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / mortality*
  • Diabetes Mellitus / epidemiology*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Hypertension / epidemiology*
  • Male
  • Mexico
  • Middle Aged
  • Obesity / epidemiology*
  • Pandemics
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / mortality*
  • Survival Rate

Grants and funding

This project was supported by a grant from the Secretaría de Educación, Ciencia, Tecnología e Innovación de la Ciudad de México CM-SECTEI/041/2020 "Red colaborativa de Investigación Traslacional para el Envejecimiento Saludable de la Ciudad de México" (RECITES). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.