Risk factors associated with delay in diagnosis and mortality in patients with COVID-19 in the city of Rio de Janeiro, Brazil

Cien Saude Colet. 2020 Oct;25(suppl 2):4131-4140. doi: 10.1590/1413-812320202510.2.26882020. Epub 2020 Jul 29.

Abstract

We investigated the predictors of delay in the diagnosis and mortality of patients with COVID-19 in Rio de Janeiro, Brazil. A cohort of 3,656 patients were evaluated (Feb-Apr 2020) and patients' sociodemographic characteristics, and social development index (SDI) were used as determinant factors of diagnosis delays and mortality. Kaplan-Meier survival analyses, time-dependent Cox regression models, and multivariate logistic regression analyses were conducted. The median time from symptoms onset to diagnosis was eight days (interquartile range [IQR] 7.23-8.99 days). Half of the patients recovered during the evaluated period, and 8.3% died. Mortality rates were higher in men. Delays in diagnosis were associated with male gender (p = 0.015) and patients living in low SDI areas (p < 0.001). The age groups statistically associated with death were: 70-79 years, 80-89 years, and 90-99 years. Delays to diagnosis greater than eight days were also risk factors for death. Delays in diagnosis and risk factors for death from COVID-19 were associated with male gender, age under 60 years, and patients living in regions with lower SDI. Delays superior to eight days to diagnosis increased mortality rates.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Betacoronavirus*
  • Brazil / epidemiology
  • Clinical Laboratory Techniques
  • Cohort Studies
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / mortality*
  • Delayed Diagnosis*
  • Female
  • Humans
  • Male
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / mortality*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Socioeconomic Factors
  • Time Factors

Supplementary concepts

  • COVID-19
  • COVID-19 diagnostic testing
  • severe acute respiratory syndrome coronavirus 2