Socioeconomic inequities of COVID-19 mortality in vulnerable Comunas of the City of Buenos Aires.

During the COVID-19 pandemic, the gap in health inequities was exposed and increased, showing how different vulnerable groups were affected. Our aim was to examine the correlation between an area-based health inequity index and mortality due to COVID-19 in people 60 years old or above in the City of Buenos Aires in 2020. We developed a Health Inequity Composite Index (HICI), including six core indicators. Each indicator value per Comuna was first standardized to a Z-score. All six Z-scores were summed into a final composite Z-score to rank the Comunas from lowest to highest social inequities. Comunas from the northern part of the city had lower inequities whereas those in the south had higher levels of inequities. COVID-19 age-standardized mortality rate in people 60 years or above was higher in the Comunas from the south and lower in those from the north. Finally, we found a strong positive correlation (Rho = 0.83, p < 0.0001 CI95% = 0.65-0.99) between HICI and age-standardized mortality rates from COVID-19 in people 60 years or above. Our finding of a strong correlation between the levels of health inequity and mortality calls for a concerted effort in narrowing or eliminating existing inequities.

Hospital and 1-year outcomes of septic syndromes in older people: a cohort study.

PURPOSE: Our objective was to describe the relationship between sepsis syndrome mortality and cognitive and physical disability in elderly persons. METHODS: A 1-year consecutive cohort study in clinical beds of a university hospital was performed. Variables were severity of sepsis syndrome, organ failure, functional status, age, sex, and positive cultures. Outcomes were in-hospital and 1-year mortalities. RESULTS: The study included 137 patients (>70 years), both sexes. Data from 116 (84.5%) patients were obtainable at 1-year follow-up. Forty-eight (35%) patients presented with sepsis (11/137, 8%) or severe sepsis (37/137, 27%). In-hospital mortality was 15.3% (0% for sepsis and 21.8% if severe) and increased with organ failure (p <.0001). One-year mortality was 54.78% (63/116), mostly related to severe sepsis; predictors were severe organ failure (p <.0001), prior functional status (p =.0005), and Mini-Mental State Examination (p =.03). Prior functional status and organ failure were independent predictors. CONCLUSIONS: In-hospital and 1-year mortality increased with septic syndrome severity, prior functional status, and organ failure.