Tasas de letalidad y factores de riesgo por COVID-19 en México / Case fatality rates and risk factors by COVID-19 in Mexico

Introducción: La COVID-19 es una enfermedad viral diseminada a nivel mundial, que es considerada una pandemia con alta tasa de mortalidad, cuyo estudio epidemiológico es fundamental para entender el riesgo asociado a poblaciones específicas. Objetivos: Estimar las tasas de letalidad y factores de riesgo asociados a mortalidad por COVID-19 en cinco Estados con más contagios en México. Métodos: Se analizaron de 297 230 pacientes positivos a COVID-19 mediante prueba de RT-PCR procedentes de 475 unidades de monitoreo en cinco Estados de México. Se estimaron tasas de letalidad y razones de probabilidad mediante el ajuste de un modelo de regresión logística multivariada. Se consideraron los factores de riesgo en un modelo que incluyó los efectos del sexo, edad, hábitos de fumador, historial de hospitalización, diagnóstico de neumonía y comorbilidades como diabetes, hipertensión, enfermedad pulmonar obstructiva crónica, asma, inmunodepresión, enfermedad renal crónica y enfermedades cardiovasculares, entre otras. Resultados: Existe mayor contagio entre las personas de 41 a 60 años de edad. Más del 90 por ciento de los fallecimientos ocurrieron después de los 41 años, con aumento de la tasa de letalidad a mayor edad. Los hombres mostraron mayor proporción de casos, fallecimientos y tasa de letalidad. El análisis logístico multivariado mostró que la edad, sexo, hospitalización, neumonía, diabetes y enfermedad renal crónica son factores de riesgo significativos (p < 0,0001) para mortalidad por COVID-19. Conclusiones: En México la edad, el sexo, la hospitalización, neumonía, diabetes y enfermedad renal crónica son factores que aumentan el riesgo de mortalidad por COVID-19. Se sugiere tener en cuenta esta información para determinar los grupos vulnerables e incrementar la atención sobre ellos para disminuir, en la medida de lo posible, el riesgo de contagio y mortalidad(AU)

Introduction: COVID-19 is a viral disease disseminated worldwide, considered a pandemic with a high mortality rate, whose epidemiological study is fundamental to understand the risk associated with specific populations. Objectives: Estimate the case fatality rates and risk factors associated with mortality from COVID-19 in the five states with more infections in Mexico. Methods: 297,230 COVID-19 positive patients were analyzed using RT-PCR tests from 475 monitoring units in five states of Mexico. Case fatality rates and probability ratios were estimated by adjusting a multivariate logistic regression model. Risk factors were considered in a model that included the effects of sex, age, smoking habits, hospitalization history, pneumonia diagnosis, and comorbidities such as diabetes, hypertension, chronic obstructive pulmonary disease, asthma, immunosuppression, chronic kidney disease, and cardiovascular disease, among others. Results: There is greater contagion among people aged 41 to 60 years. More than 90percent of deaths occurred after the age of 41, with the case fatality rate increasing at an older age. Men showed a higher proportion of cases, deaths and case fatality rate. Multivariate logistic analysis showed that age, sex, hospitalization, pneumonia, diabetes, and chronic kidney disease are significant risk factors (p < 0.0001) for COVID-19 mortality. Conclusions: In Mexico, age, sex, hospitalization, pneumonia, diabetes and chronic kidney disease are factors that increase the risk of mortality from COVID-19. It is suggested to take this information into account to determine vulnerable groups and increase attention to them to reduce, as far as possible, the risk of contagion and mortality(AU)

Chronic kidney disease is a very significant comorbidity for high risk of death in patients with COVID-19 in Mexico.

Chronic kidney disease (CKD) is a recognized public health problem and key determinant of poor health outcomes. In Mexico, this condition has been associated with high and significant risk of death in COVID-19 patients; however, not enough attention has been given to the vulnerable population as the increasing numbers and fatality rates suggest. This study evaluated the effect of interaction between CKD condition and other risk factors (sex, diabetes, hypertension and obesity) on the survival rate of positive patients for COVID-19 in Mexico. The results from this study support that CKD patients is a population at high risk for mortality for COVID-19 and that COVID-19 positive inpatients with CKD and diabetes are highly vulnerable to death.