A survival analysis of COVID-19 in the Mexican population

Abstract

Background. At present, the Americas region contributes to the largest number of cases of COVID-19 worldwide. In this area, Mexico is in third place respecting deaths (20,781 total deaths), rate that may be explained by the high proportion of the population over 50 years and the rate of chronic diseases. The aim of the present work was estimate the risk factors associated with the death rate, considering the time between symptoms onset and the death occurrence, in the Mexican population. Methods. Information of all the confirmed cases for COVID-19 reported on the public dataset released by the Epidemiological Surveillance System for Viral Respiratory Diseases of the Mexican Ministry of Health was analyzed. Kapplan-Meier curves were plotted, and a Cox proportional hazard model was constructed. Results. The analysis included 16,752 registries of confirmed cases of COVID-19 with mean age 46.55±15.55 years; 58.02% (n=9719) men and 9.37% (n=1,569) died. Men (H.R. 1.21, p<0.01, 95% C.I. 1.09-1.35), older age (H.R. 8.24, p<0.01, 95% C.I. 4.22-16.10), CKD (H.R. 1.85, p<0.01, 95% C.I. 1.51-2.25), pneumonia (H.R. 2.07, p<0.01, 95% C.I. 1.81-2.38), hospitalization and ICU admissions (H.R. 5.86, p<0.01, 95% C.I. 4.81-7.14, and H.R. 1.32, p<0.01, 95% C.I. 1.12-1.55, respectively), intubation (H.R. 2.93, p<0.01, 95% C.I. 2.50-3.45) and health care in public health services (more than twice the risk, p<0.01), were independent factors increasing the risk of death due to COVID-19. Conclusions. The risk of dying at any time during follow-up was especially higher in men, individuals at the older age groups, with chronic kidney disease and people hospitalized in the public health services.

Analysis of Survival of Patients Hospitalized with COVID-19 in Espírito Santo, Brazil

“…The risk for a more severe form of the disease was associated with comorbidities such as diabetes mellitus, hypertension and smoking [4]. Similarly, sociodemographic aspects such as advanced age (80 years or older), male sex, race/non-white color and being a public hospital user have been shown to contribute to a higher risk of death [5][6][7]. In addition, it 2 of 16 should be noted that a more critical course of the disease may promote increased hospital admissions and hospital length of stay [8], generating demands for health systems.…”

“…In this sense, by identifying characteristics that favor a more severe outcome, the studies of survival analysis have been useful since they report the time elapsed between the onset and the event of interest [9]. After electing hospital admission and/or the onset of the symptoms of COVID-19 as the initial event and death as the final event, researchers pointed out that patients with a worse survival from COVID-19 were those with dyspnea, pneumonia, ground-glass opacity, admitted to the Intensive Care Unit (ICU) with the support of mechanical ventilation, with chronic kidney disease, in addition to being of advanced age and belonging to the male sex [7,[10][11][12].…”

Associação entre comprometimento pulmonar, fatores de risco e desfechos em pacientes com covid-19 atendidos em hospital de referência na Paraíba

“…12 No entanto, verificamos uma diferença significativa no tempo desde o início dos sintomas até a realização da TC e a mortalidade, o que não foi visto em relação à necessidade de internação ou à intubação. Todavia, essa diferença não foi observada por outros trabalhos, [22][23] que compararam o tempo de sintomas à admissão entre o grupo de sobreviventes e o grupo de não-sobreviventes.…”

“…De modo geral, é uma evidência forte no meio científico que a ausência de comorbidades é maior nos indivíduos que sobrevivem à COVID-19, 23 enquanto a presença é significativamente maior nos pacientes que morrem 21 , de forma que nosso estudo obteve resultado concordante com tal aspecto.…”

A Competing Risk Analysis of Early COVID-19 Treatments

“…Several studies have associated chronic diseases such as obesity, diabetes, hypertension, and CKD, among others(30)(31)(32) with the development of severe forms of COVID-19 infection, including pneumonia. Mexico ranks third worldwide in deaths attributed to COVID-19 infection and with a high prevalence of these diseases, including CKD(33); therefore, strict control of these conditions is necessary in patients with COVID-19 infection in Mexico and the world.…”