Predictors of COVID-19 Fatality: A Worldwide Analysis of the Pandemic over Time and in Latin America

Abstract

SARS-CoV-2 has infected over one hundred million people worldwide and has affected Latin America particularly severely in terms of both cases and deaths. This study aims to determine the association between SARS-CoV-2 testing and COVID-19 fatality rate worldwide over 8 months and to examine how this relationship differs between Latin America and all other countries. This cross-sectional study used March 2021 data from 169 countries. Multivariate regressions predicted COVID-19 fatality (outcome) from the number of SARS-CoV-2 tests (exposure), while controlling for other predictors. Results for March 2021 were compared to results from June 2020. Additionally, results for Latin America were also compared to all other countries except Latin American for March 2021. SARS-CoV-2 testing was associated with a significant decrease in COVID-19 fatality rate in both June 2020 and March 2021 (RR = 0.92; 95% CI 0.87–0.96 and RR = 0.86; 95% CI 0.74–1.00, respectively). SARS-CoV-2 testing was associated with a significant decrease in COVID-19 fatality rate in Latin American countries but not in all other countries (RR = 0.45; 95% CI 0.23–0.89 and RR = 0.95; 95% CI 0.82–1.11, respectively). However, the difference between the risk ratios for June 2020 and March 2021 and between the risk ratios for Latin America and all other countries were not statistically significant. Increased SARS-CoV-2 testing may be a significant predictor of lower COVID-19 case fatality rate, specifically in Latin American countries, due to the existence of a strong association, which may have driven the worldwide results.

Effect of bloodstream infection on survival in COVID-19 patients admitted to an intensive care unit in Colombia: a matched cohort analysis

“…A systematic review and meta-analysis of the first year of the pandemic identified 46 studies in which it found a higher incidence of BSI in patients with COVID-19 than without it (OR 2.77; 95% CI 1.53-5.02), with an incidence of 29.6% of patients admitted to the ICU (95% CI, 21.7-31.8%) and with a mortality of 41% (95% CI, 30-52.8%), a range within which our data are found. The data also seem consistent with those observed in the first and second waves in Colombia, with mortality that seemed to be affected by the time at which patients were treated [ 15 ], similar to that observed in other Latin American countries [ 16 ].…”

Updated Surveillance Metrics and History of the COVID-19 Pandemic (2020-2023) in Latin America and the Caribbean: Longitudinal Trend Analysis

“…In October 2022, PAHO’s director reassured the region that disease trends insinuated a potential transition of the pandemic from an acute phase to a phase of sustained control [ 100 ]. Through 2022, the United States donated over 70 million COVID-19 vaccines to LAC directly and via the COVID-19 Vaccines Global Access (COVAX) partnership, with top recipients including Mexico (16.9 million doses), Guatemala (8.5 million doses), and Colombia (7 million doses) [ 100 , 131 , 132 ]. Larger agreements and agencies such as COVAX relied on a variety of vaccine types, mainly including messenger RNA (mRNA)–based vaccines (Pfizer-BioNTech, Moderna) and viral vector vaccines (Oxford University-AstraZeneca, Johnson & Johnson, Sputnik V) [ 133 - 135 ].…”

Country-level predictors of COVID-19 mortality

“…However, other authors have reported worldwide country-level COVID-19 mortality risk factors using data close to time of publication. Implicated risk factors include general pre-pandemic variables comprising country-level demographics (population ≥ 60 years 15 ); socioeconomic and governance factors e.g., higher GDP per capita 16 , 17 , higher income disparity 16 , higher transport infrastructure quality and lower government effectiveness 18 ; national healthcare metrics including lower general health expenditure, lower infectious disease system responsiveness and greater accountability 19 ; and population health characteristics like higher prevalence of obesity 15 , 16 , chronic obstructive pulmonary disease, Alzheimer’s disease, and depression 17 . Reported risk factors also comprise pandemic-specific variables.…”

“…Reported risk factors also comprise pandemic-specific variables. These include pandemic features e.g., duration 15 and case load 19 ; pandemic-associated public health policies inclusive of delayed international travel restrictions 15 and lower testing 18 ; and pandemic-associated public behaviours, e.g., shorter duration of mask wearing 15 . In addition, prior work also explored worldwide country-level COVID-19 mortality with a focus on select predictors, for example health system parameters 19 , 20 .…”