Journal of Preventive Medicine and Public Health

  • 제53권4호
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  • Pages.211-219
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  • 2020
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
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Association of Comorbidities With Pneumonia and Death Among COVID-19 Patients in Mexico: A Nationwide Cross-sectional Study

  • Hernandez-Vasquez, Akram (Universidad San Ignacio de Loyola, Vicerrectorado de Investigacion, Centro de Excelencia en Investigaciones Economicas y Sociales en Salud) ;
  • Azanedo, Diego (Universidad Catolica los Angeles de Chimbote, Instituto de Investigacion) ;
  • Vargas-Fernandez, Rodrigo (Universidad Cientifica del Sur) ;
  • Bendezu-Quispe, Guido (Universidad San Ignacio de Loyola, Vicerrectorado de Investigacion, Unidad de Investigacion para la Generacion y Sintesis de Evidencias en Salud)
  • 투고 : 2020.05.10
  • 심사 : 2020.05.27
  • 발행 : 2020.07.31
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초록

Objectives: The goal of this study was to identify chronic conditions and multimorbidity patterns in patients with coronavirus disease 2019 (COVID-19) and to examine their associations with pneumonia and death. Methods: This cross-sectional study analyzed the official data of COVID-19 patients in Mexico through May 18, 2020 (released by the Secretaría de Salud de México). Adjusted logistic regression models were applied to assess the associations of comorbidities with pneumonia and death. The marginal effects were estimated, and the probability of pneumonia or death according to the number of comorbidities was graphed for each year of age. Results: Of the 51 053 COVID-19 patients enrolled in the final analysis, 27 667 (54.2%) had no chronic conditions, while 13 652 (26.7%), 6518 (12.8%) and 3216 (6.3%) were reported to have 1, 2, and 3 or more simultaneous conditions, respectively. Overall, a significant incremental gradient was observed for the association between multimorbidity and pneumonia (p<0.001); for 2 chronic conditions, the adjusted odds ratio (aOR) was 2.07 (95% confidence interval [CI], 1.95 to 2.20), and for ≥3 conditions, the aOR was 2.40 (95% CI, 2.22 to 2.60). A significant incremental gradient was also found for the relationship between multimorbidity and death (p<0.001); an aOR of 2.51 (95% CI, 2.30 to 2.73) was found for 2 chronic conditions and an aOR of 3.49 (95% CI, 3.15 to 3.86) for ≥3 conditions. Conclusions: Underlying chronic conditions and multimorbidity are associated with pneumonia and death in Mexican COVID-19 patients. Future investigation is necessary to clarify the pathophysiological processes behind this association, given the high burden of chronic diseases in various countries, including Mexico.

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참고문헌

  1. Coronavirus Resource Center, Johns Hopkins University. Maps & trends [cited 2020 May 1]. Available from: https://coronavirus.jhu.edu/map.html.
  2. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323(11):1061-1069. https://doi.org/10.1001/jama.2020.1585
  3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497-506. https://doi.org/10.1016/s0140-6736(20)30183-5
  4. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med 2020;8(4):e21. https://doi.org/10.1016/s2213-2600(20)30116-8
  5. Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet 2020;395(10234):1417-1418. https://doi.org/10.1016/s0140-6736(20)30937-5
  6. World Health Organization. Noncommunicable diseases (NCD) country profiles 2018 [cited 2020 May 1]. Available from: https://apps.who.int/iris/handle/10665/274512.
  7. Nonato IC, Barrera LH, Pedroza A, Medina C, Barquera S. Hypertension in Mexican adults: prevalence, diagnosis and type of treatment. Ensanut MC 2016. Salud Publica Mex 2018;60(3): 233-243 (Spanish). https://doi.org/10.21149/8813
  8. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J 2020;55(5):2000547. https://doi.org/10.1183/13993003.00547-2020
  9. Henry BM, Lippi G. Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection. Int Urol Nephrol 2020;52(6):1193-1194. https://doi.org/10.1007/s11255-020-02451-9
  10. Boettler T, Newsome PN, Mondelli MU, Maticic M, Cordero E, Cornberg M, et al. Care of patients with liver disease during the COVID-19 pandemic: EASL-ESCMID position paper. JHEP Rep 2020;2(3):100113. https://doi.org/10.1016/j.jhepr.2020.100113
  11. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395(10229):1054-1062. https://doi.org/10.1016/s0140-6736(20)30566-3
  12. Shi Y, Yu X, Zhao H, Wang H, Zhao R, Sheng J. Host susceptibility to severe COVID-19 and establishment of a host risk score: findings of 487 cases outside Wuhan. Crit Care 2020;24(1):108. https://doi.org/10.1186/s13054-020-2833-7
  13. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis 2020;94:91-95. https://doi.org/10.1016/j.ijid.2020.03.017
  14. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020;368:m1091.
  15. Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19) [cited 2020 Apr 30]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/groups-at-higher-risk.html.
  16. Sun ML, Yang JM, Sun YP, Su GH. Inhibitors of RAS might be a good choice for the therapy of COVID-19 pneumonia. Zhonghua Jie He He Hu Xi Za Zhi 2020;43(3):219-222 (Chinese).
  17. Diaz JH. Hypothesis: angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19. J Travel Med 2020;27(3):taaa041. https://doi.org/10.1093/jtm/taaa041
  18. Bravi F, Flacco ME, Carradori T, Volta CA, Cosenza G, De Togni A, et al. Predictors of severe or lethal COVID-19, including angiotensin converting enzyme inhibitors and angiotensin II receptor blockers, in a sample of infected Italian citizens. PLoS One 2020;15(6):e0235248. https://doi.org/10.1371/journal.pone.0235248
  19. Mo P, Xing Y, Xiao Y, Deng L, Zhao Q, Wang H, et al. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis 2020:ciaa270.
  20. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020;8(5):475-481. https://doi.org/10.1016/s2213-2600(20)30079-5
  21. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 2020:e200994.
  22. Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Invest Radiol 2020;55(6):327-331. https://doi.org/10.1097/RLI.0000000000000672
  23. Liu W, Tao ZW, Wang L, Yuan ML, Liu K, Zhou L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin Med J (Engl) 2020;133(9):1032-1038. https://doi.org/10.1097/CM9.0000000000000775
  24. Arokiasamy P, Uttamacharya U, Jain K, Biritwum RB, Yawson AE, Wu F, et al. The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal? BMC Med 2015;13:178. https://doi.org/10.1186/s12916-015-0402-8
  25. Patel AB, Verma A. COVID-19 and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: what is the evidence? JAMA 2020;323(18):1769-1770.
  26. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382(18):1708-1720. https://doi.org/10.1056/NEJMoa2002032
  27. Dietz W, Santos-Burgoa C. Obesity and its implications for COVID-19 mortality. Obesity (Silver Spring) 2020;28(6):1005. https://doi.org/10.1002/oby.22818
  28. Ryan DH, Ravussin E, Heymsfield S. COVID 19 and the patient with obesity - the editors speak out. Obesity (Silver Spring) 2020;28(5):847. https://doi.org/10.1002/oby.22808
  29. D'Antiga L. Coronaviruses and immunosuppressed patients: the facts during the third epidemic. Liver Transpl 2020;26(6): 832-834. https://doi.org/10.1002/lt.25756
  30. Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: a clinical-therapeutic staging proposal. J Heart Lung Transplant 2020;39(5):405-407. https://doi.org/10.1016/j.healun.2020.03.012
  31. Lippi G, Henry BM. Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID-19). Respir Med 2020;167:105941. https://doi.org/10.1016/j.rmed.2020.105941
  32. Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 2020;97(5):829-838. https://doi.org/10.1016/j.kint.2020.03.005
  33. Nunes BP, Flores TR, Mielke GI, Thume E, Facchini LA. Multimorbidity and mortality in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr 2016;67:130-138. https://doi.org/10.1016/j.archger.2016.07.008
  34. Landi F, Liperoti R, Russo A, Capoluongo E, Barillaro C, Pahor M, et al. Disability, more than multimorbidity, was predictive of mortality among older persons aged 80 years and older. J Clin Epidemiol 2010;63(7):752-759. https://doi.org/10.1016/j.jclinepi.2009.09.007
  35. Rivera-Almaraz A, Manrique-Espinoza B, Avila-Funes JA, Chatterji S, Naidoo N, Kowal P, et al. Disability, quality of life and all-cause mortality in older Mexican adults: association with multimorbidity and frailty. BMC Geriatr 2018;18(1):236. https://doi.org/10.1186/s12877-018-0928-7

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