Analysis of mortality and comorbidity due to Covid-19 in Cuba
Keywords:
COVID-19, SARS-CoV-2, coronavirus, comorbidities, mortalityAbstract
Introduction: Comorbidities have been related to highrisk of contracting COVID-19, and of having poor evolution and mortality.
Objective: To identify risk factors associated with mortality at the end of the hospital stay in patients diagnosed with COVID-19 in Cuba.
Methods: A retrospective cohort of all patients confirmed COVID-19 in Cuba, aged 18 years or older, diagnosed from March 11 to October 15, 2020. The source of information was the national database of the Ministry of Public health. Age, sex and comorbidities were collected, and classified as recovered and deceased. This is an analytical study of factors and comorbidities associated with mortality.
Results: This study analyzed 5,490 patients (97.7% recovered vs 2.3% deceased). The deceased were significantly older (72.8 vs 44.5 years). The most frequent comorbidities in the deceased were hypertension (47.6% vs 7.8%), diabetes (27.4% vs 2.6%), ischemic heart disease (14.5% vs 0.9%), chronic kidney disease (11.3% vs 0.3%) and COPD (11.3% vs 0.5%). An independent risk of mortality was found at the age of 60 years or more (OR: 10,090, 95% CI: 6,247-16,299), chronic kidney disease (OR: 8,434, 95% CI: 3,400-20,919), cancer (OR: 7,169 , 95% CI: 2,920-17,601), chronic obstructive pulmonary disease (OR: 5,300, 95% CI: 2,376-11,822), obesity (OR: 4,230, 95% CI: 1,362-13,139), heart failure (OR: 4,197, CI 95%: 1,085-16,244), diabetes (OR: 2,360, 95% CI: 1,339-4,159), hypertension (OR: 2,264, 95% CI: 1,398-3,668) and ischemic heart disease (OR: 2,321, 95% CI: 1,168 -4,610). A significant association of comorbidities was found, with two, three and more than three (OR: 22.9, 95% CI: 13.4-39.2), (OR: 72.5, 95% CI: 39.8-132, 1) and (OR: 88.9, 95% CI: 36.2-217.8) respectively. The most frequent combination of comorbidities among the deceased subjects was hypertension with diabetes (17.7% vs 1.9%) and hypertension with chronic kidney disease (8.1% vs 0.2%).
Conclusions: Advanced age, chronic kidney disease, ischemic heart disease, heart failure, hypertension, diabetes, cancer, chronic obstructive pulmonary disease, obesity and the number of comorbidities were significantly related to mortality and could help to identify patients with higher risk.
Keywords: COVID-19; SARS-CoV-2; coronavirus; comorbidities; mortality.
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