Pre-existing comorbidity, the highest risk factor for poor prognosis of COVID-19 among the Mexican population

• Main Authors: Basilio Calixto-Calderón, María F. Vázquez-González, Rafael Martínez Peláez, Josué R. Bermeo-Escalona, Vicente García, Luis J. Mena, Gladys Maestre, Jorge R. Parra-Michel, Leobardo A. Ceja Bravo, Pedro L. López-de-Alba
• Format: Article
• Language: English
• Published: Universidad De La Salle Bajío 2021-04-01
• Series: Nova Scientia
• Subjects: Case fatality rate; comorbidity; coronavirus; COVID-19; death risk; pandemic
• Online Access: http://novascientia.delasalle.edu.mx/ojs/index.php/Nova/article/view/2823

The coronavirus disease 2019 (COVID-19) pandemic represents a challenge for public health and a high risk for patients with pre-existing comorbidity. As of July 20, 2020, the Case Fatality Rate (CFR) was 11.30% and the Mortality Rate (MR) was 31.28 deaths per 100,000 population. In Mexico, the prevalence of obesity, diabetes mellitus, and hypertension among the adult Mexican population is 30%, 9.2%, and 40%, respectively. The objective of this research was to identify the risk factors associated with eight comorbidities and their dependency on age for death caused by COVID-19. Method: This study used the dataset published on July 20, 2020, by the General Directorate of Epidemiology of the Ministry of Health of Mexico. From this dataset, we analysed 130,896 positive COVID-19 cases, where 35,483 (27.107%) patients had one comorbidity, and 95,413 (72.892%) patients had not medical comorbidity. Statistical analyses include the Case Fatality Rate (CFR), the estimation of the Odds Ratio (OR), and its 95% Confidence Interval (CI). Results: The highest CFR was 14.382% for COPD, 10.266% for CKD, 10.126% for diabetes, and 8.954% for hypertension. The obesity CFR was 3.535%. Moreover, we detected a higher risk for patients with COPD, diabetes, and CKD, resulting in OR of 4.443 (95% CI: 3.404-5.799), 3.283 (95% CI: 3.018-3.570), and 3.016 (95% CI: 2.248-4.047), respectively.   Conclusion: This study corroborates that the highest risk for severe disease and death caused by COVID-19 among the Mexican population are pre-existing comorbidities. Findings show that COPD, CKD, diabetes, hypertension, and cardiovascular disease increase the risk of death for patients older than 54 years. The most vulnerable age group is older than 65 years.