Comorbidities associated with COVID-19 mortality in adults in Lima, Peru: a retrospective cohort study

Authors

DOI:

https://doi.org/10.17843/rpmesp.2023.402.12170

Keywords:

COVID-19, Comorbidity, Prognosis, Hospitalization, Peru

Abstract

Objectives. To evaluate comorbidities associated with mortality in adult patients hospitalized due to COVID-19 in hospitals in Lima and Callao. Materials and methods. In this retrospective cohort study, we analyzed data from adult patients hospitalized due to COVID-19 reported to the National Epidemiological Surveillance System of the Peruvian Ministry of Health from March to October 2020. We estimated relative risks with 95% confidence intervals using Poisson regression models with robust variance to assess comorbidities associated with mortality by age group: young adults (18-29 years), adults (30-59 years) and older adults (≥60 years). Results. We included 2366 young adults, 23,781 adults and 25,356 older adults. Older adults had the highest mortality (63.7%) compared to adults (27.1%) and young adults (8.5%). Regardless of age group, the presence of neurological disease, renal disease, liver disease, and cancer was associated with an increased risk of mortality. Additionally, cardiovascular disease was also a risk factor in young adults; obesity, diabetes, cardiovascular disease, chronic lung disease, and immunodeficiency in adults; and obesity and chronic lung disease in the elderly. Conclusions. Regardless of age groups, individuals with chronic neurologic disease, renal disease, liver disease, and cancer were at high risk of death from COVID-19.

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References

Ministerio de Salud. Sala Situacional - Covid 19 en el Perú [Internet]. [citado el 30 de julio de 2020]. Disponible en: https://covid19.minsa.gob.pe/sala_situacional.asp.

Acciones del Gobierno frente al COVID-19 (08/05/2020) [Internet]. [citado el 18 de mayo de 2020]. Disponible en: https://www.gob.pe/institucion/pcm/informes-publicaciones/563660-acciones-del-gobierno-frente-al-covid-19-08-05-2020.

Ministerio de Salud (MINSA). Resolución Ministerial N° 184-2020-MINSA. Creación de el Grupo de Trabajo de innovación de tecnologías sanitarias [Internet]. 2020 [citado el 10 de mayo de 2020]. Disponible en: https://www.gob.pe/institucion/minsa/normas-legales/473513-184-2020-minsa.

Díaz-Vélez C, Urrunaga-Pastor D, Romero-Cerdán A, Peña-Sánchez ER, Fernández Mogollon JL, Cossio Chafloque JD, et al. Risk factors for mortality in hospitalized patients with COVID-19 from three hospitals in Peru: a retrospective cohort study. F1000Res. 2021;10:224. doi: 10.12688/f1000research.51474.1.

Parohan M, Yaghoubi S, Seraji A, Javanbakht MH, Sarraf P, Djalali M. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies. The Aging Male. 2020;23(5):1416–24. doi: 10.1080/13685538.2020.1774748.

Mejía F, Medina C, Cornejo E, Morello E, Vásquez S, Alave J, et al. Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru. PLOS ONE. 2020;15(12):e0244171. doi:10.1371/journal.pone.0244171.

Gesesew HA, Koye DN, Fetene DM, Woldegiorgis M, Kinfu Y, Geleto AB, et al. Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review. BMJ Open. 2021;11(2):e044618. doi: 10.1136/bmjopen-2020-044618.

Gao Y, Chen Y, Liu M, Shi S, Tian J. Impacts of immunosuppression and immunodeficiency on COVID-19: A systematic review and meta-analysis. Journal of Infection. 2020;81(2):e93–5. doi:10.1016/j.jinf.2020.05.017.

Ministerio de Salud (MINSA). Alertas epidemiologicas 2020 [Internet]. [citado el 10 de mayo de 2020]. Disponible en: https://www.dge.gob.pe/portal/includes/boletin/alertas2020.html.

Ministerio de Salud del Perú. Documento Técnico: Modelo de Cuidado Integral de Salud por Curso de Vida [Internet]. [citado el 20 de marzo de 2023]. Disponible en: https://cdn.www.gob.pe/uploads/document/file/496394/resolucion-ministerial-030-2020-MINSA.pdf.

Centro Nacional de Epidemiología, Prevención y Control de Enfermedades. NotiWeb [Internet]. [citado el 22 de septiembre de 2021]. Disponible en: https://app7.dge.gob.pe/notiWeb/index.php/index/login#no-back-button.

Vargas-Herrera J, Ruiz KP, Nuñez GG, Ohno JM, Pérez-Lu JE, Huarcaya WV, et al. Resultados preliminares del fortalecimiento del sistema informático nacional de defunciones. Revista Peruana de Medicina Experimental y Salud Pública. 2018;35(3):505–14. doi:10.17843/rpmesp.2018.353.3913.

Hueda-Zavaleta M, Copaja-Corzo C, Bardales-Silva F, Flores-Palacios R, Barreto-Rocchetti L, Benites-Zapata VA. Factores asociados a la muerte por COVID-19 en pacientes admitidos en un hospital público en Tacna, Perú. Revista Peruana de Medicina Experimental y Salud Pública [Internet]. 2021 [citado el 30 de junio de 2021];38(2). doi:10.17843/rpmesp.2021.382.7158.

Vences MA, Pareja-Ramos JJ, Otero P, Veramendi-Espinoza LE, Vega-Villafana M, Mogollón-Lavi J, et al. Factors associated with mortality in patients hospitalized with COVID-19: A prospective cohort in a Peruvian

national referral hospital. Medwave. 2021;21(06):e8231–e8231. doi: 10.5867/medwave.2021.06.8231.

Abate SM, Checkol YA, Mantefardo B. Global prevalence and determinants of mortality among patients with COVID-19: A systematic review and meta-analysis. Annals of Medicine and Surgery. 2021;64:102204. doi: 10.1016/j.amsu.2021.102204.

Nuñez-Ramos JA, Forero Illera E, Quintero Barrios JL, Macareno Arroyo HA, Larios Sanjuan DJ, Manzur Barbur MC, et al. Prognostic Factors in Hospitalized COVID-19 Patients at the Start of the Pandemic in Colombia: A Retrospective Cohort Study. Cureus. 13(5):e14865. doi: 10.7759/cureus.14865.

Sistema de Salud en el Perú y el COVID-19 [Internet]. Escuela de Gobierno y Políticas Públicas. [citado el 23 de septiembre de 2021]. Disponible en: https://escuela.pucp.edu.pe/gobierno.

Navarrete-Mejía PJ, Velasco-Guerrero JC, Loro-Chero L. Automedicación en época de pandemia: Covid-19. Rev Cuerpo Méd Hosp Nac Almanzor Aguinaga Asenjo. 2020;350–5.

Richardson S, Gitlin J, Kozel Z, Levy S, Rahman H, Hirsch JS, et al. In-Hospital 30-Day Survival Among Young Adults With Coronavirus Disease 2019: A Cohort Study. Open Forum Infect Dis. 2021;8(6):ofab233.

doi: 10.1093/ofid/ofab233.

Becerra-Muñoz VM, Núñez-Gil IJ, Eid CM, García Aguado M, Romero R, Huang J, et al. Clinical profile and predictors of in-hospital mortality among older patients hospitalised for COVID-19. Age and Ageing.

;50(2):326–34. doi:10.1093/ageing/afaa258.

Santos MM, Lucena EES, Bonfada D, Santos AC, Vechi HT, Lima KC. Brazilian Older People Hospitalized by COVID-19: Characteristics and Prognostic Factors in a Retrospective Cohort Study. J Appl Gerontol.

;40(6):571–81. doi:10.1177/0733464820983976.

Sánchez-Ríos CP, Barreto-Rodríguez JO, Centeno-Sáenz GI, Vázquez-Rojas H. COVID-19 in older adults Mexican, descriptive analysis. Neumol Cir Torax. 2021;79(4):224–9.

Levin AT, Hanage WP, Owusu-Boaitey N, Cochran KB, Walsh SP, Meyerowitz-Katz G. Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications. Eur J Epidemiol. 2020;35(12):1123–38. doi: 10.1007/s10654-020-00698-1.

Wallentin L, Lindbäck J, Eriksson N, Hijazi Z, Eikelboom JW, Ezekowitz MD, et al. Angiotensin-converting enzyme 2 (ACE2) levels in relation to risk factors for COVID-19 in two large cohorts of patients with atrial fibrillation. European Heart Journal. 2020;41(41):4037–46. doi: 10.1093/eurheartj/ehaa697.

García-Azorín D, Martínez-Pías E, Trigo J, Hernández-Pérez I, Valle-Peñacoba G, Talavera B, et al. Neurological Comorbidity Is a Predictor of Death in Covid-19 Disease: A Cohort Study on 576 Patients. Frontiers in Neurology. 2020;11:781. doi: 10.3389/fneur.2020.00781.

Eskandar EN, Altschul DJ, Ramos R de la G, Cezayirli P, Unda SR, Benton J, et al. Neurologic Syndromes Predict Higher In-Hospital Mortality in COVID-19. Neurology. 2021;96(11):e1527–38. doi:10.1212/WNL.0000000000011356.

Menon T, Gandhi SAQ, Tariq W, Sharma R, Sardar S, Arshad AM, et al. Impact of Chronic Kidney Disease on Severity and Mortality in COVID-19 Patients: A Systematic Review and Meta-analysis. Cureus. 2021;13(4):e14279. doi:10.7759/cureus.14279.

Betjes MGH. Immune cell dysfunction and inflammation in end-stage renal disease. Nat Rev Nephrol. 2013;9(5):255–65. doi: 10.1038/nrneph.2013.44.

Chou C-Y, Wang S-M, Liang C-C, Chang C-T, Liu J-H, Wang I-K, et al. Risk of Pneumonia Among Patients With Chronic Kidney Disease in Outpatient and Inpatient Settings: A Nationwide Population-Based Study. Medicine. 2014;93(27):e174. doi:10.1097/MD.0000000000000174.

Nagarajan R, Krishnamoorthy Y, Rajaa S, Hariharan VS. COVID-19 Severity and Mortality Among Chronic Liver Disease Patients: A Systematic Review and Meta-Analysis. Prev Chronic Dis. 2022;19:E53. doi:10.5888/pcd19.210228.

Hussain A, Mahawar K, Xia Z, Yang W, EL-Hasani S. Obesity and mortality of COVID-19. Meta-analysis. Obes Res Clin Pract. 2020;14(4):295–300. doi: 0.1016/j.orcp.2020.07.002.

Asthma and COVID-19 – studies from WHO/Europe [Internet]. [citado el 24 de septiembre de 2021]. Disponible en: https://www.euro.who.int/en/countries/belgium/news/news/2021/8/asthma-and-covid-19-studies-from-whoeurope.

Sunjaya AP, Allida SM, Di Tanna GL, Jenkins CR. Asthma and COVID-19 risk: a systematic review and meta-analysis. Eur Respir J. 2022;59(3):2101209. doi:10.1183/13993003.01209-2021.

Chávez V, E J. Prevalencia de sobrepeso y obesidad en el Perú. Revista Peruana de Ginecología y Obstetricia. 2017;63(4):593–8.

Jaganath D, Miranda JJ, Gilman RH, Wise RA, Diette GB, Miele CH, et al. Prevalence of chronic obstructive pulmonary disease and variation in risk factors across four geographically diverse resource-limited settings in Peru. Respir Res. 2015;16:40. doi:10.1186/s12931-015-0198-2.

Herrera- Añazco P, Pacheco-Mendoza J, Taype-Rondan A. La enfermedad renal crónica en el Perú: Una revisión narrativa de los artículos científicos publicados. Acta Médica Peruana. 2016;33(2):130–7.

Published

2023-06-30

Issue

Section

Original Article

How to Cite

1.
Soto-Cabezas MG, Reyes-Vega MF, Soriano-Moreno AN, Ordoñez-Ibargüen L, Martel KS, Flores-Jaime N, et al. Comorbidities associated with COVID-19 mortality in adults in Lima, Peru: a retrospective cohort study. Rev Peru Med Exp Salud Publica [Internet]. 2023 Jun. 30 [cited 2024 Apr. 27];40(2):132-40. Available from: https://rpmesp.ins.gob.pe/index.php/rpmesp/article/view/12170

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