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墨西哥患有 COVID-19 及既往非传染性疾病和可改变的危险因素的患者住院和死亡风险增加。

Increased Risk of Hospitalization and Death in Patients with COVID-19 and Pre-existing Noncommunicable Diseases and Modifiable Risk Factors in Mexico.

机构信息

INCAP Research Center for the Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala.

Universidad Anáhuac México, Instituto Nacional de Salud Pública, Evisys Consulting, Ciudad de México, México.

出版信息

Arch Med Res. 2020 Oct;51(7):683-689. doi: 10.1016/j.arcmed.2020.07.003. Epub 2020 Jul 22.

DOI:10.1016/j.arcmed.2020.07.003
PMID:32747155
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7375298/
Abstract

BACKGROUND

The population in Mexico has high prevalence rates of noncommunicable diseases (NCDs). Hospitalization and death of COVID-19 patients in the countries most affected by the pandemic has been associated to chronic comorbidities.

OBJECTIVE

To describe the prevalence of NCDs in patients with COVID-19 in Mexico and analyze the increased risk due to comorbidities and risk factors on hospitalization, utilization of intensive care units and death.

METHODS

A cross-sectional study was performed from 212,802 confirmed COVID-19 cases reported by the Ministry of Health up to June 27, 2020. Odds ratios were performed using logistic regression model.

RESULTS

Up to 47.40% of patients with COVID-19 diagnosis were also reported with a comorbidity, with hypertension being the most frequent (20.12%). The report of at least one NCD significantly increased the risk of death with respect to patients without such diagnoses. Chronic kidney disease increased the risk of death the most (OR 2.31), followed by diabetes (OR 1.69), immunosuppression (OR 1.62), obesity (OR 1.42), hypertension (OR 1.24), chronic obstructive pulmonary disease (OR 1.20). The comorbidities that most increased the risk of ICU and of intubation were diabetes, immunosuppression and obesity.

CONCLUSION

NCD comorbidities increase the severity of COVID-19 infection. Given high NCD prevalence rates among the Mexican population, the pandemic poses a special threat to the health system and to society. Special prevention measures need to be strengthened for persons with NCD diagnoses in the short-term. In the mid-term, disease control strategies need to be improved to protect these patients against COVID-19 severity.

摘要

背景

墨西哥人口中非传染性疾病(NCD)的患病率很高。在受大流行影响最严重的国家,COVID-19 患者的住院和死亡与慢性合并症有关。

目的

描述墨西哥 COVID-19 患者中 NCD 的患病率,并分析由于合并症和危险因素导致的住院、使用重症监护病房和死亡的风险增加。

方法

对卫生部报告的截至 2020 年 6 月 27 日的 212802 例确诊 COVID-19 病例进行了横断面研究。使用逻辑回归模型进行比值比分析。

结果

多达 47.40%的 COVID-19 患者还被报告患有合并症,其中高血压最为常见(20.12%)。与没有此类诊断的患者相比,至少有一种 NCD 的报告显著增加了死亡风险。慢性肾脏病增加死亡风险的幅度最大(OR 2.31),其次是糖尿病(OR 1.69)、免疫抑制(OR 1.62)、肥胖症(OR 1.42)、高血压(OR 1.24)、慢性阻塞性肺疾病(OR 1.20)。最增加 ICU 和插管风险的合并症是糖尿病、免疫抑制和肥胖症。

结论

NCD 合并症增加了 COVID-19 感染的严重程度。鉴于墨西哥人口中 NCD 的高患病率,大流行对卫生系统和社会构成了特殊威胁。需要在短期内加强对患有 NCD 诊断的人群的特殊预防措施。从中期来看,需要改善疾病控制策略,以保护这些患者免受 COVID-19 严重程度的影响。

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