Cifuentes Myriam Patricia, Rodriguez-Villamizar Laura Andrea, Rojas-Botero Maylen Liseth, Alvarez-Moreno Carlos Arturo, Fernández-Niño Julián Alfredo
Direction of Epidemiology and Demography, Government of Colombia Ministry of Health and Social Protection, Bogota, Colombia.
Department of Public Health, School of Medicine, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
J Epidemiol Community Health. 2021 Jul;75(7):610-615. doi: 10.1136/jech-2020-216275. Epub 2021 Mar 4.
After 8 months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. We aimed to identify the effect of some socioeconomic inequality-related factors on COVID-19 mortality in Colombia.
We conducted a survival analysis in a nation-wide retrospective cohort study of confirmed cases of COVID-19 in Colombia from 2 March 2020 to 26 October 2020. We calculated the time to death or recovery for each confirmed case in the cohort. We used an extended multivariable time-dependent Cox regression model to estimate the HR by age groups, sex, ethnicity, type of health insurance, area of residence and socioeconomic strata.
There were 1 033 218 confirmed cases and 30 565 deaths for COVID-19 in Colombia between 2 March and 26 October. The risk of dying for COVID-19 among confirmed cases was higher in males (HR 1.68 95% CI 1.64 to 1.72), in people older than 60 years (HR 296.58 95% CI 199.22 to 441.51), in indigenous people (HR 1.20 95% CI 1.08 to 1.33), in people with subsidised health insurance regime (HR 1.89 95% CI 1.83 to 1.96) and in people living in the very low socioeconomic strata (HR 1.44 95% CI 1.24 to 1.68).
Our study provides evidence of socioeconomic inequalities in COVID-19 mortality in terms of age groups, sex, ethnicity, type of health insurance regimen and socioeconomic status.
在新冠疫情爆发8个月后，拉丁美洲国家的新冠死亡率位居世界前列。尽管该地区是世界上最不平等的地区之一，但关于社会经济状况对这些国家新冠死亡率影响的报道却很少。我们旨在确定一些与社会经济不平等相关的因素对哥伦比亚新冠死亡率的影响。
我们对2020年3月2日至2020年10月26日哥伦比亚全国范围内确诊的新冠病例进行了回顾性队列研究，并进行了生存分析。我们计算了队列中每个确诊病例的死亡或康复时间。我们使用扩展的多变量时间依赖性Cox回归模型，按年龄组、性别、种族、医疗保险类型、居住地区和社会经济阶层估计风险比。
2020年3月2日至10月26日期间，哥伦比亚有1033218例新冠确诊病例，30565人死亡。确诊病例中，男性（风险比1.68，95%置信区间1.64至1.72）、60岁以上人群（风险比296.58，95%置信区间199.22至441.51）、原住民（风险比1.20，95%置信区间1.08至1.33）、参加补贴医疗保险制度的人群（风险比1.89，95%置信区间1.83至1.96）以及社会经济阶层极低的人群（风险比1.44，95%置信区间1.24至1.68）感染新冠后死亡风险更高。
我们的研究提供了证据，表明在年龄组、性别、种族、医疗保险制度类型和社会经济地位方面，新冠死亡率存在社会经济不平等现象。
