Ángeles Correa María Guadalupe, Villarreal Ríos Enrique, Galicia Rodríguez Liliana, Vargas Daza Emma Rosa, Frontana Vázquez Gabriel, Monrroy Amaro Sergio Javier, Pinal Viridiana Ruiz, Álvarez Javier Dávalos, Santibáñez Beltrán Shaid
Instituto Mexicano del Seguro Social Ciudad de Querétaro México Instituto Mexicano del Seguro Social, Ciudad de Querétaro, México.
Rev Panam Salud Publica. 2022 May 2;46:e40. doi: 10.26633/RPSP.2022.40. eCollection 2022.
To determine the relative risk of a lethal outcome associated with chronic degenerative conditions in patients with COVID-19.
A cohort study was conducted using electronic medical records belonging to patients who tested positive for COVID-19 on RT-PCR while receiving care as outpatients or inpatients in a social security system facility between March 2020 and March 2021. Two study groups were formed. The exposed group was divided into four subgroups, each of which was diagnosed with one and only one chronic condition (diabetes, hypertension, obesity, or chronic kidney disease); the unexposed group was obtained from the medical records of patients without comorbidities. A total of 1 114 medical records were examined using simple random sampling. Once the minimum sample size was reached, the relative risk was calculated for each chronic condition. Combinations of two, three, and four conditions were created, and each of them was included in the analysis.
In the absence of a chronic degenerative condition, the prevalence of a lethal outcome from COVID-19 is 3.8%; in the presence of type 2 diabetes mellitus, 15.8%; in the presence of arterial hypertension, 15.6%; and in the presence of obesity, 15.0%. For diabetes and hypertension combined, the prevalence of a lethal outcome is 54.1%; for diabetes and obesity combined, 36.8%, and for obesity and hypertension combined, 28.1%.
In patients with COVID-19, the relative risk of a lethal outcome is 4.17 for those with diabetes, 4.13 for those with hypertension, and 3.96 for those with obesity. For two chronic conditions combined, the relative risk doubles or triples. The relative risk of a lethal outcome is 14.27 for diabetes plus hypertension; 9.73 for diabetes plus obesity, and 7.43 for obesity plus hypertension. Chronic conditions do not present alone; they generally occur together, hence the significance of the relative risks for lethal outcomes presented in this paper.
确定2019冠状病毒病（COVID-19）患者中与慢性退行性疾病相关的致死结局的相对风险。
采用队列研究，使用2020年3月至2021年3月期间在社会保障系统设施中作为门诊或住院患者接受治疗且RT-PCR检测COVID-19呈阳性的患者的电子病历。形成了两个研究组。暴露组分为四个亚组，每个亚组被诊断患有且仅患有一种慢性疾病（糖尿病、高血压、肥胖或慢性肾脏病）；未暴露组来自无合并症患者的病历。使用简单随机抽样检查了总共1114份病历。达到最小样本量后，计算每种慢性疾病的相对风险。创建了两种、三种和四种疾病的组合，并将每种组合纳入分析。
在没有慢性退行性疾病的情况下，COVID-19致死结局的患病率为3.8%；患有2型糖尿病时为15.8%；患有动脉高血压时为15.6%；患有肥胖症时为15.0%。糖尿病和高血压合并时，致死结局的患病率为54.1%；糖尿病和肥胖合并时为36.8%，肥胖和高血压合并时为28.1%。
在COVID-19患者中，糖尿病患者致死结局的相对风险为4.17，高血压患者为4.13，肥胖患者为3.96。两种慢性疾病合并时，相对风险会加倍或增至三倍。糖尿病加高血压致死结局的相对风险为14.27；糖尿病加肥胖为9.73，肥胖加高血压为7.43。慢性疾病并非单独出现；它们通常共同发生，因此本文中呈现的致死结局相对风险具有重要意义。
