Leniz Javiera, Hernández-Jaña Sam, Soto Mauricio, Arenas Eduardo, Margozzini Paula, Suarez Francisco, Capurro Daniel, Rojas María Paulina, Bambs Claudia
Escuela de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.
PLoS One. 2024 Dec 30;19(12):e0314376. doi: 10.1371/journal.pone.0314376. eCollection 2024.
Most of the evidence on risk factors for COVID-19 complications comes from North America or Europe with very little research from Latin-America. We aimed to evaluate the association between sociodemographic, clinical factors and the risk of COVID-19 complications among adults in Chile, the fifth Latin-American country with more COVID-19 reported cases since de beginning of the Pandemic.
A retrospective population-based cohort study using data from electronic health records from a large Primary Care Network, linked to national hospital, immunization, Covid-19 PCR surveillance, mortality and birth records. We included people 18+ years old enrolled in the Primary Care Network between 1st January 2020 and 31st December 2021. Using Multivariate Cox proportional hazard models, we evaluate the association between sociodemographic, clinical characteristics with three COVID-19 complications: (1) a hospital admission, (2) an ICU admission, and (3) death due to a COVID-19 infection that occurred between the 1st January 2020 and the 31st December 2021.
44,674 people were included. The mean age was 44.30 (sd 17.31), 55.6% were female, 15.9% had a type of healthcare insurance for people from the lowest category of income, 11.6% and 9.4% had a record of hypertension or diabetes mellitus diagnosis. Among the 44,674 people, 455 (1.02%) had a hospital admission due to a COVID-19 infection and 216(0.48%) of them also had an ICU admission. Among the 44,674 people,148(0.33%) died due to COVID-19 infection. Older age and male sex were consistently associated with a higher risk of the three COVID-19 complications. Hypertension and diabetes were associated with a higher risk of a hospital admission and death, but not with an ICU admissions due to COVID-19 infection. Having two or more COVID-19 vaccine doses compared with no doses was associated with a lower risk of any hospital admission (HR 0.81; 95% CI 0.77-0.84), an ICU admission (HR 0.60; 95% CI 0.57-0.63) and death (HR 0.50; 95% CI 0.46-0.54). Pregnant or puerperal women were more likely to be admitted to hospital (HR 2.89; 95% CI 1.41-5.89) or ICU (HR 3.04; 95% CI 1.01-9.14).
Sociodemographic and clinical factors associated with COVID-19 complications such as age, sex and pre-existing conditions were comparable to those reported in similar studies from higher-income countries, and can be used to predict severity in COVID-19 patients.
关于新冠病毒疾病（COVID-19）并发症风险因素的大多数证据来自北美或欧洲，拉丁美洲的相关研究很少。我们旨在评估社会人口统计学、临床因素与智利成年人中COVID-19并发症风险之间的关联，智利是自疫情开始以来报告COVID-19病例数第五多的拉丁美洲国家。
一项基于人群的回顾性队列研究，使用来自大型初级保健网络电子健康记录的数据，并与国家医院、免疫接种、COVID-19聚合酶链反应监测、死亡率和出生记录相链接。我们纳入了2020年1月1日至2021年12月31日期间在初级保健网络登记的18岁及以上人群。使用多变量Cox比例风险模型，我们评估社会人口统计学、临床特征与三种COVID-19并发症之间的关联：（1）住院，（2）入住重症监护病房（ICU），以及（3）2020年1月1日至2021年12月31日期间因COVID-19感染死亡。
共纳入44674人。平均年龄为44.30岁（标准差17.31），55.6%为女性，15.9%拥有针对最低收入人群的某种医疗保险，11.6%和9.4%有高血压或糖尿病诊断记录。在这44674人中，455人（1.02%）因COVID-19感染住院，其中216人（0.48%）也入住了ICU。在这44674人中，148人（0.33%）因COVID-19感染死亡。年龄较大和男性一直与三种COVID-19并发症的较高风险相关。高血压和糖尿病与住院和死亡的较高风险相关，但与因COVID-19感染入住ICU无关。与未接种疫苗相比，接种两剂或更多剂COVID-19疫苗与任何住院风险较低（风险比[HR]0.81；95%置信区间[CI]0.77 - 0.84）、入住ICU风险较低（HR 0.60；95% CI 0.57 - 0.63）和死亡风险较低（HR 0.50；95% CI 0.46 - 0.54）相关。孕妇或产后妇女更有可能住院（HR 2.89；95% CI 1.41 - 5.89）或入住ICU（HR 3.04；95% CI 1.01 - 9.14）。
与COVID-19并发症相关的社会人口统计学和临床因素，如年龄、性别和基础疾病，与高收入国家类似研究中报告的因素相当，可用于预测COVID-19患者的病情严重程度。
