Julian Guilherme Silva, Spinardi Júlia, Díaz Melissa, Ospina Diana Buitrago, Caballero Nohemi, Goularte-Silva Vinicius, Kyaw Moe H
Pfizer, Evidence Generation Medical Affairs, Brazil.
Pfizer, Vaccines Medical Affairs, Brazil.
J Glob Health. 2025 Apr 28;15:04141. doi: 10.7189/jogh.15.04141.
Identifying cases at higher risk for severe COVID-19 outcomes is essential for tailoring interventions for prevention and treatment. We aimed to determine the factors related to hospitalisation, intensive care unit (ICU) admission, use of ventilatory support, and mortality in four Latin American countries.
We conducted a retrospective study using national COVID-19 surveillance databases from Argentina, Brazil, Colombia, and Mexico, covering the period from January 2021 to December 2022. We used multivariate logistic regression models to identify factors associated with hospitalisation, ICU admission, ventilatory support, and death, adjusting for confounding variables.
We included 34 955 384 confirmed cases in the analysis. Age and sex were significantly associated with increased odds of all outcomes. For hospitalisation, in cases aged >85 years, the odds ratio (OR) for hospitalisation ranged from 26.46 (95% confidence interval (CI) = 25.67-27.28) in Mexico to 2763.87 (95% CI = 2644.40-2888.73) in Brazil, and for males, it ranged from 1.42 (95% CI = 1.41-1.43) in Colombia to 1.77 (95% CI = 1.76-1.78) in Brazil. Indigenous race was significantly associated with higher odds of hospitalisation (ORs ranging from 1.26 to 1.98) and death (ORs ranging from 1.05 to 1.84). The number of comorbidities reported was related to increased odds of severe outcomes and varied across countries. The odds of death for cases with zero vaccine doses were significantly higher (ORs ranging from 1.72 to 31.73) compared to cases with two doses. Similarly, the odds of death for cases with one dose were significantly higher (ORs ranging from 1.73 to 7.00) compared to cases with two doses.
Even in a post-vaccine implementation scenario, individual factors such as age, gender, comorbidities, and race still pose a risk to severe COVID-19, which demands tailoring public health strategies for prevention and treatment.
识别新冠病毒病（COVID-19）严重后果风险较高的病例对于制定预防和治疗干预措施至关重要。我们旨在确定四个拉丁美洲国家中与住院、重症监护病房（ICU）收治、使用通气支持及死亡相关的因素。
我们利用来自阿根廷、巴西、哥伦比亚和墨西哥的全国COVID-19监测数据库进行了一项回顾性研究，涵盖2021年1月至2022年12月期间。我们使用多变量逻辑回归模型来识别与住院、ICU收治、通气支持和死亡相关的因素，并对混杂变量进行了调整。
我们在分析中纳入了34955384例确诊病例。年龄和性别与所有结局的几率增加显著相关。对于住院情况，在年龄大于85岁的病例中，住院几率比（OR）在墨西哥为26.46（95%置信区间（CI）=25.67-27.28），在巴西为2763.87（95%CI=2644.40-2888.73）；对于男性，在哥伦比亚为1.42（95%CI=1.41-1.43），在巴西为1.77（95%CI=1.76-1.78）。原住民种族与住院几率较高（OR范围为1.26至1.98）和死亡几率较高（OR范围为1.05至1.84）显著相关。报告的合并症数量与严重结局几率增加相关，且各国情况有所不同。与接种两剂疫苗的病例相比，未接种疫苗的病例死亡几率显著更高（OR范围为1.72至31.73）。同样，与接种两剂疫苗的病例相比，接种一剂疫苗的病例死亡几率显著更高（OR范围为1.73至7.00）。
即使在疫苗接种后的情况下，年龄、性别、合并症和种族等个体因素仍然对严重COVID-19构成风险，这需要制定针对性的公共卫生预防和治疗策略。
