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Review
. 2022;30(5):1189-1195.
doi: 10.1007/s10389-020-01397-7. Epub 2020 Oct 19.

A multivariate analysis of risk factors associated with death by Covid-19 in the USA, Italy, Spain, and Germany

Alexandre de Fátima Cobre  1 , Beatriz Böger  1 , Raquel de Oliveira Vilhena  2 , Mariana Millan Fachi  1 , Josiane Marlei Muller Fernandes Dos Santos  1 , Fernanda Stumpf Tonin  1
Affiliations
Review

A multivariate analysis of risk factors associated with death by Covid-19 in the USA, Italy, Spain, and Germany

Alexandre de Fátima Cobre et al. Z Gesundh Wiss. 2022.

Abstract

Aim: Our aim was to investigate the risk factors associated with death from COVID-19 in four countries: The USA, Italy, Spain, and Germany.

Subject and methods: We used data from the Institute for Health Metrics and Evaluation with projection information from January-August 2020. A multivariate analysis of logistic regression was performed. The following factors were analyzed (per day): number of beds needed for the hospital services, number of intensive care units (ICU) beds required, number of ventilation devices, number of both hospital and ICU admissions due to COVID-19. Nagelkerke's R2 coefficient of determination was used to evaluate the model's predictive ability. The quality of the model's fit was assessed by the Hosmer-Lemeshow and the chi-square tests.

Results: Among the evaluated countries, Italy presented greater need for ICU beds/day (≤ 98; OR = 2315.122; CI 95% [334.767-16,503.502]; p < 0.001) and daily ventilation devices (≤ 118; OR = 1784.168; CI 95% [250.217-12,721.995]; p < 0.001). It is expected that both Italy and Spain have a higher ICU admission rate due to COVID-19 (n = 14/day). Spain will need more beds/day (≤ 357; OR = 146.838; CI 95% [113.242-190.402]; p < 0.001) and probably will have a higher number of daily hospital admissions (n = 48/day). All the above-mentioned factors have an important impact on patients' mortality due to COVID-19 in all four countries.

Conclusions: Further investments in hospitals' infrastructure, as well as the development of innovative devices for patient's ventilation, are paramount to fight the pandemic in the USA, Italy, Spain, and Germany.

Keywords: COVID-19; Germany; Italy; Risk factors; Spain; USA.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

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