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. 2022 Nov 8:12:05038.
doi: 10.7189/jogh.12.05038.

Probability of hospitalisation and death among COVID-19 patients with comorbidity during outbreaks occurring in Mexico City

José Sifuentes-Osornio #  1 , Ofelia Angulo-Guerrero #  2 , Guillermo De Anda-Jáuregui #  3   4 , Juan L Díaz-De-León-Santiago  2 , Enrique Hernández-Lemus  3   4 , Héctor Benítez-Pérez  5 , Luis A Herrera  3   6 , Oliva López-Arellano  2 , Arturo Revuelta-Herrera  5 , Ana R Rosales-Tapia  7 , Manuel Suárez-Lastra  7 , David Kershenobich  1 , Rosaura Ruiz-Gutiérrez  2   8
Affiliations

Probability of hospitalisation and death among COVID-19 patients with comorbidity during outbreaks occurring in Mexico City

José Sifuentes-Osornio et al. J Glob Health. .

Abstract

Background: We compared the probability of hospitalization and death caused by COVID-19 in patients with comorbidities during three periods defined for this study: first-wave (FW), interwave period (IP), and second-wave (SW) observed in Mexico City.

Methods: In this registry-based study, we included individuals over 20 years of age. During the FW (symptomatic), the IP, and the SW (symptomatic and asymptomatic), participants were diagnosed using nasopharyngeal swabs. Symptomatic individuals with risk factors for serious disease or death were referred to the hospital. SARS-CoV-2 infection was defined by RT-qPCR in all hospitalized patients. All data were added to the SISVER database. Bayesian analysis and False Discovery Rate were used for further evaluation.

Results: The study included 2 260 156 persons (mean age of 43.1 years). Of these, 8.6% suffered from DM, 11.6% arterial hypertension, and 9.7% obesity. Of the total, 666 694 persons tested positive (29.5%). Of the infected persons, a total of 85 587 (12.8%) were hospitalized: 24 023 in the FW; 16 935 in the IP, and 44 629 in the SW. Of the hospitalized patients, there were 42 979 deaths (50.2%), in the FW, 11 964 (49.8%), in the IP, 6794 (40.1%), and in the SW 24 221 (54.3%). The probability of death among individuals hospitalized with or without comorbidities increased consistently in all age groups. A significant increase in the Fatality Rate was observed in individuals with comorbidities (1.36E-19< = FDR< = 3.36E-2). A similar trend was also observed in individuals without comorbidities (1.03E-44< = FDR< = 5.58E-4).

Conclusions: The data from this study show a considerable increase in the number of detected cases of infection between the FW and SW. In addition, 12.8% of those infected were hospitalized for severe COVID-19. A high mortality rate was observed among hospitalized patients (>50%). An age-dependent probability of death was observed with a positive trend in hospitalized patients with and without comorbidities.

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Conflict of interest statement

Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no conflicts of interest.

Figures

Figure 1
Figure 1
An increase in the number of hospitalizations was observed with age group.
Figure 2
Figure 2
A) Global lethality probability of COVID-19 patients by age group and period and B) Mortality probability of hospitalized COVID-19 patients by age group and period using Bayes probability test.
Figure 3
Figure 3
A) Mortality probability of hospitalized COVID-19 patients with diabetes mellitus by age group and period, B) Mortality probability of hospitalized COVID-19 patients with diabetes mellitus by age group and period, and C) Mortality probability of hospitalized COVID-19 patients with hypertension by age group and period using Bayes probability test.
Figure 4
Figure 4
Pearson correlation between weekly case fatality rate (CFR) for hospitalized patients and hospital occupancy. Lethality increases during periods of higher transmission and demand for hospitalization. It was observed that lethality across all age groups decreased as hospital occupation improved at the end of the first wave and increased again during the second wave.
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