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. 2022 Nov 10;19(22):14803.
doi: 10.3390/ijerph192214803.

Epidemiological Profile and Social Welfare Index as Factors Associated with COVID-19 Hospitalization and Severity in Mexico City: A Retrospective Analysis

Mario Antonio Téllez-González  1 , Juan Antonio Pineda-Juárez  1 , Juan Antonio Suárez-Cuenca  2 , Mónica Escamilla-Tilch  1 , Daniel Santillán-Cortez  1 , Silvia García  2 , Sofía Lizeth Alcaraz-Estrada  3 , Juan Carlos Pérez-Razo  3 , Carlos Alberto Delgado-Quintana  4 , Joel Vargas-Hernández  4 , Sandra Muñoz-López  4 , Maricela Escarela-Serrano  4 , Maribel Santosbeña-Lagunes  4 , Alejandro Alanís-Vega  4 , Ricardo Platón Vázquez-Alvarado  4 , José Alfredo Merino-Rajme  4 , Paul Mondragón-Terán  1
Affiliations

Epidemiological Profile and Social Welfare Index as Factors Associated with COVID-19 Hospitalization and Severity in Mexico City: A Retrospective Analysis

Mario Antonio Téllez-González et al. Int J Environ Res Public Health. .

Abstract

Epidemiological data indicate that Mexico holds the 19th place in cumulative cases (5506.53 per 100,000 inhabitants) of COVID-19 and the 5th place in cumulative deaths (256.14 per 100,000 inhabitants) globally and holds the 4th and 3rd place in cumulative cases and deaths in the Americas region, respectively, with Mexico City being the most affected area. Several modifiable and non-modifiable risk factors have been linked to a poor clinical outcome in COVID-19 infection; however, whether socioeconomic and welfare factors are associated with clinical outcome has been scanty addressed. This study tried to investigate the association of Social Welfare Index (SWI) with hospitalization and severity due to COVID-19. A retrospective analysis was conducted at the Centro Médico Nacional "20 de Noviembre"-ISSSTE, based in Mexico City, Mexico. A total of 3963 patients with confirmed or suspected COVID-19, registered from March to July 2020, were included, retrieved information from the Virology Analysis and Reference Unit Database. Demographic, symptoms and clinical data were analyzed, as well as the SWI, a multidimensional parameter based on living and household conditions. An adjusted binary logistic regression model was performed in order to compare the outcomes of hospitalization, mechanical ventilation requirement (MVR) and mortality between SWI categories: Very high (VHi), high (Hi), medium (M) and low (L). The main findings show that lower SWI were independently associated with higher probability for hospital entry: VHi vs. Hi vs. M vs. L-SWI (0 vs. +0.24 [OR = 1.24, CI95% 1.01-1.53] vs. +0.90 [OR = 1.90, CI95% 1.56-2.32] vs. 0.73 [OR = 1.73, CI95% 1.36-2.19], respectively); Mechanical Ventilation Requirement: VHi vs. M vs. L-SWI (0 vs. +0.45 [OR = 1.45, CI95% 1.11-1.87] vs. +0.35 [OR = 1.35, CI95% 1.00-1.82]) and mortality: VHi vs. Hi vs. M (0 vs. +0.54 [OR = 1.54, CI95% 1.22-1.94] vs. +0.41 [OR = 1.41, CI95% 1.13-1.76]). We concluded that SWI was independently associated with the poor clinical outcomes in COVID-19, beyond demographic, epidemiological and clinical characteristics.

Keywords: COVID-19; Mexico; healthcare disparities; social welfare; socioeconomic factors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Total COVID-19 cases (n, %) and COVID-19 cases per 100,00 inhabitants in the 16 majors in Mexico City and by Social Welfare Index.
Figure 2
Figure 2
Flow chart of the data entering in the analysis.
Figure 3
Figure 3
Exponential growth and cumulative cases related to positive (RT-PCR test) and suspected COVID-19 cases: (A) represents total cases included from Mexico City and (B) represents the number of cases per 100,000 inhabitants, between March–July 2020.
Figure 4
Figure 4
Exponential growth of COVID-19 cases per major divided by SWI categories and per 100,000 inhabitants, between March–July 2020. (A)—Low-SWI, (B)—Medium-SWI, (C)—High-SWI, (D)—Very High-SWI.
See this image and copyright information in PMC

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