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. 2025 Apr 28:15:04141.
doi: 10.7189/jogh.15.04141.

Risk factors for severe COVID-19 outcomes in LATAM countries in the post-vaccination era: an analysis of national surveillance data in Argentina, Brazil, Colombia, and Mexico

Guilherme Silva Julian #  1 , Júlia Spinardi #  2   3 , Melissa Díaz  4 , Diana Buitrago Ospina  4 , Nohemi Caballero  4 , Vinicius Goularte-Silva  5 , Moe H Kyaw  6
Affiliations

Risk factors for severe COVID-19 outcomes in LATAM countries in the post-vaccination era: an analysis of national surveillance data in Argentina, Brazil, Colombia, and Mexico

Guilherme Silva Julian et al. J Glob Health. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

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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 the following activities and relationships: drafting support for the preparation of this manuscript was provided by IQVIA and funded by Pfizer. MHK, GSJ and MHK are employees of Pfizer. The other authors do not report other relevant affiliations or financial involvement with any organisation or entity with an interest or conflict with the subject matter or materials discussed in the manuscript in addition to those disclosed.

Figures

Figure 1
Figure 1
Age and comorbidities distribution of COVID-19 confirmed, hospitalised, and deceased cases. Panel A. Number of confirmed cases by age. Panel B. Number of hospitalised cases by age. Panel C. Number of deceased cases by age. Panel D. Percentage of cases by the number of comorbidities.
Figure 2
Figure 2
Factors related to hospitalisation and death in the general ward among COVID-19 confirmed cases across countries. Panel A. Hospitaliasation in Argentina. Panel B. Hospitalisation in Brazil. Panel C. Hospitalisation in Colombia. Panel D. Hospitalisation in Mexico. Panel E. Death in Argentina. Panel F. Death in Brazil. Panel G. Death in Colombia. Panel H. Death in Mexico.
Figure 3
Figure 3
Factors related to ICU admission and the use of ventilatory support among COVID-19 confirmed cases across countries. Panel A. ICU admission in Argentina. Panel B. ICU admission in Brazil. Panel C. ICU admission in Mexico. Panel D. Use of ventilatory support in Argentina. Panel E. Use of ventilatory support in Brazil. Panel F. Use of ventilatory support in Colombia. Panel G. Use of ventilatory support in Mexico. ICU – intensive care unit
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