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[Risk factors for COVID-19 severe complications comparing three major epidemiological waves: An approach from primary
Pablo Francisco Oliva-Sánchez1, Felipe Vadillo-Ortega2, Rafael Bojalil-Parra3
1Universidad Autónoma Metropolitana, Unidad Xochimilco, Departamento de Atención de la Salud, Ciudad de México, México; Dirección de Investigación, Instituto Nacional de Medicina Genómica, Ciudad de México, México.
Objectives:
To describe the association between chronic noncommunicable diseases and age with hospitalization, death and severe clinical outcomes for COVID-19 in confirmed cases within the mexican population, comparing the first three epidemiological waves of the pandemic in Mexico.
Design:
We performed an analysis using Mexico's Government Epidemiological Surveillance System database for COVID-19.
Emplacement:
Mexico's Epidemiological Surveillance System for Respiratory Diseases.
Participants:
Mexican population confirmed with SARS-CoV-2 registered on Mexico's Epidemiological Surveillance System for Respiratory Diseases.
Primary Measurements:
The analysed severe outcomes were hospitalization, pneumonia, use of mechanical ventilation, intensive care unit admission and death. The association (odds ratio) between the outcomes and clinical variables was evaluated, comparing the three epidemiological waves in Mexico.
Results:
Age over 65 is associated with a higher ratio of hospitalization and pneumonia, independent of the effect of chronic comorbidities. There is an interaction between age and obesity, which is associated with hospitalization, pneumonia and highly associated with death. These findings were consistent throughout the three epidemiological waves.
Conclusion:
Obesity, COPD and diabetes in interaction with age, are associated with worse clinical outcomes and, more importantly, death in patients with COVID-19.
Insights
Older adults and those with obesity, COPD, and diabetes face higher COVID-19 risks. These chronic conditions, especially with age, significantly increase hospitalization, severe outcomes, and death, consistent across pandemic waves in Mexico.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Context:
- COVID-19 pandemic in Mexico
- Analysis of three epidemiological waves
- Utilized Mexico's Epidemiological Surveillance System for Respiratory Diseases database
Purpose:
- To determine the association between chronic noncommunicable diseases, age, and severe COVID-19 outcomes
- To compare these associations across the first three epidemiological waves in Mexico
Summary:
- Older age (>65) independently increases hospitalization and pneumonia risk
- Obesity interacts with age, elevating hospitalization, pneumonia, and significantly, death risk
- Chronic conditions (obesity, COPD, diabetes) combined with age worsen COVID-19 clinical outcomes, including mortality
Impact:
- Highlights the critical role of age and comorbidities in COVID-19 severity
- Provides evidence for targeted public health interventions for vulnerable populations in Mexico
- Findings remained consistent across different pandemic waves, underscoring persistent risk factors
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