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Risk factors associated with severe COVID-19 outcomes in Jamaica: a cross-sectional study of national surveillance
Karen Webster-Kerr1, Andriene Grant1, Ardene Harris1
1Ministry of Health and Wellness Kingston Jamaica Ministry of Health and Wellness, Kingston, Jamaica.
Insights
COVID-19 disproportionately affected males and older individuals in Jamaica, with increased risk of severe disease and death starting at age 40. Geographic region also influenced COVID-19 mortality outcomes.
Area of Science:
- Epidemiology
- Public Health
Background:
- COVID-19 (Coronavirus Disease 2019) has posed a significant global health challenge.
- Understanding demographic and regional risk factors is crucial for effective public health interventions.
Purpose of the Study:
- To characterize COVID-19 cases and outcomes in Jamaica.
- To identify risk factors associated with severe COVID-19.
Main Methods:
- Cross-sectional analysis of national surveillance data (March-December 2020).
- Utilized World Health Organization case definitions.
- Employed Chi-square, Fisher exact, and logistic regression analyses.
Main Results:
- 12,169 COVID-19 cases analyzed; 4.2% severe disease, 62.1% mortality among severe cases.
- Severe disease associated with male sex (OR 1.4) and age ≥40 (OR 6.5).
- Mortality linked to male sex (OR 1.4), age ≥40 (OR 17.9), and Western Health Region.
Conclusions:
- COVID-19 cases skewed younger and female; deaths skewed older and male.
- Age 40+ and male sex are significant risk factors for severe COVID-19 and death.
- Geographic variations in mortality highlight regional disparities in health outcomes.
Objectives:
To describe the characteristics and outcomes of COVID-19 cases in Jamaica and to explore the risk factors associated with severe COVID-19 from 9 March to 31 December 2020.
Methods:
A cross-sectional analysis of national surveillance data was conducted using confirmed COVID-19 cases in Jamaica. Definitions of a confirmed case, disease severity, and death were based on World Health Organization guidelines. Chi-square and Fisher exact tests were used to determine association with outcomes. Logistic regression models were used to determine predictors of severe COVID-19.
Results:
This analysis included 12 169 cases of COVID-19 (median age, 36 years; 6 744 females [ 55.4%]) of which 512 cases (4.2%) presented with severe disease, and of those, 318 patients (62.1%) died (median age at death, 71.5 years). Severe disease was associated with being male (OR 1.4; 95% CI, 1.2-1.7) and 40 years or older (OR, 6.5; 95% CI, 5.1-8.2). COVID-19 death was also associated with being male (OR, 1.4; 95% CI, 1.1-1.7), age 40 years or older (OR, 17.9; 95% CI, 11.6-27.7), and in the Western versus South East Health Region (OR 1.7; 95% CI, 1.2-2.3).
Conclusions:
The findings of this cross-sectional analysis indicate that confirmed cases of COVID-19 in Jamaica were more likely to be female and younger individuals, whereas COVID-19 deaths occurred more frequently in males and older individuals. There is increased risk of poor COVID-19 outcomes beginning at age 40, with males disproportionately affected. COVID-19 death also varied by geographic region. This evidence could be useful to other countries with similar settings and to policymakers charged with managing outbreaks and health.
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