Epidemiology and risk factors for death in leptospirosis: A 20-year retrospective cohort study in Brazil

Leptospirosis, a zoonotic disease caused by Leptospira, is prevalent in tropical areas like Brazil. This study aimed to describe the demographics, outcomes, and mortality risk factors in leptospirosis patients in Brazil.

We conducted a retrospective cohort study using data from the Brazilian DATASUS database (2001-2020) to evaluate outcomes in individuals diagnosed with leptospirosis. Cases were confirmed through clinical and laboratory criteria. Risk factors for mortality were assessed using both univariate and multivariate regression analyses.

Of 64,963 patients, 80.2% were male, and 10.6% experienced all-cause mortality. Some of the risk factors for mortality included respiratory symptoms (OR 3.23), age >60 (OR 2.07), jaundice (OR 1.75), and renal insufficiency (OR 2.07).

Leptospirosis remains a significant health burden in Brazil, especially for young adult males. This study highlights critical risk and protective factors, which may inform targeted interventions and public health policies. Future research should explore non-binary classifications of variables to improve the understanding of leptospirosis mortality determinants.