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Téllez-González MA, Pineda-Juárez JA, Suárez-Cuenca JA, Escamilla-Tilch M, Santillán-Cortez D, García S, Alcaraz-Estrada SL, Pérez-Razo JC, Delgado-Quintana CA, Vargas-Hernández J, Muñoz-López S, Escarela-Serrano M, Santosbeña-Lagunes M, Alanís-Vega A, Vázquez-Alvarado RP, Merino-Rajme JA, Mondragón-Terán P. Epidemiological Profile and Social Welfare Index as Factors Associated with COVID-19 Hospitalization and Severity in Mexico City: A Retrospective Analysis. Int J Environ Res Public Health 2022; 19:14803. [PMID: 36429525 PMCID: PMC9690264 DOI: 10.3390/ijerph192214803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/21/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
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.
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Affiliation(s)
| | | | | | - Mónica Escamilla-Tilch
- Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico
| | - Daniel Santillán-Cortez
- Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico
| | - Silvia García
- Centro Médico Nacional “20 de Noviembre”, Clinical Research Service, Mexico City 03229, Mexico
| | | | - Juan Carlos Pérez-Razo
- Centro Médico Nacional “20 de Noviembre”, Genomics Research Division, Mexico City 03229, Mexico
| | | | | | - Sandra Muñoz-López
- Centro Médico Nacional “20 de Noviembre”, COVID-19 Group, Mexico City 03229, Mexico
| | | | | | | | | | | | - Paul Mondragón-Terán
- Centro Médico Nacional “20 de Noviembre”, Coordination of Research, Mexico City 03229, Mexico
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