Skip to content
2000
image of Risk factors for Mortality in Patients with COVID-19 in Cuernavaca- Morelos

Abstract

Background

The world changed in December 2019 due to respiratory tract infection cases, initially of unknown etiology, later known as COVID-19.

Objective

This study aimed to determine the factors and comorbidities associated with mortality from COVID-19 in Mexico.

Methods

It was a cross-sectional and observational prospective study of patients treated at an IMSS (Mexican Institute of Social Security) Hospital in Morelos with a confirmed diagnosis of COVID-19. Logistic regression models and survival analyses were developed to identify factors associated with mortality risk.

Results

3,965 patients were analyzed, with most deaths occurring in men. The mortality risks were higher in men who were older than 50 years. The most significant associations were: age older than 80 years (HR:3.17), endotracheal intubation (HR:1.54), dyspnea (HR: 13.55), and polypnea (HR:1.54).

Conclusion

The risk of death in this population was high, considering the absence of primary protective measures at the beginning of the pandemic and the lack of consistency in using personal protection elements.

Loading

Article metrics loading...

/content/journals/crmr/10.2174/011573398X336783250117111654
2025-01-22
2025-04-25
Loading full text...

Full text loading...

References

  1. Fricke-Galindo I. Falfán-Valencia R. Genetics insight for covid-19 susceptibility and severity: A review. Front. Immunol. 2021 12 622176 10.3389/fimmu.2021.622176 33868239
    [Google Scholar]
  2. Sharma A. Ahmad Farouk I. Lal S.K. COVID-19: A review on the novel coronavirus disease evolution, transmission, detection, control and prevention. Viruses 2021 13 2 202 10.3390/v13020202 33572857
    [Google Scholar]
  3. Hu B. Guo H. Zhou P. Shi Z.L. Characteristics of SARS-CoV-2 and COVID-19. Nat. Rev. Microbiol. 2021 19 3 141 154 10.1038/s41579‑020‑00459‑7 33024307
    [Google Scholar]
  4. Huang C. Wang Y. Li X. Ren L. Zhao J. Hu Y. Zhang L. Fan G. Xu J. Gu X. Cheng Z. Yu T. Xia J. Wei Y. Wu W. Xie X. Yin W. Li H. Liu M. Xiao Y. Gao H. Guo L. Xie J. Wang G. Jiang R. Gao Z. Jin Q. Wang J. Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 395 10223 497 506 10.1016/S0140‑6736(20)30183‑5 31986264
    [Google Scholar]
  5. Li Q. Guan X. Wu P. Wang X. Zhou L. Tong Y. Ren R. Leung K.S.M. Lau E.H.Y. Wong J.Y. Xing X. Xiang N. Wu Y. Li C. Chen Q. Li D. Liu T. Zhao J. Liu M. Tu W. Chen C. Jin L. Yang R. Wang Q. Zhou S. Wang R. Liu H. Luo Y. Liu Y. Shao G. Li H. Tao Z. Yang Y. Deng Z. Liu B. Ma Z. Zhang Y. Shi G. Lam T.T.Y. Wu J.T. Gao G.F. Cowling B.J. Yang B. Leung G.M. Feng Z. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N. Engl. J. Med. 2020 382 13 1199 1207 10.1056/NEJMoa2001316 31995857
    [Google Scholar]
  6. Bogoch I Watts A Thomas A Huber C Kraemer M Khan K Pneumonia of unknown etiology in Wuhan, China: Potential for international spread via commercial air travel. J. Trav. Med. 2020 10.1093/jtm/taaa008
    [Google Scholar]
  7. Vincent J.L. Taccone F.S. Understanding pathways to death in patients with COVID-19. Lancet Respir. Med. 2020 8 5 430 432 10.1016/S2213‑2600(20)30165‑X 32272081
    [Google Scholar]
  8. Wang W. Tang J. Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J. Med. Virol. 2020 92 4 441 447 10.1002/jmv.25689 31994742
    [Google Scholar]
  9. Bauchner H. Sharfstein J. A bold response to the Covid-19 pandemic: Medical students, national service, and public health. JAMA 2020 323 18 1790 1791 10.1001/jama.2020.6166 32267488
    [Google Scholar]
  10. Sanche S. Lin Y.T. Xu C. Romero-Severson E. Hengartner N. Ke R. High contagiousness and rapid spread of severe acute respiratory syndrome coronavirus 2. Emerg. Infect. Dis. 2020 26 7 1470 1477 10.3201/eid2607.200282 32255761
    [Google Scholar]
  11. World Health Organization Modes of transmission of virus causing Covid-19: Implications for IPC precaution recommendations. 2020 Available from: https://www.who.int/ news-room/commentaries/detail/modes-of-transmission-of-virus-causingCovid-19-implications-for-ipc-precaution-recommendations
  12. Liu Y. Gu Z. Xia S. Shi B. Zhou X.N. Shi Y. Liu J. What are the underlying transmission patterns of COVID-19 outbreak? An age-specific social contact characterization. EClinicalMedicine 2020 22 100354 10.1016/j.eclinm.2020.100354 32313879
    [Google Scholar]
  13. Li Y. Wang J.X. Chen X. Can a toilet promote virus transmission? From a fluid dynamics perspective. Phys. Fluids 2020 32 6 065107 10.1063/5.0013318 32574232
    [Google Scholar]
  14. Rothan H.A. Byrareddy S.N. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J. Autoimmun. 2020 109 102433 10.1016/j.jaut.2020.102433 32113704
    [Google Scholar]
  15. Du Toit A. Outbreak of a novel coronavirus. Nat. Rev. Microbiol. 2020 18 3 123 10.1038/s41579‑020‑0332‑0 31988490
    [Google Scholar]
  16. Wang D. Hu B. Hu C. Zhu F. Liu X. Zhang J. Wang B. Xiang H. Cheng Z. Xiong Y. Zhao Y. Li Y. Wang X. Peng Z. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020 323 11 1061 1069 10.1001/jama.2020.1585 32031570
    [Google Scholar]
  17. Zhao S. Lin Q. Ran J. Musa S.S. Yang G. Wang W. Lou Y. Gao D. Yang L. He D. Wang M.H. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak. Int. J. Infect. Dis. 2020 92 214 217 10.1016/j.ijid.2020.01.050 32007643
    [Google Scholar]
  18. Parra-Bracamonte G.M. Lopez-Villalobos N. Parra-Bracamonte F.E. Clinical characteristics and risk factors for mortality of patients with COVID-19 in a large data set from Mexico. Ann. Epidemiol. 2020 52 93 98.e2 10.1016/j.annepidem.2020.08.005 32798701
    [Google Scholar]
  19. Munayco C. Chowell G. Tariq A. Undurraga E.A. Mizumoto K. Risk of death by age and gender from CoVID-19 in Peru, March- May, 2020. Aging 2020 12 14 13869 13881 10.18632/aging.103687 32692724
    [Google Scholar]
  20. Antonelli M. Penfold R.S. Merino J. Sudre C.H. Molteni E. Berry S. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the covid symptom study app: A prospective, community-based, nested, case-control study. Lancet Infect Dis. 2022 22 1 43 55 10.1016/S1473‑3099(21)00460‑6
    [Google Scholar]
  21. Brosh-Nissimov T. Orenbuch-Harroch E. Chowers M. Elbaz M. Nesher L. Stein M. Maor Y. Cohen R. Hussein K. Weinberger M. Zimhony O. Chazan B. Najjar R. Zayyad H. Rahav G. Wiener-Well Y. BNT162b2 vaccine breakthrough: Clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel. Clin. Microbiol. Infect. 2021 27 11 1652 1657 10.1016/j.cmi.2021.06.036 34245907
    [Google Scholar]
  22. Hippisley-Cox J. Coupland C.A.C. Mehta N. Keogh R.H. Diaz-Ordaz K. Khunti K. Lyons R.A. Kee F. Sheikh A. Rahman S. Valabhji J. Harrison E.M. Sellen P. Haq N. Semple M.G. Johnson P.W.M. Hayward A. Nguyen-Van-Tam J.S. Risk prediction of covid-19 related death and hospital admission in adults after covid-19 vaccination: National prospective cohort study. BMJ 2021 374 n2244 10.1136/bmj.n2244 34535466
    [Google Scholar]
  23. McKeigue P. McAllister D. Robertson C. Hutchinson S. McGurnaghan S. Stockton D. Efficacy of two doses of COVID-19 vaccine against severe COVID-19 in those with risk conditions and residual risk to the clinically extremely vulnerable: The REACT-SCOT case-control study. medRxiv 2021 2021.09.13.21262360 10.1101/2021.09.13.21262360
    [Google Scholar]
  24. Meyerowitz E.A. Richterman A. Gandhi R.T. Sax P.E. Transmission of SARS-CoV-2: A review of viral, host, and environmental factors. Ann. Intern. Med. 2021 174 1 69 79 10.7326/M20‑5008 32941052
    [Google Scholar]
  25. Du R.H. Liang L.R. Yang C.Q. Wang W. Cao T.Z. Li M. Guo G.Y. Du J. Zheng C.L. Zhu Q. Hu M. Li X.Y. Peng P. Shi H.Z. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: A prospective cohort study. Eur. Respir. J. 2020 55 5 2000524 10.1183/13993003.00524‑2020 32269088
    [Google Scholar]
  26. Neri S. Barranco G. León M. Tovar S. Rendón M. Flores M. Predictive factors of death in patients with influenza A H1N1 pneumonia. Med Int Mex. 2011 27 5 421 428
    [Google Scholar]
  27. Padilla-Raygoza N. Navarro-Olivos E. Gallardo-Luna M.J. Magos-Vázquez F.J. Díaz-Martínez D.A. Sandoval-Salazar C. Díaz-Becerril L.A. Clinical data, comorbidities, and mortality of covid-19 in the state of guanajuato, mexico until may 20, 2020. Cent. Asian J. Glob. Health 2020 9 1 e527 10.5195/cajgh.2020.527 35866097
    [Google Scholar]
  28. Hoffmann M. Kleine-Weber H. Schroeder S. Krüger N. Herrler T. Erichsen S. Schiergens T.S. Herrler G. Wu N.H. Nitsche A. Müller M.A. Drosten C. Pöhlmann S. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020 181 2 271 280.e8 10.1016/j.cell.2020.02.052 32142651
    [Google Scholar]
  29. Leung C. Risk factors for predicting mortality in elderly patients with COVID-19: A review of clinical data in China. Mech. Ageing Dev. 2020 188 111255 10.1016/j.mad.2020.111255 32353398
    [Google Scholar]
  30. Yang J. Hu J. Zhu C. Obesity aggravates COVID-19: A systematic review and meta-analysis. J. Med. Virol. 2021 93 1 257 261 10.1002/jmv.26237 32603481
    [Google Scholar]
  31. Song J. Zeng M. Wang H. Qin C. Hou H.Y. Sun Z.Y. Xu S.P. Wang G.P. Guo C.L. Deng Y.K. Wang Z.C. Ma J. Pan L. Liao B. Du Z.H. Feng Q.M. Liu Y. Xie J.G. Liu Z. Distinct effects of asthma and COPD comorbidity on disease expression and outcome in patients with COVID-19. Allergy 2021 76 2 483 496 10.1111/all.14517 32716553
    [Google Scholar]
  32. COVID-19 Guide for the care of critically ill patients with SARS- CoV-2 infection Mexican College of Critical Care Medicine. Crit. Care Med. 2020 33 1 7 42 10.35366/93279
    [Google Scholar]
  33. Wan Y. Shang J. Sun S. Tai W. Chen J. Geng Q. He L. Chen Y. Wu J. Shi Z. Zhou Y. Du L. Li F. Molecular mechanism for antibody-dependent enhancement of coronavirus entry. J. Virol. 2020 94 5 e02015-19 10.1128/JVI.02015‑19 31826992
    [Google Scholar]
  34. Arentz M. Yim E. Klaff L. Lokhandwala S. Riedo F.X. Chong M. Lee M. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020 323 16 1612 1614 10.1001/jama.2020.4326 32191259
    [Google Scholar]
  35. Hernández-Galdamez D.R. González-Block M.Á. Romo-Dueñas D.K. Lima-Morales R. Hernández-Vicente I.A. Lumbreras-Guzmán M. Méndez-Hernández P. Increased risk of hospitalization and death in patients with covid-19 and pre-existing noncommunicable diseases and modifiable risk factors in Mexico. Arch. Med. Res. 2020 51 7 683 689 10.1016/j.arcmed.2020.07.003 32747155
    [Google Scholar]
  36. Martos-Benítez F.D. Soler-Morejón C.D. García-del Barco D. Chronic comorbidities and clinical outcomes in patients with and without COVID-19: A large population-based study using national administrative healthcare open data of Mexico. Intern. Emerg. Med. 2021 16 6 1507 1517 10.1007/s11739‑020‑02597‑5 33411264
    [Google Scholar]
  37. Peeples L. Avoiding pitfalls in the pursuit of a COVID-19 vaccine. Proc. Natl. Acad. Sci. USA 2020 117 15 8218 8221 10.1073/pnas.2005456117 32229574
    [Google Scholar]
  38. Fu Y. Cheng Y. Wu Y. Understanding SARS-CoV-2-mediated inflammatory responses: From mechanisms to potential therapeutic tools. Virol. Sin. 2020 35 3 266 271 10.1007/s12250‑020‑00207‑4 32125642
    [Google Scholar]
  39. Jin Y. Yang H. Ji W. Wu W. Chen S. Zhang W. Duan G. Virology, epidemiology, pathogenesis, and control of covid-19. Viruses 2020 12 4 372 10.3390/v12040372 32230900
    [Google Scholar]
  40. Liu K. Chen Y. Lin R. Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J. Infect. 2020 80 6 e14 e18 10.1016/j.jinf.2020.03.005 32171866
    [Google Scholar]
  41. Kim T. Improving preparedness for and response to coronavirus disease 19 (covid-19) in long-term care hospitals in Korea. Infect. Chemother. 2020 52 2 133 141 10.3947/ic.2020.52.2.133 32406211
    [Google Scholar]
  42. Yang X Yu Y Xu J Shu H Xia J Liu H Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir Med. 2020 May 8 5 475 481 10.1016/S2213‑2600(20)30079‑5
    [Google Scholar]
  43. Bedolla-Barajas M. Morales-Romero J. Bedolla-Pulido T.R. Meza-López C. Robles-Figueroa M. Pulido-Guillén N.A. Orozco-Alatorre L.G. Andrade-Castellanos C.A. Low prevalence of asthma in Mexican children and adults with a positive rtRT-PCR test for SARS-CoV-2: A cross-sectional study during the 2020 pandemic. Allergol. Immunopathol. 2021 49 3 1 7 10.15586/aei.v49i3.7 33938182
    [Google Scholar]
  44. Kammar-García A. Vidal-Mayo J.J. Vera-Zertuche J.M. Lazcano- Hernández M. Vera-López O. Segura-Badilla O. Aguilar-Alonso P. Navarro-Cruz A.R. Impact of comorbidities in mexican sars-cov-2-positive patients: A retrospective analysis in a national cohort. Rev. Invest. Clin. 2020 72 3 151 158 10.24875/RIC.20000207 32584330
    [Google Scholar]
  45. Bello-Chavolla O.Y. Bahena-López J.P. Antonio-Villa N.E. Vargas-Vázquez A. González-Díaz A. Márquez-Salinas A. Fermín-Martínez C.A. Naveja J.J. Aguilar-Salinas C.A. Predicting mortality due to SARS-CoV-2: A mechanistic score relating obesity and diabetes to covid-19 outcomes in Mexico. J. Clin. Endocrinol. Metab. 2020 105 8 2752 2761 10.1210/clinem/dgaa346 32474598
    [Google Scholar]
  46. Jordan R.E. Adab P. Cheng K.K. Covid-19: Risk factors for severe disease and death. BMJ 2020 368 m1198 10.1136/bmj.m1198 32217618
    [Google Scholar]
  47. Zheng F. Liao C. Fan Q. Chen H. Zhao X. Xie Z. Li X. Chen C. Lu X. Liu Z. Lu W. Chen C. Jiao R. Zhang A. Wang J. Ding X. Zeng Y. Cheng L. Huang Q. Wu J. Luo X. Wang Z. Zhong Y. Bai Y. Wu X. Jin R. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr. Med. Sci. 2020 40 2 275 280 10.1007/s11596‑020‑2172‑6 32207032
    [Google Scholar]
  48. Tagarro A. Epalza C. Santos M. Sanz-Santaeufemia F.J. Otheo E. Moraleda C. Calvo C. Screening and severity of coronavirus disease 2019 (covid-19) in children in Madrid, Spain. JAMA Pediatr. 2020 e201346 10.1001/jamapediatrics.2020.1346 32267485
    [Google Scholar]
  49. Sawalha A.H. Zhao M. Coit P. Lu Q. Epigenetic dysregulation of ACE2 and interferon-regulated genes might suggest increased COVID-19 susceptibility and severity in lupus patients. Clin. Immunol. 2020 215 108410 10.1016/j.clim.2020.108410 32276140
    [Google Scholar]
  50. National center for immunization and respiratory diseases (NCIRD), division of viral diseases. 2023 Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html
  51. Diaz D.P. Description of COVID-19 mortality in three Latin American countries: Colombia, Argentina and Mexico 2020-2021. Available from: https://repository.javeriana.edu.co/handle/10554/64643
  52. Cepal - OPS The prolongation of the health crisis and its impact on health, the economy and social development. 2021 Available from: https://www.cepal.org/es/publicaciones/47301-la-prolongacion-la-crisis-sanitaria-su-impacto-la-salud-la-economia-desarrollo
  53. Abrams E.M. Szefler S.J. COVID-19 and the impact of social determinants of health. Lancet Respir. Med. 2020 8 7 659 661 10.1016/S2213‑2600(20)30234‑4 32437646
    [Google Scholar]
  54. Mena G.E. Martinez P.P. Mahmud A.S. Marquet P.A. Buckee C.O. Santillana M. Socioeconomic status determines COVID-19 incidence and related mortality in Santiago, Chile. Science 2021 372 6545 eabg5298 10.1126/science.abg5298 33906968
    [Google Scholar]
  55. Zhang P. Wei M. Jing P. Li Z. Li J. Zhu F. COVID-19 in children: Epidemic issues and candidate vaccines. Chin. Med. J. 2022 135 11 1314 1324 10.1097/CM9.0000000000002169 35830254
    [Google Scholar]
  56. Najjar-Debbiny R. Gronich N. Weber G. Khoury J. Amar M. Stein N. Goldstein L.H. Saliba W. Effectiveness of paxlovid in reducing severe coronavirus disease 2019 and mortality in high-risk patients. Clin. Infect. Dis. 2023 76 3 e342 e349 10.1093/cid/ciac443 35653428
    [Google Scholar]
  57. Mirbeyk M. Saghazadeh A. Rezaei N. Geriatrics and COVID-19. Adv. Exp. Med. Biol. 2021 1318 209 222 10.1007/978‑3‑030‑63761‑3_13 33973181
    [Google Scholar]
  58. Senkal N. Bahat G. Medetalibeyoglu A. Cebeci T. Deniz D. Catma Y. Oren M.M. Caparali E.B. Bayrakdar S. Basaran S. Kose M. Erelel M. Karan M.A. Tukek T. Comparison of clinical characteristics and outcome measures of PCR-positive and PCR-negative patients diagnosed as COVID-19: Analyses focusing on the older adults. Exp. Gerontol. 2022 170 111998 10.1016/j.exger.2022.111998 36341785
    [Google Scholar]
  59. Kalaiselvan P. Yingchoncharoen P. Thongpiya J. Motes A. Nugent K. Covid-19 infections and inflammatory markers in patients hospitalized during the first year of the pandemic. J. Prim. Care Community Health 2023 14 21501319231206911 10.1177/21501319231206911 37864436
    [Google Scholar]
  60. La-Beck N.M. Lee Y.R. Patel J. Yang H. Stout M. Kologey A. Ruesewald A. Alvarez C.A. Clinical characteristics and patterns of immune responses in covid-19 patients from a rural community hospital. Cureus 2024 16 6 e61600 10.7759/cureus.61600 38962589
    [Google Scholar]
/content/journals/crmr/10.2174/011573398X336783250117111654
Loading
/content/journals/crmr/10.2174/011573398X336783250117111654
Loading

Data & Media loading...


  • Article Type:
    Research Article
Keywords: SARS CoV 2 ; Cuernavaca ; Mexico ; risk factors ; mortality ; COVID-19
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test