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Fatores associados a maior risco de ocorrência de óbito por COVID-19: análise de sobrevivência com base em casos confirmados

Maria Helena Rodrigues Galvão, Ângelo Giuseppe Roncalli

2020Revista Brasileira de Epidemiologia103 citationsDOIOpen Access PDF

Abstract

OBJECTIVE: To perform a survival analysis of individuals diagnosed with COVID-19 identified by health information systems, analyzing the factors associated with the highest risk of death. METHODS: Survival analysis of individuals notified with COVID-19 in Rio Grande do Norte State using data from the Health Information Systems for the surveillance of cases of and deaths from COVID-19. The dependent variable was the period until the outcome occurrence. The independent variables were sex, self-reported skin color, age group, residence in the capital, and the presence of comorbidities. For data analysis the Kaplan-Meyer method and Cox-time-dependent Regression Model for multivariate analysis were used, with the covariable "period since the event notification recorded in days". RESULTS: Highest risk of death were observed in individuals aged 80 or older (HR = 8.06; p < 0.001), male (HR = 1.45, p < 0.001), non-white skin color (HR = 1.13; p < 0.033) or with no information (HR = 1.29; p < 0.001), with comorbidities (HR = 10.44; p < 0.001) or presence of comorbidities not reported (HR = 10.87; p < 0.001). CONCLUSION: The highest risk of occurrence of deaths from COVID-19 was observed in older adults, especially those over 80, patients who have comorbidities, men, and of non-white skin color. From the identification of the profile of patients with a higher risk of death with the identification by the health system, specific strategies of health care must be taken to prevent the evolution to death in these cases.

Topics & Concepts

MedicineProportional hazards modelMultivariate analysisResidenceDemographyCoronavirus disease 2019 (COVID-19)Internal medicineDiseaseInfectious disease (medical specialty)SociologyCOVID-19 and healthcare impactsEducation during COVID-19 pandemicCOVID-19 Clinical Research Studies