• Hector Najera and Ana G Ortega-Avila.
• Programme for Development Studies (PUED), National Autonomous University of Mexico, Mexico City, Mexico; University of Bristol, Bristol, United Kingdom. Electronic address: pthen@bristol.ac.uk.
• Am J Prev Med. 2021 Apr 1; 60 (4): 471-477.

IntroductionSeveral studies in developed and developing countries have analyzed the health risk factors associated with COVID-19 mortality. Comorbid diseases are a key explanatory factor behind COVID-19 mortality, but current studies treat comorbidities in isolation, at average-population values, and rarely assess how death risk varies for different health profiles across institutions. Estimating death risk variations for different interactions between comorbid diseases and across healthcare institutions is crucial to gaining a significant depth of understanding in relation to mortality during the pandemic.MethodsThis study relies on data from approximately half a million people in Mexico (of all recorded cases through August 15, 2020) and on Bayesian estimation to provide a more robust estimate of the combined effect of several comorbidities and institutional inequalities on COVID-19 mortality.ResultsThe findings of the study illustrate the additive effects of several comorbid diseases, with the presence of obesity, diabetes, hypertension, and chronic kidney disease increasing the mortality risk of COVID-19. There are also variations in the risk of death across the heterogeneous Mexican health system.ConclusionsThis study shows that COVID-19 mortality risk sharply increases in patients with 2 or more comorbid diseases (obesity, diabetes, hypertension, and cardiovascular diseases) in Mexico. However, death risk varied significantly across institutions for patients with the same comorbidity profile.Copyright © 2020. Published by Elsevier Inc.

43 keywords...

hide…