Sex, Age, and Comorbidities Are Associated with SARS-CoV-2 Infection, COVID-19 Severity, and Fatal Outcome in a Mexican Population: A Retrospective Multi-Hospital Study

People with comorbidities and the male sex are at a higher risk of developing severe COVID-19. In the present study, we aim to investigate the associated factors for infection, severity, and death due to COVID-19 in a population from Nuevo León, México. Epidemiological COVID-19 data were collected from 65 hospitals from December 2020 to May 2022. A total of 75,232 cases were compiled from which 25,722 cases were positive for SARS-CoV-2. Male sex, older age, diabetes, obesity, and hypertension were associated with infection. In addition to the above-mentioned factors, renal disease, cardiovascular disease, and immunosuppression were found to be associated with increased COVID-19 severity. These factors, as well as neurological diseases, are also associated with death due to COVID-19. When comparing the different variants of SARs-CoV-2, the variant B1.1.519 increased the probability of death by 2.23 times compared to the AY.20 variant. Male sex, older age, diabetes, obesity, and hypertension are associated with SARS-CoV-2 infection, severity, and death. Along with the aforementioned comorbidities, renal disease, cardiovascular disease, and immunosuppression are also associated with severity and death. Another factor associated with death is the presence of neurological disease. The SARS-CoV-2 B1.1.519 variant increases the odds of death compared to the SARS-CoV-2 AY.20 variant.

[1]  M. Rosales,et al.  Two-year follow-up of the COVID-19 pandemic in Mexico , 2023, Frontiers in Public Health.

[2]  B. Singer,et al.  Comparative analyses of eighteen rapid antigen tests and RT-PCR for COVID-19 quarantine and surveillance-based isolation , 2022, Communications Medicine.

[3]  Bette C Liu,et al.  Household transmission of COVID-19 in 2020 in New South Wales, Australia. , 2022, Communicable diseases intelligence.

[4]  M. Bermúdez de León,et al.  Extension and Severity of Self-Reported Side Effects of Seven COVID-19 Vaccines in Mexican Population , 2022, Frontiers in Public Health.

[5]  J. E. Muñoz-Medina,et al.  Genetic Analysis of SARS-CoV-2 Variants in Mexico during the First Year of the COVID-19 Pandemic , 2021, Viruses.

[6]  A. Hidalgo-Miranda,et al.  The Evolutionary Landscape of SARS-CoV-2 Variant B.1.1.519 and Its Clinical Impact in Mexico City , 2021, medRxiv.

[7]  S. Gómez-García,et al.  Risk Factors for SARS-CoV-2 Infection, Pneumonia, Intubation, and Death in Northeast Mexico , 2021, Frontiers in Public Health.

[8]  Y. Kuo,et al.  Smoking and risk of COVID-19 hospitalization , 2021, Respiratory Medicine.

[9]  Amrita Mukherjee,et al.  Outcomes of COVID-19 in CKD Patients: A Multicenter Electronic Medical Record Cohort Study. , 2021, Clinical journal of the American Society of Nephrology : CJASN.

[10]  J. Margolick,et al.  Aging in COVID-19: Vulnerability, immunity and intervention , 2020, Ageing Research Reviews.

[11]  H. Peckham,et al.  Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission , 2020, Nature Communications.

[12]  Zhènglì Shí,et al.  Characteristics of SARS-CoV-2 and COVID-19 , 2020, Nature Reviews Microbiology.

[13]  Eun Sug Park,et al.  Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 , 2020, Lancet.

[14]  C. Pabelick,et al.  Sex steroids skew ACE2 expression in human airway: a contributing factor to sex differences in COVID-19? , 2020, American journal of physiology. Lung cellular and molecular physiology.

[15]  A. Pradhan,et al.  Sex differences in severity and mortality from COVID-19: are males more vulnerable? , 2020, Biology of sex differences.

[16]  U. Fresán,et al.  Independent Role of Severe Obesity as a Risk Factor for COVID‐19 Hospitalization: A Spanish Population‐Based Cohort Study , 2020, Obesity.

[17]  Ying Song,et al.  Blood pressure control and adverse outcomes of COVID-19 infection in patients with concomitant hypertension in Wuhan, China , 2020, Hypertension Research.

[18]  D. Sin,et al.  COVID-19 and COPD , 2020, European Respiratory Journal.

[19]  L. Carmona,et al.  Clinical outcomes of hospitalised patients with COVID-19 and chronic inflammatory and autoimmune rheumatic diseases: a multicentric matched cohort study , 2020, Annals of the Rheumatic Diseases.

[20]  K. Bhaskaran,et al.  OpenSAFELY: factors associated with COVID-19 death in 17 million patients , 2020, Nature.

[21]  K. Farsalinos,et al.  Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option? , 2020, Internal and Emergency Medicine.

[22]  S. Bae,et al.  Clinical characteristics of asymptomatic and symptomatic patients with mild COVID-19 , 2020, Clinical Microbiology and Infection.

[23]  J. Lessler,et al.  Estimating the burden of SARS-CoV-2 in France , 2020, Science.

[24]  Eun Ji Kim,et al.  Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. , 2020, JAMA.

[25]  Jiaofeng Huang,et al.  The impact of COPD and smoking history on the severity of COVID‐19: A systemic review and meta‐analysis , 2020, Journal of medical virology.

[26]  Bolin Wang,et al.  Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis , 2020, Aging.

[27]  C. Eastin,et al.  Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China , 2020, The Journal of Emergency Medicine.

[28]  Jiang Chang,et al.  A Multi-hospital Study in Wuhan, China：Protective Effects of Non-menopause and Female Hormones on SARS-CoV-2 infection , 2020, medRxiv.

[29]  G. Lippi,et al.  Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection , 2020, International Urology and Nephrology.

[30]  G. Lippi,et al.  Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID-19) , 2020, Respiratory Medicine.

[31]  D. Sin,et al.  ACE-2 expression in the small airway epithelia of smokers and COPD patients: implications for COVID-19 , 2020, European Respiratory Journal.

[32]  G. Onder,et al.  Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. , 2020, JAMA.

[33]  G. Lippi,et al.  Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19) , 2020, European Journal of Internal Medicine.

[34]  Hong Jiang,et al.  Coronavirus disease 2019 in elderly patients: Characteristics and prognostic factors based on 4-week follow-up , 2020, Journal of Infection.

[35]  Xin Zhou,et al.  Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China , 2020, The Journal of Emergency Medicine.

[36]  Ruchong Chen,et al.  Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China , 2020, The Lancet Oncology.

[37]  Kai Zhao,et al.  A pneumonia outbreak associated with a new coronavirus of probable bat origin , 2020, Nature.

[38]  U. Senarath,et al.  Worldwide epidemic of obesity , 2020, Obesity and Obstetrics.

[39]  R. N. Alvarado,et al.  Encuesta Nacional de Consumo de Drogas en Estudiantes 2014: Reporte de Tabaco , 2015 .

[40]  Dan Xu,et al.  Losartan attenuates chronic cigarette smoke exposure-induced pulmonary arterial hypertension in rats: Possible involvement of angiotensin-converting enzyme-2 , 2010, Toxicology and Applied Pharmacology.