Comorbidities and the risk of death among individuals infected by COVID-19 in Espírito Santo, Brazil

Martinez, Edson Zangiacomi; Aragon, Davi Casale; Pontes, Carolina Moreira; Nunes, Altacílio Aparecido; Maciel, Ethel Leonor Noia; Jabor, Pablo; Zandonade, Eliana

doi:10.1590/0037-8682-0138-2021

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Revista da Sociedade Brasileira de Medicina Tropical

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Short Communication • Rev. Soc. Bras. Med. Trop. 54 • 2021 • https://doi.org/10.1590/0037-8682-0138-2021 copy

Comorbidities and the risk of death among individuals infected by COVID-19 in Espírito Santo, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

INTRODUCTION:

We investigated the association of self-reported comorbidities with fatality risk among individuals infected with Coronavirus disease 2019 (COVID-19) in Espírito Santo State, Brazil.

METHODS:

We included 212,620 individuals, ≥30 years old. The data were obtained from the COVID-19 panel. Kaplan-Meier curves and Cox regression model were used.

RESULTS:

COVID-19-positive individuals presenting with chronic conditions were at a higher risk of fatality than individuals without these comorbidities. Age had a significant effect on these relationships.

CONCLUSIONS:

Comorbidities were associated with an increased risk of fatality. Middle-aged people (30-59 years) with comorbidities should also be considered as a vulnerable group.

Keywords:
COVID-19; Coronavirus disease; Comorbidities; Chronic diseases; Epidemiology; Survival analysis

	Age groups	Males			Females
Comorbidity	(years)	n ^a	Pr ^b	95%CI	n ^a	Pr ^b	95%CI

Diabetes	30 - 39	32,642	1.00	(0.90 - 1.12)	38,018	1.60	(1.48 - 1.43)
	40 - 49	26,168	3.77	(3.54 - 4.01)	31,177	4.42	(4.19 - 4.65)
	50 - 59	18,532	9.42	(9.00 - 9.85)	22,748	10.63	(10.23 - 11.03)
	60 - 69	11,633	16.52	(15.85 - 17.21)	13,480	18.00	(17.36 - 18.66)
	70 - 80	5,369	20.08	(19.01 - 21.18)	5,908	23.32	(22.25 - 24.42)
	80 - 90	2,159	18.62	(17.00 - 20.33)	2,761	21.95	(20.42 - 23.54)
	>90 yr old	444	14.86	(11.69 - 18.52)	745	18.79	(16.05 - 21.79)

Obesity	30 - 39	32,631	2.28	(2.12 - 2.45)	37,986	3.08	(2.91 - 3.26)
	40 - 49	26,149	2.92	(2.72 - 3.13)	31,149	3.49	(3.29 - 3.70)
	50 - 59	18,523	2.84	(2.61 - 3.09)	22,735	3.66	(3.41 - 3.91)
	60 - 69	11,626	2.82	(2.53 - 3.14)	13,476	4.01	(3.69 - 4.36)
	70 - 80	5,363	2.59	(2.18 - 3.05)	5,900	4.39	(3.88 - 4.94)
	80 - 90	2,162	2.22	(1.64 - 2.93)	2,764	4.52	(3.78 - 5.36)
	>90 yr old	444	1.13	(0.37 - 2.61)	745	3.09	(1.97 - 4.60)

Smoking	30 - 39	32,646	1.64	(1.50 - 1.78)	38,016	0.95	(0.86 - 1.06)
	40 - 49	26,170	1.67	(1.52 - 1.84)	31,176	1.17	(1.05 - 1.30)
	50 - 59	18,532	2.08	(1.88 - 2.29)	22,748	1.58	(1.42 - 1.75)
	60 - 69	11,635	2.94	(2.64 - 3.26)	13,479	1.65	(1.44 - 1.88)
	70 - 80	5,366	3.78	(3.29 - 4.33)	5,910	1.42	(1.14 - 1.76)
	80 - 90	2,163	4.85	(3.99 - 5.85)	2,766	1.55	(1.13 - 2.09)
	>90 yr old	443	4.97	(3.14 - 7.42)	747	2.81	(1.75 - 4.27)

Kidney comorbidity	30 - 39	32,647	0.18	(0.14 - 0.24)	38,018	0.22	(0.18 - 0.27)
	40 - 49	26,172	0.39	(0.32 - 0.48)	31,179	0.38	(0.32 - 0.46)
	50 - 59	18,536	0.69	(0.58 - 0.82)	22,748	0.51	(0.42 - 0.61)
	60 - 69	11,636	1.46	(1.25 - 1.70)	13,482	0.88	(0.72 - 1.05)
	70 - 80	5,368	2.48	(2.08 - 2.93)	5,911	1.62	(1.32 - 1.98)
	80 - 90	2,161	3.79	(3.03 - 4.69)	2,766	2.46	(1.91 - 3.11)
	>90 yr old	444	4.28	(2.60 - 6.60)	747	2.14	(1.23 - 3.46)

Pulmonary comorbidity	30 - 39	32,639	1.26	(1.14 - 1.38)	38,018	2.49	(2.34 - 2.66)
	40 - 49	26,170	1.22	(1.09 - 1.36)	31,177	2.63	(2.46 - 2.81)
	50 - 59	18,529	1.49	(1.32 - 1.67)	22,744	2.87	(2.66 - 3.10)
	60 - 69	11,638	2.55	(2.27 - 2.85)	13,479	3.19	(2.90 - 3.50)
	70 - 80	5,366	4.12	(3.60 - 4.69)	5,910	4.59	(4.07 - 5.15)
	80 - 90	2,162	7.86	(6.76 - 9.08)	2,764	7.16	(6.23 - 8.19)
	>90 yr old	443	11.29	(8.49 - 14.61)	746	8.31	(6.43 - 10.53)

Cardiac comorbidity	30 - 39	32,641	4.86	(4.63 - 5.10)	38,019	5.75	(5.52 - 5.99)
	40 - 49	26,167	11.69	(11.30 - 12.09)	31,181	15.43	(15.03 - 15.84)
	50 - 59	18,531	24.04	(23.43 - 24.66)	22,747	29.04	(28.45 - 29.63)
	60 - 69	11,639	37.90	(37.02 - 38.79)	13,481	41.87	(41.03 - 42.70)
	70 - 80	5,369	48.24	(46.90 - 49.59)	5,910	52.05	(50.76 - 53.33)
	80 - 90	2,162	52.91	(50.78 - 55.04)	2,765	54.97	(53.10 - 56.84)
	>90 yr old	444	54.95	(50.19 - 59.65)	745	52.21	(48.56 - 55.85)

	Age groups	Males		Females
Comorbidity	(years)	HR	95%CI ^a	HR	95%CI ^a

Diabetes	30 - 39	16.23	(8.991 - 29.310)*	10.71	(6.033 - 19.020)*
	40 - 49	5.861	(4.228 - 8.125)*	7.451	(5.329 - 10.420)*
	50 - 59	3.609	(2.934 - 4.439)*	3.766	(2.972 - 4.771)*
	60 - 69	2.546	(2.206 - 2.939)*	2.974	(2.513 - 3.519)*
	70 - 80	1.695	(1.475 - 1.949)*	2.344	(2.001 - 2.747)*
	80 - 90	1.498	(1.257 - 1.785)*	1.757	(1.485 - 2.079)*
	>90 yr old	1.409	(0.983 - 2.010)	1.327	(0.990 - 1.779)

Obesity	30 - 39	10.35	(6.087 - 17.600)*	11.67	(7.221 - 18.800)*
	40 - 49	7.636	(5.461 - 10.680)*	7.784	(5.432 - 11.150)*
	50 - 59	3.380	(2.433 - 4.695)*	4.793	(3.541 - 6.487)*
	60 - 69	3.012	(2.346 - 3.867)*	3.517	(2.771 - 4.462)*
	70 - 80	2.373	(1.784 - 3.156)*	2.724	(2.120 - 3.499)*
	80 - 90	1.893	(1.279 - 2.802)*	1.981	(1.494 - 2.626)*
	>90 yr old	4.150	(1.697 - 10.150)*	1.172	(0.639 - 2.150)

Smoking	30 - 39	5.835	(2.692 - 12.650)*	4.062	(1.283 - 12.860)*
	40 - 49	5.685	(3.512 - 9.204)*	2.940	(1.302 - 6.641)*
	50 - 59	3.774	(2.660 - 5.356)*	3.522	(2.129 - 5.825)*
	60 - 69	2.826	(2.197 - 3.634)*	2.229	(1.426 - 3.483)*
	70 - 80	2.253	(1.796 - 2.827)*	2.219	(1.421 - 3.465)*
	80 - 90	1.924	(1.456 - 2.541)*	2.183	(1.412 - 3.375)*
	>90 yr old	1.755	(1.035 - 2.974)*	2.137	(1.221 - 3.738)*

Kidney comorbidity	30 - 39	30.41	(12.31 - 75.08)*	52.07	(26.07 - 104.00)*
	40 - 49	10.55	(5.893 - 18.90)*	12.14	(6.404 - 23.00)*
	50 - 59	6.910	(4.500 - 10.610)*	9.142	(5.526 - 15.130)*
	60 - 69	3.776	(2.821 - 5.055)*	5.250	(3.515 - 7.840)*
	70 - 80	2.537	(1.960 - 3.285)*	4.138	(3.035 - 5.641)*
	80 - 90	2.061	(1.536 - 2.765)*	2.743	(1.974 - 3.810)*
	>90 yr old	2.280	(1.295 - 4.013)*	2.043	(1.116 - 3.741)*

Pulmonary comorbidity	30 - 39	4.920	(1.993 - 12.15)*	1.796	(0.657 - 4.905)
	40 - 49	2.466	(1.162 - 5.235)*	2.808	(1.596 - 4.943)*
	50 - 59	4.012	(2.736 - 5.883)*	2.937	(1.952 - 4.420)*
	60 - 69	2.577	(1.980 - 3.353)*	1.562	(1.075 - 2.269)*
	70 - 80	2.144	(1.713 - 2.684)*	2.335	(1.813 - 3.009)*
	80 - 90	1.651	(1.302 - 2.094)*	1.553	(1.215 - 1.983)*
	>90 yr old	1.588	(1.075 - 2.346)*	1.550	(1.046 - 2.297)*

Cardiac comorbidity	30 - 39	4.802	(2.822 - 8.170)*	8.312	(5.301 - 13.04)*
	40 - 49	3.687	(2.790 - 4.871)*	4.057	(3.003 - 5.479)*
	50 - 59	2.364	(1.958 - 2.854)*	3.221	(2.572 - 4.033)*
	60 - 69	2.056	(1.791 - 2.359)*	2.298	(1.938 - 2.724)*
	70 - 80	1.643	(1.437 - 1.878)*	1.889	(1.589 - 2.233)*
	80 - 90	1.330	(1.139 - 1.553)*	1.661	(1.402 - 1.967)*
	>90 yr old	1.632	(1.213 - 2.196)*	1.446	(1.123 - 1.863)*

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[1] Corresponding author: Edson Zangiacomi Martinez. e-mail:edson@fmrp.usp.br