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Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico

Bello-Chavolla, Omar Yaxmehen ; Bahena-López, Jessica Paola ; Antonio-Villa, Neftali Eduardo ; Vargas-Vázquez, Arsenio ; González-Díaz, Armando ; Márquez-Salinas, Alejandro ; Fermín-Martínez, Carlos A ; Naveja, J Jesús ; Aguilar-Salinas, Carlos A

The journal of clinical endocrinology and metabolism, 2020-08, Vol.105 (8), p.2752-2761 [Periódico revisado por pares]

US: Oxford University Press

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Título:
Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico
Autor: Bello-Chavolla, Omar Yaxmehen ; Bahena-López, Jessica Paola ; Antonio-Villa, Neftali Eduardo ; Vargas-Vázquez, Arsenio ; González-Díaz, Armando ; Márquez-Salinas, Alejandro ; Fermín-Martínez, Carlos A ; Naveja, J Jesús ; Aguilar-Salinas, Carlos A
Assuntos: Adult ; Age Factors ; Aged ; Betacoronavirus ; China ; Chronic kidney failure ; Comorbidity ; Coronavirus Infections - immunology ; Coronavirus Infections - mortality ; COVID-19 ; Databases, Factual ; Diabetes Mellitus - mortality ; Disease Susceptibility ; Epidemiology ; Female ; Health aspects ; Hospitalization - statistics & numerical data ; Humans ; Hypertension ; Immunocompromised Host ; Immunotherapy ; Lung diseases ; Male ; Mediation ; Medical research ; Medicine, Experimental ; Mexico ; Mexico - epidemiology ; Middle Aged ; Mortality ; Obesity ; Obesity - mortality ; Pandemics ; Pneumonia, Viral - immunology ; Pneumonia, Viral - mortality ; Prognosis ; Proportional Hazards Models ; Pulmonary Disease, Chronic Obstructive - mortality ; Renal Insufficiency, Chronic - mortality ; Risk Assessment - methods ; Risk Factors ; SARS-CoV-2 ; Sex Factors ; Type 2 diabetes
É parte de: The journal of clinical endocrinology and metabolism, 2020-08, Vol.105 (8), p.2752-2761
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SourceType-Scholarly Journals-1
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Descrição: Abstract Background The SARS-CoV-2 outbreak poses a challenge to health care systems due to its high complication rates in patients with cardiometabolic diseases. Here, we identify risk factors and propose a clinical score to predict COVID-19 lethality, including specific factors for diabetes and obesity, and its role in improving risk prediction. Methods We obtained data of confirmed and negative COVID-19 cases and their demographic and health characteristics from the General Directorate of Epidemiology of the Mexican Ministry of Health. We investigated specific risk factors associated to COVID-19 positivity and mortality and explored the impact of diabetes and obesity on modifying COVID-19-related lethality. Finally, we built a clinical score to predict COVID-19 lethality. Results Among the 177 133 subjects at the time of writing this report (May 18, 2020), we observed 51 633 subjects with SARS-CoV-2 and 5,332 deaths. Risk factors for lethality in COVID-19 include early-onset diabetes, obesity, chronic obstructive pulmonary disease, advanced age, hypertension, immunosuppression, and chronic kidney disease (CKD); we observed that obesity mediates 49.5% of the effect of diabetes on COVID-19 lethality. Early-onset diabetes conferred an increased risk of hospitalization and obesity conferred an increased risk for intensive care unit admission and intubation. Our predictive score for COVID-19 lethality included age ≥ 65 years, diabetes, early-onset diabetes, obesity, age < 40 years, CKD, hypertension, and immunosuppression and significantly discriminates lethal from non-lethal COVID-19 cases (C-statistic = 0.823). Conclusions Here, we propose a mechanistic approach to evaluate the risk for complications and lethality attributable to COVID-19, considering the effect of obesity and diabetes in Mexico. Our score offers a clinical tool for quick determination of high-risk susceptibility patients in a first-contact scenario.
Editor: US: Oxford University Press
Idioma: Inglês

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Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico

Bello-Chavolla, Omar Yaxmehen ; Bahena-López, Jessica Paola ; Antonio-Villa, Neftali Eduardo ; Vargas-Vázquez, Arsenio ; González-Díaz, Armando ; Márquez-Salinas, Alejandro ; Fermín-Martínez, Carlos A ; Naveja, J Jesús ; Aguilar-Salinas, Carlos A

US: Oxford University Press

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