ABSTRACT
Background: The coronavirus disease 2019 (COVID-19) pandemic is a serious health problem. The Mexican adult population has a high prevalence of obesity and chronic diseases that increase the risk of dying from this disease. Objective: To identify comorbidities predicting the risk of mortality at 30 days in hospitalized adult subjects with positive laboratory COVID-19 test and to evaluate the interaction between chronic diseases and gender. Material and methods: A retrospective cohort study was conducted in 2020, in a western region of the Mexican Pacific. Data from 51,135 hospitalized patients with positive COVID-19 test were analyzed and were retrieved from a normative system for the epidemiological surveillance of viral respiratory diseases (SINOLAVE, according to its initials in Spanish). Death within the first 30 days from hospital admission was the main outcome and risk ratios (RR) with 95% confidence intervals (95% CI) were calculated. Results: The overall mortality rate was 49.6% and most of the comorbidities analyzed were associated with a higher risk of death. There were significant interactions between gender and obesity (p = 0.003) and chronic kidney disease (p = 0.019). The effect of obesity on the risk of a fatal outcome varied by gender: female, RR = 1.04 (95% CI 1.03-1.07);male, RR = 1.07 (95% CI: 1.06-1.09). Conclusions: A high mortality was observed among the hospitalized patients analyzed and statistically significant factors associated with their risk were identified (gender, obesity, and kidney disease).