Risk Factors for Mortality of Adult Patients With COVID-19: A Two-Year Cohort Study in a Private Tertiary Care Center in Mexico (preprint)

During the COVID-19 pandemic, the high prevalence of comorbidities in Mexico, as well as the disparities between public and private health subsystems, substantially contributed to the severe impact it had in the country. The objective of this study was to evaluate and compare risk factors present at admission for mortality of hospitalized patients with COVID-19. A 2-year retrospective cohort study of hospitalized adult patients with COVID-19 was conducted at a private tertiary care center. The study population consisted of 1,258 patients with a median age of 56 ± 16.5 years, of whom 1,093 recovered (86.8%) and 165 died (13.1%). In the univariate analysis, older age (p <0.001), comorbidities such as hypertension (p <0.001) and diabetes (p <0.001), signs and symptoms of respiratory distress, and markers of acute inflammatory response were significantly more frequent in non-survivors. The multivariate analysis showed that older age (p <0.001), the presence of cyanosis (p 0.005) and previous myocardial infarction (p 0.032) were independent predictors for mortality. In the studied cohort, risk factors present at admission associated with an increased risk of death were older age, cyanosis and a previous myocardial infarction, which can be used as valuable predictors for patients’ outcomes. To our knowledge, this is the first study analyzing predictors of mortality in COVID-19 patients attended on a private tertiary hospital in Mexico.

Preventive measures against the COVID-19 pandemic in Mexico: A cross-sectional study (preprint)

Background: In December 2019, the World Health Organization announced a new viral pneumonia due to SARS-CoV-2, which originated in Wuhan, China. In Mexico, the official announcement regarding the first coronavirus disease 2019 (COVID-19) case was made on February 29, 2020. Understanding how Mexicans behave during the pandemic could present a complete picture of the pandemic in Mexico while providing better handling of the pandemic. Methods: : This was a cross-sectional survey in which we inquired about the Mexican population's behavior and preventive measures. In total, 4004 subjects from the general population responded to the survey. The survey comprised a questionnaire that included demographic data, housing conditions, daily coexistence with people, use of preventive measures, confidence in the Mexican health-care sector, acceptance of medical procedures, and knowledge of COVID-19. Results: : Participants' mean age was 30 ± 13.7 years, and 43.8% of participants reported at least one comorbidity. Almost 99% of the participants mentioned knowing the symptoms of COVID-19. Moreover, 68.1% of them lived with three to five cohabitants, and 87.4% of them stated that at least one household member had to break social isolation every week. Although 77.5% of participants considered that they followed proper social distancing measures, 60% of them mentioned that they knew at least six individuals who did not follow social distancing measures. Furthermore, 96.2% of participants reported using preventive measures at least 50% of the time. Face masks were used by 99.5% of them, but only 51.3% used a certified mask. Conclusions: : The COVID-19 pandemic outcomes in Mexico are the result of multiple negative factors, such as high rates of comorbidities (e.g., diabetes and hypertension); a high number of people living together at home, with many people breaking social isolation; and most of the population using noncertified preventive measures, which may not have the necessary effectiveness.