The Role of Health Preconditions on COVID-19 Deaths in Portugal: Evidence from Surveillance Data of the First 20293 Infection Cases

• Published in: Journal of clinical medicine Vol. 9; no. 8; p. 2368
• Main Authors: Nogueira, Paulo Jorge, de Araújo Nobre, Miguel, Costa, Andreia, Ribeiro, Ruy M., Furtado, Cristina, Bacelar Nicolau, Leonor, Camarinha, Catarina, Luís, Márcia, Abrantes, Ricardo, Vaz Carneiro, António
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.08.2020; MDPI
• Subjects: Age; Clinical medicine; Comorbidity; Confidence intervals; Coronaviruses; COVID-19; Datasets; Diabetes; Disease; Generalized linear models; Health surveillance; Hospitalization; Intensive care; Laboratories; Mortality; Population; Public health; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; Variables; Ventilators; Portugal; China
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm9082368

Background: It is essential to study the effect of potential co-factors on the risk of death in patients infected by COVID-19. The identification of risk factors is important to allow more efficient public health and health services strategic interventions with a significant impact on deaths by COVID-19. This study aimed to identify factors associated with COVID-19 deaths in Portugal. Methods: A national dataset with the first 20,293 patients infected with COVID-19 between 1 January and 21 April 2020 was analyzed. The primary outcome measure was mortality by COVID-19, measured (registered and confirmed) by Medical Doctors serving as health delegates on the daily death registry. A logistic regression model using a generalized linear model was used for estimating Odds Ratio (OR) with 95% confidence intervals (95% CI) for each potential risk indicator. Results: A total of 502 infected patients died of COVID-19. The risk factors for increased odds of death by COVID-19 were: sex (male: OR = 1.47, ref = female), age ((56–60) years, OR = 6.01; (61–65) years, OR = 10.5; (66–70) years, OR = 20.4; (71–75) years, OR = 34; (76–80) years, OR = 50.9; (81–85) years, OR = 70.7; (86–90) years, OR = 83.2; (91–95) years, OR = 91.8; (96–104) years, OR = 140.2, ref = (0–55)), Cardiac disease (OR = 2.86), Kidney disorder (OR = 2.95), and Neuromuscular disorder (OR = 1.58), while condition (None (absence of precondition); OR = 0.49) was associated with a reduced chance of dying after adjusting for other variables of interest. Conclusions: Besides age and sex, preconditions justify the risk difference in mortality by COVID-19.