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Socioeconomic disparities associated with mortality in patients hospitalized for COVID-19 in Colombia

Socioeconomic disparities play an important role in the development of severe clinical outcomes including deaths from COVID-19. However, the current scientific evidence in regard the association between measures of poverty and COVID-19 mortality in hospitalized patients is scant. The objective of th...

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Autores principales: Mendoza Cardozo, Oscar Ignacio, Pérez Bedoya, Juan Pablo, Ruiz Galvis, Lina Marcela, Pérez Aguirre, Carlos Andrés, Rodríguez Rey, Boris Anghelo, Barengo, Noël Christopher, Cardona Jiménez, Johnatan, Díaz Valencia, Paula Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157783/
https://www.ncbi.nlm.nih.gov/pubmed/37151581
http://dx.doi.org/10.3389/fpubh.2023.1139379
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author Mendoza Cardozo, Oscar Ignacio
Pérez Bedoya, Juan Pablo
Ruiz Galvis, Lina Marcela
Pérez Aguirre, Carlos Andrés
Rodríguez Rey, Boris Anghelo
Barengo, Noël Christopher
Cardona Jiménez, Johnatan
Díaz Valencia, Paula Andrea
author_facet Mendoza Cardozo, Oscar Ignacio
Pérez Bedoya, Juan Pablo
Ruiz Galvis, Lina Marcela
Pérez Aguirre, Carlos Andrés
Rodríguez Rey, Boris Anghelo
Barengo, Noël Christopher
Cardona Jiménez, Johnatan
Díaz Valencia, Paula Andrea
author_sort Mendoza Cardozo, Oscar Ignacio
collection PubMed
description Socioeconomic disparities play an important role in the development of severe clinical outcomes including deaths from COVID-19. However, the current scientific evidence in regard the association between measures of poverty and COVID-19 mortality in hospitalized patients is scant. The objective of this study was to investigate whether there is an association between the Colombian Multidimensional Poverty Index (CMPI) and mortality from COVID-19 in hospitalized patients in Colombia from May 1, 2020 to August 15, 2021. This was an ecological study using individual data on hospitalized patients from the National Institute of Health of Colombia (INS), and municipal level data from the High-Cost Account and the National Administrative Department of Statistics. The main outcome variable was mortality due to COVID-19. The main exposure variable was the CMPI that ranges from 0 to 100% and was categorized into five levels: (i) level I (0%−20%), (ii) level II (20%−40%), (iii) level III (40%−60%), (iv) level IV (60%−80%); and (v) level V (80%−100%). The higher the level, the higher the level of multidimensional poverty. A Bayesian multilevel logistic regression model was applied to estimate Odds Ratio (OR) and their corresponding 95% credible intervals (CI). In addition, a subgroup analysis was performed according to the epidemiological COVID-19 waves using the same model. The odds for dying from COVID-19 was 1.46 (95% CI 1.4–1.53) for level II, 1.41 (95% CI 1.33–1.49) for level III and 1.70 (95% CI 1.54–1.89) for level IV hospitalized COVID-19 patients compared with the least poor patients (CMPI level I). In addition, age and male sex also increased mortality in COVID-19 hospitalized patients. Patients between 26 and 50 years-of-age had 4.17-fold increased odds (95% CI 4.07–4.3) of death compared with younger than 26-years-old patients. The corresponding for 51–75 years-old patients and those above the age of 75 years were 9.17 (95% CI 8.93–9.41) and 17.1 (95% CI 16.63–17.56), respectively. Finally, the odds of death from COVID-19 in hospitalized patients gradually decreased as the pandemic evolved. In conclusion, socioeconomic disparities were a major risk factor for mortality in patients hospitalized for COVID-19 in Colombia.
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spelling pubmed-101577832023-05-05 Socioeconomic disparities associated with mortality in patients hospitalized for COVID-19 in Colombia Mendoza Cardozo, Oscar Ignacio Pérez Bedoya, Juan Pablo Ruiz Galvis, Lina Marcela Pérez Aguirre, Carlos Andrés Rodríguez Rey, Boris Anghelo Barengo, Noël Christopher Cardona Jiménez, Johnatan Díaz Valencia, Paula Andrea Front Public Health Public Health Socioeconomic disparities play an important role in the development of severe clinical outcomes including deaths from COVID-19. However, the current scientific evidence in regard the association between measures of poverty and COVID-19 mortality in hospitalized patients is scant. The objective of this study was to investigate whether there is an association between the Colombian Multidimensional Poverty Index (CMPI) and mortality from COVID-19 in hospitalized patients in Colombia from May 1, 2020 to August 15, 2021. This was an ecological study using individual data on hospitalized patients from the National Institute of Health of Colombia (INS), and municipal level data from the High-Cost Account and the National Administrative Department of Statistics. The main outcome variable was mortality due to COVID-19. The main exposure variable was the CMPI that ranges from 0 to 100% and was categorized into five levels: (i) level I (0%−20%), (ii) level II (20%−40%), (iii) level III (40%−60%), (iv) level IV (60%−80%); and (v) level V (80%−100%). The higher the level, the higher the level of multidimensional poverty. A Bayesian multilevel logistic regression model was applied to estimate Odds Ratio (OR) and their corresponding 95% credible intervals (CI). In addition, a subgroup analysis was performed according to the epidemiological COVID-19 waves using the same model. The odds for dying from COVID-19 was 1.46 (95% CI 1.4–1.53) for level II, 1.41 (95% CI 1.33–1.49) for level III and 1.70 (95% CI 1.54–1.89) for level IV hospitalized COVID-19 patients compared with the least poor patients (CMPI level I). In addition, age and male sex also increased mortality in COVID-19 hospitalized patients. Patients between 26 and 50 years-of-age had 4.17-fold increased odds (95% CI 4.07–4.3) of death compared with younger than 26-years-old patients. The corresponding for 51–75 years-old patients and those above the age of 75 years were 9.17 (95% CI 8.93–9.41) and 17.1 (95% CI 16.63–17.56), respectively. Finally, the odds of death from COVID-19 in hospitalized patients gradually decreased as the pandemic evolved. In conclusion, socioeconomic disparities were a major risk factor for mortality in patients hospitalized for COVID-19 in Colombia. Frontiers Media S.A. 2023-03-29 /pmc/articles/PMC10157783/ /pubmed/37151581 http://dx.doi.org/10.3389/fpubh.2023.1139379 Text en Copyright © 2023 Mendoza Cardozo, Pérez Bedoya, Ruiz Galvis, Pérez Aguirre, Rodríguez Rey, Barengo, Cardona Jiménez and Díaz Valencia. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Mendoza Cardozo, Oscar Ignacio
Pérez Bedoya, Juan Pablo
Ruiz Galvis, Lina Marcela
Pérez Aguirre, Carlos Andrés
Rodríguez Rey, Boris Anghelo
Barengo, Noël Christopher
Cardona Jiménez, Johnatan
Díaz Valencia, Paula Andrea
Socioeconomic disparities associated with mortality in patients hospitalized for COVID-19 in Colombia
title Socioeconomic disparities associated with mortality in patients hospitalized for COVID-19 in Colombia
title_full Socioeconomic disparities associated with mortality in patients hospitalized for COVID-19 in Colombia
title_fullStr Socioeconomic disparities associated with mortality in patients hospitalized for COVID-19 in Colombia
title_full_unstemmed Socioeconomic disparities associated with mortality in patients hospitalized for COVID-19 in Colombia
title_short Socioeconomic disparities associated with mortality in patients hospitalized for COVID-19 in Colombia
title_sort socioeconomic disparities associated with mortality in patients hospitalized for covid-19 in colombia
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157783/
https://www.ncbi.nlm.nih.gov/pubmed/37151581
http://dx.doi.org/10.3389/fpubh.2023.1139379
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