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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: OMAR YAXMEHEN BELLO CHAVOLLA
JESSICA PAOLA BAHENA LOPEZ
Neftali Eduardo Antonio Villa
ARSENIO VARGAS VAZQUEZ
ARMANDO GONZALEZ DIAZ
Alejandro Márquez Salinas
Carlos Alberto Fermín Martínez
J. Jesús Naveja
CARLOS ALBERTO AGUILAR SALINAS
Palabras clave : MEDICINA Y CIENCIAS DE LA SALUD;Ciencias médicas;Ciencias clínicas;Enfermedades virales;Infección por coronavirus;COVID-19;Síndrome respiratorio agudo severo;Enfermedades del sistema endócrino;Diabetes;Desordenes nutricionales;Obesidad;México;Virus diseases;Coronavirus infections;SARS-CoV-2;Severe Acute Respiratory Syndrome;Endocrine system diseases;Diabetes mellitus;Nutrition disorders;Obesity;Mexico
Fecha de publicación: 2020
Editorial : Endocrine Society & Oxford University Press
Descripción : 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.
URI : http://repositorio.inger.gob.mx/jspui/handle/20.500.12100/17215
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Journal of Clinical Endocrinology and Metabolism (1945-7197) Vol. 105 (2020).pdf3.78 MBAdobe PDFVisualizar/Abrir