Non-communicable diseases, sociodemographic vulnerability and the risk of mortality in hospitalised children and adolescents with COVID-19 in Brazil: a cross-sectional observational study.
Non-communicable diseases, sociodemographic vulnerability and the risk of mortality in hospitalised children and adolescents with COVID-19 in Brazil: a cross-sectional observational study.
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DOI：
10.1136/bmjopen-2021-050724
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发表时间：
2021-09-06
期刊：
影响因子：
2.9
通讯作者：
Ferraro AA
中科院分区：
文献类型：
--
作者：
Sousa BLA;Brentani A;Costa Ribeiro CC;Dolhnikoff M;Grisi SJFE;Ferrer APS;Ferraro AA
分析既往合并症、种族、地区和社会经济发展与住院儿童和青少年的 COVID-19 死亡率之间的关系。使用巴西卫生部公开数据进行的横断面观察研究。全国。 2020 年 1 月 1 日至 2020 年 12 月 7 日期间，共有 5857 名 20 岁以下的患者入院，他们均因实验室确诊的 COVID-19 住院。我们使用多级混合效应广义线性模型来研究院内死亡率，按年龄、国家地区、非传染性疾病存在情况、种族和社会经济发展情况进行分层分析。就个体而言，大多数纳入的合并症都是死亡的危险因素。值得注意的是，哮喘是一个保护因素（OR 0.4，95% CI 0.24 至 0.67）。患有一种以上的合并症使死亡几率几乎增加十倍（OR 9.67，95% CI 6.89 至 13.57）。与白人儿童相比，原住民、帕尔多族（混血）和东亚人的死亡率显着较高（分别为 OR 5.83，95% CI 2.43 至 14.02；OR 1.93，95% CI 1.48 至 2.51；OR 2.98，95% CI 1.02 至 8.71）。我们还发现了区域影响（北部死亡率较高 — OR 3.4，95% CI 2.48 至 4.65）和社会经济关联（来自社会经济较发达城市的儿童死亡率较低 — OR 0.26，95% CI 0.17 至 0.38）。除了与合并症相关外，我们还发现种族、地区和社会经济因素影响了巴西因 COVID-19 住院儿童的死亡率。我们的研究结果确定了儿童中的风险群体，应优先考虑采取疫苗接种等公共卫生措施。
To analyse how previous comorbidities, ethnicity, regionality and socioeconomic development are associated with COVID-19 mortality in hospitalised children and adolescents. Cross-sectional observational study using publicly available data from the Brazilian Ministry of Health. Nationwide. 5857 patients younger than 20 years old, all of them hospitalised with laboratory-confirmed COVID-19, from 1 January 2020 to 7 December 2020. We used multilevel mixed-effects generalised linear models to study in-hospital mortality, stratifying the analysis by age, region of the country, presence of non-communicable diseases, ethnicity and socioeconomic development. Individually, most of the included comorbidities were risk factors for mortality. Notably, asthma was a protective factor (OR 0.4, 95% CI 0.24 to 0.67). Having more than one comorbidity increased almost tenfold the odds of death (OR 9.67, 95% CI 6.89 to 13.57). Compared with white children, Indigenous, Pardo (mixed) and East Asian had significantly higher odds of mortality (OR 5.83, 95% CI 2.43 to 14.02; OR 1.93, 95% CI 1.48 to 2.51; OR 2.98, 95% CI 1.02 to 8.71, respectively). We also found a regional influence (higher mortality in the North—OR 3.4, 95% CI 2.48 to 4.65) and a socioeconomic association (lower mortality among children from more socioeconomically developed municipalities—OR 0.26, 95% CI 0.17 to 0.38) Besides the association with comorbidities, we found ethnic, regional and socioeconomic factors shaping the mortality of children hospitalised with COVID-19 in Brazil. Our findings identify risk groups among children that should be prioritised for public health measures, such as vaccination.
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DOI：
10.1016/s0140-6736(17)30402-6
发表时间：
2017-03-04
期刊：
Lancet (London, England)
影响因子：
--
作者：
Mendenhall E;Kohrt BA;Norris SA;Ndetei D;Prabhakaran D
通讯作者：
Prabhakaran D
影响因子：
168.9
作者：
Singer, Merrill;Bulled, Nicola;Mendenhall, Emily
通讯作者：
Mendenhall, Emily
影响因子：
34.3
作者：
Baqui, Pedro;Bica, Ioana;van der Schaar, Mihaela
通讯作者：
van der Schaar, Mihaela
影响因子：
4.7
作者：
Santos, Ricardo Ventura;Borges, Gabriel Mendes;Welch, James R.
通讯作者：
Welch, James R.
影响因子：
3.9
作者：
Palamim CVC;Ortega MM;Marson FAL
通讯作者：
Marson FAL