Socioeconomic inequalities associated with mortality for COVID-19 in Colombia: a cohort nationwide study
Socioeconomic inequalities associated with mortality for COVID-19 in Colombia: a cohort nationwide study
复制标题
DOI：
10.1136/jech-2020-216275
复制
发表时间：
2021-07-01
影响因子：
6.3
通讯作者：
Fernandez-Nino, Julian Alfredo
中科院分区：
文献类型：
--
作者：
Cifuentes, Myriam Patricia;Rodriguez-Villamizar, Laura Andrea;Fernandez-Nino, Julian Alfredo
背景COVID-19大流行8个月后，拉丁美洲国家的COVID-19死亡率最高。尽管是世界上最不平等的地区之一，但很少有关于社会经济条件对他们国家COVID-19死亡率影响的报告。我们旨在确定一些社会经济不平等相关因素对哥伦比亚COVID-19死亡率的影响。方法我们对哥伦比亚2020年3月2日至2020年10月26日确诊的COVID-19病例进行了一项全国性回顾性队列研究，并进行了生存分析。我们计算了队列中每个确诊病例的死亡或康复时间。我们使用扩展的多变量时间依赖性考克斯回归模型，按年龄组、性别、种族、健康保险类型、居住地区和社会经济阶层估计HR。结果3月2日至10月26日，哥伦比亚共确诊1 033 218例COVID-19病例，死亡30 565例。确诊病例中死于COVID-19的风险男性较高（HR 1.68 95% CI 1.64 - 1.72），60岁以上人群（HR 296.58 95% CI 199.22至441.51），土著人（HR 1.20 95% CI 1.08至1.33），在享受补贴医疗保险制度的人中，（HR 1.89 95% CI 1.83至1.96）和生活在极低社会经济阶层的人（HR 1.44 95% CI 1.24至1.68）。结论我们的研究提供了COVID-19死亡率在年龄组、性别、种族、健康保险方案类型和社会经济地位方面存在社会经济不平等的证据。
Background After 8 months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. We aimed to identify the effect of some socioeconomic inequality-related factors on COVID-19 mortality in Colombia. Methods We conducted a survival analysis in a nation-wide retrospective cohort study of confirmed cases of COVID-19 in Colombia from 2 March 2020 to 26 October 2020. We calculated the time to death or recovery for each confirmed case in the cohort. We used an extended multivariable time-dependent Cox regression model to estimate the HR by age groups, sex, ethnicity, type of health insurance, area of residence and socioeconomic strata. Results There were 1 033 218 confirmed cases and 30 565 deaths for COVID-19 in Colombia between 2 March and 26 October. The risk of dying for COVID-19 among confirmed cases was higher in males (HR 1.68 95% CI 1.64 to 1.72), in people older than 60 years (HR 296.58 95% CI 199.22 to 441.51), in indigenous people (HR 1.20 95% CI 1.08 to 1.33), in people with subsidised health insurance regime (HR 1.89 95% CI 1.83 to 1.96) and in people living in the very low socioeconomic strata (HR 1.44 95% CI 1.24 to 1.68). Conclusion Our study provides evidence of socioeconomic inequalities in COVID-19 mortality in terms of age groups, sex, ethnicity, type of health insurance regimen and socioeconomic status.