Geographic factors associated with poorer outcomes in patients diagnosed with covid-19 in primary health care

Magallón-Botaya, R. (Universidad de Zaragoza) ; Oliván-Blázquez, B. (Universidad de Zaragoza) ; Ramírez-Cervantes, K.L. ; Méndez-López-de-La-manzanara, F. ; Aguilar-Palacio, I. (Universidad de Zaragoza) ; Casajuana-Closas, M. ; Andrés-Esteban, E.

Resumen: Background: The prognosis of older age COVID-19 patients with comorbidities is associated with a more severe course and higher fatality rates but no analysis has yet included factors related to the geographical area/municipality in which the affected patients live, so the objective of this study was to analyse the prognosis of patients with COVID-19 in terms of sex, age, comorbidi-ties, and geographic variables. Methods: A retrospective cohort of 6286 patients diagnosed with COVID-19 was analysed, considering demographic data, previous comorbidities and geographic variables. The main study variables were hospital admission, intensive care unit (ICU) admission and death due to worsening symptoms; and the secondary variables were sex, age, comorbidities and geographic variables (size of the area of residence, distance to the hospital and the driving time to the hospital). A comparison analysis and a multivariate Cox model were performed. Results: The multivariate Cox model showed that women had a better prognosis in any type of analysed prog-nosis. Most of the comorbidities studied were related to a poorer prognosis except for dementia, which is related to lower admissions and higher mortality. Suburban areas were associated with greater mortality and with less hospital or ICU admission. Distance to the hospital was also associated with hospital admission. Conclusions: Factors such as type of municipality and distance to hospital act as social health determinants. This fact must be taken account in order to stablish specifics prevention measures and treatment protocols.

Idioma: Inglés

DOI: 10.3390/ijerph18073842

Año: 2021

Publicado en: International journal of environmental research and public health 18, 7 (2021), 3842 [11 pp]
ISSN: 1661-7827

Factor impacto JCR: 4.614 (2021)

Categ. JCR: PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH rank: 45 / 183 = 0.246 (2021) - Q1 - T1
Categ. JCR: PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH rank: 71 / 210 = 0.338 (2021) - Q2 - T2
Categ. JCR: ENVIRONMENTAL SCIENCES rank: 100 / 279 = 0.358 (2021) - Q2 - T2

Factor impacto CITESCORE: 4.5 - Medicine (Q2) - Environmental Science (Q2)

Factor impacto SCIMAGO: 0.814 - Pollution (Q1) - Health, Toxicology and Mutagenesis (Q1)

Financiación: info:eu-repo/grantAgreement/ES/ISCIII/COV20-00519
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/COV20-00634
Financiación: info:eu-repo/grantAgreement/ES/ISCIII-RedIAPP/RD16-0007-0001
Financiación: info:eu-repo/grantAgreement/ES/ISCIII-RedIAPP/RD16-0007-0005

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Psicología Social (Dpto. Psicología y Sociología)
Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)
Área (Departamento): Área Medic.Prevent.Salud Públ. (Dpto. Microb.Ped.Radio.Sal.Pú.)