Mortality and survival of COVID-19

Epidemiol Infect. 2020 Jun 25:148:e123. doi: 10.1017/S0950268820001405.

Abstract

This study aims to identify the risk factors associated with mortality and survival of COVID-19 cases in a state of the Brazilian Northeast. It is a historical cohort with a secondary database of 2070 people that presented flu-like symptoms, sought health assistance in the state and tested positive to COVID-19 until 14 April 2020, only moderate and severe cases were hospitalised. The main outcome was death as a binary variable (yes/no). It also investigated the main factors related to mortality and survival of the disease. Time since the beginning of symptoms until death/end of the survey (14 April 2020) was the time variable of this study. Mortality was analysed by robust Poisson regression, and survival by Kaplan-Meier and Cox regression. From the 2070 people that tested positive to COVID-19, 131 (6.3%) died and 1939 (93.7%) survived, the overall survival probability was 87.7% from the 24th day of infection. Mortality was enhanced by the variables: elderly (HR 3.6; 95% CI 2.3-5.8; P < 0.001), neurological diseases (HR 3.9; 95% CI 1.9-7.8; P < 0.001), pneumopathies (HR 2.6; 95% CI 1.4-4.7; P < 0.001) and cardiovascular diseases (HR 8.9; 95% CI 5.4-14.5; P < 0.001). In conclusion, mortality by COVID-19 in Ceará is similar to countries with a large number of cases of the disease, although deaths occur later. Elderly people and comorbidities presented a greater risk of death.

Keywords: Brazil; COVID-19; epidemiology; mortality; survival.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Brazil / epidemiology
  • COVID-19
  • Cardiovascular Diseases / complications
  • Cohort Studies
  • Comorbidity
  • Coronavirus Infections / complications
  • Coronavirus Infections / mortality*
  • Diabetes Complications / complications
  • Female
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Kaplan-Meier Estimate
  • Kidney Diseases / complications
  • Lung Diseases / complications
  • Male
  • Middle Aged
  • Nervous System Diseases / complications
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / mortality*
  • Poisson Distribution
  • Proportional Hazards Models
  • Risk Factors
  • Sex Factors
  • Time Factors