Predicting Mortality Due to SARS-CoV-2: A Mechanistic Score Relating Obesity and Diabetes to COVID-19 Outcomes in Mexico.

Autor:	Bello-Chavolla OY; Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.; Division of Research, Instituto Nacional de Geriatría, Mexico City, Mexico., Bahena-López JP; Plan de Estudios Comcinados en Medicina (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico., Antonio-Villa NE; Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.; Plan de Estudios Comcinados en Medicina (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico., Vargas-Vázquez A; Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.; Plan de Estudios Comcinados en Medicina (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico., González-Díaz A; Centro de Estudios en Antropología, Facultad de Ciencias Políticas y Sociales, Universidad Nacional Autónoma de México, Mexico City, Mexico., Márquez-Salinas A; Division of Research, Instituto Nacional de Geriatría, Mexico City, Mexico.; Plan de Estudios Comcinados en Medicina (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico., Fermín-Martínez CA; Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.; Plan de Estudios Comcinados en Medicina (PECEM), Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico., Naveja JJ; Department of Physicochemistry, Instituto de Química, Universidad Nacional Autónoma de México, Mexico City, Mexico., Aguilar-Salinas CA; Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.; Department of Endocrinolgy and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2020 Aug 01; Vol. 105 (8).
DOI:	10.1210/clinem/dgaa346
Abstrakt:	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. (© Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu