Fraction of COVID-19 hospitalizations and deaths attributable to chronic diseases

AimTo estimate the fraction of hospitalizations and deaths from COVID-19 attributable to chronic diseases due to poor nutrition and smoking in Mexico. MethodsWe used data from the Mexican surveillance system of COVID-19. We considered six chronic diseases (obesity, COPD, hypertension, diabetes, cardiovascular disease, and chronic kidney disease) to define a multimorbidity variable: no diseases, 1 disease, 2 diseases, or 3 or more diseases. We calibrated the database using bias quantification methods to consider the undiagnosed cases of chronic diseases. To estimate the risks of hospitalization and death due to chronic diseases, we fitted Poisson regression models with robust standard errors, adjusting for possible confounders. Using these risks, we calculated attributable fractions using the population attributable fraction (PAF). ResultsChronic diseases accounted for to 25.4% (24.8%, 26.1%), 28.3% (27.8%, 28.7%) and 15.3% (14.9%,15.7%) of the hospitalizations among adults below 40 years, 40 to 59, and 60 years and older respectively (95% CI). For COVID-19-related deaths, 50.1% (48.6%, 51.5%), 40.5% (39.7%, 41.3%), and 18.7% (18.0%, 19.5%) were attributable to chronic diseases in adults under 40 years, 40 to 59, and 60 years and older, respectively. ConclusionChronic diseases linked to malnutrition and tobacco use contributed to a higher burden of hospitalization and deaths from COVID-19 in Mexico, particularly among younger adults. Medical and structural interventions to curb chronic disease incidence and facilitate disease control are urgently needed.