Analysis of Fatality of Cases by the New Coronavirus, in the Mexican State of Guanajuato: A Cross-sectional Study

Aims: COVID-19 has been a big public health challenge around the world in the past several months. The aim of this study is to describe the epidemic and report of fatality of confirmed cases of COVID-19 in the Mexican state of Guanajuato, until October 2, 2020.

Study Design: Cross-sectional, quantitative, analytical study.

Place and Duration of Study: Registries of confirmed cases for COVID-19 in Mexican population from January until October 2, 2020, from National System of Epidemiological Surveillance/ General Direction of Epidemiology/ Secretary of Health, Mexico.

Methodology: Based on the National Epidemiological Surveillance System Database from Mexico was used in this study. Data were collected on age, sex, comorbidities (i.e., diabetes, chronic obstructive pulmonary disease, asthma, hypertension, cardiovascular disease, immunosuppression, chronic kidney disease, obesity, and smoking), date of death, and real-time reverse transcription polymerase test results. Statistical analyses used were Case Fatality Ratio, Chi- squared test and P-value to show relationships among variables. Odds Ratio and confidence intervals at 95% were reported to show the effect of comorbidities on death due to COVID-19. Also, a Bayesian network model was fitted to assess the statistical dependence among risk factors, comorbidities, and death.

Results: There were 100,109 suspected cases, of which 41.69% were positive for SARS-CoV-2. Being older than 60 and male had a higher effect on fatality by COVID-19. In Guanajuato state, 1,457 (48.68%) of deaths occurred in Mexican Institute of Social Security, with a case fatality ratio of 15.63%; meanwhile, in the Ministry of Health from Guanajuato State occurred 1,260 (42.10%) of the deaths with a case fatality ratio of 4.14%. Diabetes (OR 5.16, CI95% 4.77–5.59), chronic obstructive pulmonary disease (OR 6.34, CI95% 5.37–7.49), immunosuppression (OR 2.85, CI95% 2.17–3.76), cardiovascular disease (OR 4.20, CI95% 3.51–5.02), hypertension (OR 4.74, CI95% 4.39–5.11), chronic kidney disease (OR 6.27, CI95% 5.30–7.42), obesity (OR 1.87, CI95% 1.72–2.03), and smoking (OR 1.60, CI95% 1.41–1.81) had effect on death by COVID-19. Asthma had a preventive effect on death (OR=0.72, CI95% 0.54–0.97), but this effect is diluted after adjusting by sex and age. In all cases, age and sex, acted as confounder.

Conclusion: Among the Guanajuato population with COVID-19, the main risk factor for dying were age and sex. However, diabetes, chronic obstructive pulmonary disease, immunosuppression, cardiovascular disease, chronic kidney disease, obesity, and smoking are risk factors for dying. Although, comorbidities and risk factors are highly correlated. HIV/AIDS has no effect on fatality from SARS-CoV-2 disease and whereas asthma shows to be a protective factor.