About: Unequal impact of structural health determinants and comorbidity on COVID-19 severity and lethality in older Mexican adults: Considerations beyond chronological aging

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About: Unequal impact of structural health determinants and comorbidity on COVID-19 severity and lethality in older Mexican adults: Considerations beyond chronological aging Goto Sponge NotDistinct Permalink

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Unequal impact of structural health determinants and comorbidity on COVID-19 severity and lethality in older Mexican adults: Considerations beyond chronological aging
Creator	Aguilar-Salinas, Carlos Antonio-Villa, Neftali Fermín-Martínez, Carlos González-Díaz, Armando Márquez-Salinas, Alejandro Paola Bahena-López, Jessica Vargas-Vázquez, Arsenio Yaxmehen Bello-Chavolla, Omar Yaxmehen, Omar García-Peña, Carmen Miguel Gutiérrez-Robledo, Luis Msci,
Source	Medline; PMC
abstract	BACKGROUND: COVID-19 has had a disproportionate impact on older adults. Mexico's population is younger, yet COVID-19’s impact on older adults is comparable to countries with older population structures. Here, we aim to identify health and structural determinants that increase susceptibility to COVID-19 in older Mexican adults beyond chronological aging. METHODS: We analyzed confirmed COVID-19 cases in older adults using data from the General Directorate of Epidemiology of Mexican Ministry of Health. We modeled risk factors for increased COVID-19 severity and mortality, using mixed models to incorporate multilevel data concerning healthcare access and marginalization. We also evaluated structural factors and comorbidity profiles compared to chronological age for COVID-19 mortality risk prediction. RESULTS: We analyzed 20,804 confirmed SARS-CoV-2 cases in adults aged ≥60 years. Male sex, smoking, diabetes, and obesity were associated with pneumonia, hospitalization and ICU admission in older adults, CKD and COPD were associated with hospitalization. High social lag indexes and access to private care were predictors of COVID-19 severity and mortality. Age was not a predictor of COVID-19 severity in individuals without comorbidities and combination of structural factors and comorbidities were better predictors of COVID-19 lethality and severity compared to chronological age alone. COVID-19 baseline lethality hazards were heterogeneously distributed across Mexican municipalities, particularly when comparing urban and rural areas. CONCLUSIONS: Structural factors and comorbidity explain excess risk for COVID-19 severity and mortality over chronological age in older Mexican adults. Clinical decision-making related to COVID-19 should focus away from chronological aging onto more a comprehensive geriatric care approach.
has issue date	2020-06-29(xsd:dateTime)
bibo:doi	10.1093/gerona/glaa163
bibo:pmid	32598450
has license	no-cc
sha1sum (hex)	fa4ae318727500c135441d638c7acfbebbb2af64
schema:url	https://doi.org/10.1093/gerona/glaa163
resource representing a document's title	Unequal impact of structural health determinants and comorbidity on COVID-19 severity and lethality in older Mexican adults: Considerations beyond chronological aging
has PubMed Central identifier	PMC7337730
has PubMed identifier	32598450
schema:publication	J Gerontol A Biol Sci Med Sci
resource representing a document's body	covid:fa4ae318727500c135441d638c7acfbebbb2af64#body_text
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