Higher coronavirus disease‑19 mortality linked to comorbidities: A comparison between low‑middle income and high‑income countries
نویسندگان
1 Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
2 Department of Community Medicine, KD Medical College, Mathura, Uttar Pradesh, India
3 Department of Community and Family Medicine, All India Institute of Medical Sciences, Guwahati, Assam, India
4 Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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چکیده
BACKGROUND: Global burden of disease (GBD) provides the estimates of mortality and morbidity,while case fatality rate (CFR) helps in understanding the severity of the disease. People infectedwith severe acute respiratory syndrome coronavirus 2 (SARS CoV‑2) with underlying medicalconditions have shown higher levels of unfavorable outcomes including mortality. We assessed theassociation of SARS‑CoV‑2 CFR with disability‑adjusted life years (DALY) of various comorbiditiesin the low‑middle income countries (LMIC) and high‑income countries (HIC) to study the relationshipof coronavirus disease‑19 (COVID‑19) mortality with GBDs and to understand the linkage betweenCOVID‑19 mortality and comorbidities.MATERIALS AND METHODS: This was an ecological study with secondary data analysis comparingthe DALY of various morbidities from GBD with CFR of COVID‑19. Gross domestic product was thebasis of stratifying 177 countries into low‑middle income (LMIC) and high‑income groups (HIC). Themortality was analyzed using Pearson correlation and linear regression.RESULTS: The median global CFR of SARS‑CoV‑2 was 2.15. The median CFR among LMIC (n = 60)and HIC (n = 117) was 2.01 (0.00–28.20) and 2.29 (0.00–17.26), respectively. The regression analysisfound that, in both LMIC and HIC, maternal disorders were associated with higher SARS‑CoV‑2CFR, while tuberculosis, mental health disorders, and were associated with lower CFR. Further, inLMIC, musculoskeletal disorders and nutritional deficiencies were associated with higher CFR, whilerespiratory disorders were associated with lower CFR.CONCLUSIONS: SARS‑CoV‑2 infection appears to be a systemic disease. Individuals withcomorbidities, such as maternal disorders, neurological diseases, musculoskeletal disorders, andnutritional deficiencies, have poorer outcomes with COVID‑19, leading to higher mortality.
