Omar Yaxmehen Bello?Chavolla|Armando González-Díaz|Neftali Eduardo Antonio?Villa|Carlos A. Fermín?Martínez|Alejandro Márquez?Salinas|Arsenio Vargas?Vázquez|Jessica Paola Bahena-López|Carmen García?Peña|Carlos A. Aguilar?Salinas|Luis Miguel Gutiérrez?Robledo
Unequal Impact of Structural Health Determinants and Comorbidity on COVID-19 Severity and Lethality in Older Mexican Adults: Considerations Beyond Chronological Aging
Instituto Nacional de Pediatria|Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán|Universidad Nacional Autónoma de México|Universidad Nacional Autónoma de México|Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán|Universidad Nacional Autónoma de México|Universidad Nacional Autónoma de México|Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán|Universidad Nacional Autónoma de México|Universidad Nacional Autónoma de México|Instituto Nacional de Pediatria|Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán|Tecnológico de Monterrey|Instituto Nacional de Pediatria
covid19 disproportionate impact older adults mexicos population younger yet covid19s impact older adults comparable countries older population structures aim identify health structural determinants increase susceptibility covid19 older mexican adults beyond chronological agingwe analyzed confirmed covid19 cases older adults using data general directorate epidemiology mexican ministry health modeled risk factors increased covid19 severity mortality using mixed models incorporate multilevel data concerning healthcare access marginalization also evaluated structural factors comorbidity profiles compared chronological age covid19 mortality risk predictionwe analyzed 20 804 confirmed sarscov2 cases adults aged 60 older male sex smoking diabetes obesity associated pneumonia hospitalization intensive care unit icu admission older adults ckd copd associated hospitalization high social lag indexes access private care predictors covid19 severity mortality age predictor covid19 severity individuals without comorbidities combination structural factors comorbidities better predictors covid19 lethality severity compared chronological age alone covid19 baseline lethality hazards heterogeneously distributed across mexican municipalities particularly comparing urban rural areasstructural factors comorbidity explain excess risk covid19 severity mortality chronological age older mexican adults clinical decisionmaking related covid19 focus away chronological aging onto comprehensive geriatric care approach