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Geographic Factors Associated with Poorer Outcomes in Patients Diagnosed with COVID-19 in Primary Health Care

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Listed:
  • Rosa Magallón-Botaya

    (GAIAP Research Group, Institute for Health Research Aragon (IIS Aragon), 50009 Zaragoza, Spain
    Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, 50009 Zaragoza, Spain
    Research Network on Preventive Activities and Health Promotion (RedIAPP), 08007 Barcelona, Spain)

  • Bárbara Oliván-Blázquez

    (GAIAP Research Group, Institute for Health Research Aragon (IIS Aragon), 50009 Zaragoza, Spain
    Research Network on Preventive Activities and Health Promotion (RedIAPP), 08007 Barcelona, Spain
    Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain)

  • Karen Lizzette Ramírez-Cervantes

    (Department of Applied Economics, Rey Juan Carlos University, 28300 Madrid, Spain
    Bleeding Patient Research Group, Idi-Paz Research Institute, 28029 Madrid, Spain
    Prevention Department, Spanish Association against Cancer, 28040 Madrid, Spain)

  • Fátima Méndez-López-de-la-Manzanara

    (GAIAP Research Group, Institute for Health Research Aragon (IIS Aragon), 50009 Zaragoza, Spain)

  • Isabel Aguilar-Palacio

    (GAIAP Research Group, Institute for Health Research Aragon (IIS Aragon), 50009 Zaragoza, Spain
    Department of Preventive Medicine and Public Health, University of Zaragoza, 50009 Zaragoza, Spain
    GRISSA Research Group, 50009 Zaragoza, Spain)

  • Marc Casajuana-Closas

    (Research Network on Preventive Activities and Health Promotion (RedIAPP), 08007 Barcelona, Spain
    Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain)

  • Eva Andrés-Esteban

    (Department of Applied Economics, Rey Juan Carlos University, 28300 Madrid, Spain
    Bleeding Patient Research Group, Idi-Paz Research Institute, 28029 Madrid, Spain)

Abstract

Background : The prognosis of older age COVID-19 patients with comorbidities is associated with a more severe course and higher fatality rates but no analysis has yet included factors related to the geographical area/municipality in which the affected patients live, so the objective of this study was to analyse the prognosis of patients with COVID-19 in terms of sex, age, comorbidities, and geographic variables. Methods : A retrospective cohort of 6286 patients diagnosed with COVID-19 was analysed, considering demographic data, previous comorbidities and geographic variables. The main study variables were hospital admission, intensive care unit (ICU) admission and death due to worsening symptoms; and the secondary variables were sex, age, comorbidities and geographic variables (size of the area of residence, distance to the hospital and the driving time to the hospital). A comparison analysis and a multivariate Cox model were performed. Results : The multivariate Cox model showed that women had a better prognosis in any type of analysed prognosis. Most of the comorbidities studied were related to a poorer prognosis except for dementia, which is related to lower admissions and higher mortality. Suburban areas were associated with greater mortality and with less hospital or ICU admission. Distance to the hospital was also associated with hospital admission. Conclusions : Factors such as type of municipality and distance to hospital act as social health determinants. This fact must be taken account in order to stablish specifics prevention measures and treatment protocols.

Suggested Citation

  • Rosa Magallón-Botaya & Bárbara Oliván-Blázquez & Karen Lizzette Ramírez-Cervantes & Fátima Méndez-López-de-la-Manzanara & Isabel Aguilar-Palacio & Marc Casajuana-Closas & Eva Andrés-Esteban, 2021. "Geographic Factors Associated with Poorer Outcomes in Patients Diagnosed with COVID-19 in Primary Health Care," IJERPH, MDPI, vol. 18(7), pages 1-11, April.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:7:p:3842-:d:531080
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    References listed on IDEAS

    as
    1. Vageesh Jain & Jin-Min Yuan, 2020. "Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(5), pages 533-546, June.
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