IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0240346.html
   My bibliography  Save this article

Physiological and socioeconomic characteristics predict COVID-19 mortality and resource utilization in Brazil

Author

Listed:
  • Salomón Wollenstein-Betech
  • Amanda A B Silva
  • Julia L Fleck
  • Christos G Cassandras
  • Ioannis Ch Paschalidis

Abstract

Background: Given the severity and scope of the current COVID-19 pandemic, it is critical to determine predictive features of COVID-19 mortality and medical resource usage to effectively inform health, risk-based physical distancing, and work accommodation policies. Non-clinical sociodemographic features are important explanatory variables of COVID-19 outcomes, revealing existing disparities in large health care systems. Methods and findings: We use nation-wide multicenter data of COVID-19 patients in Brazil to predict mortality and ventilator usage. The dataset contains hospitalized patients who tested positive for COVID-19 and had either recovered or were deceased between March 1 and June 30, 2020. A total of 113,214 patients with 50,387 deceased, were included. Both interpretable (sparse versions of Logistic Regression and Support Vector Machines) and state-of-the-art non-interpretable (Gradient Boosted Decision Trees and Random Forest) classification methods are employed. Death from COVID-19 was strongly associated with demographics, socioeconomic factors, and comorbidities. Variables highly predictive of mortality included geographic location of the hospital (OR = 2.2 for Northeast region, OR = 2.1 for North region); renal (OR = 2.0) and liver (OR = 1.7) chronic disease; immunosuppression (OR = 1.7); obesity (OR = 1.7); neurological (OR = 1.6), cardiovascular (OR = 1.5), and hematologic (OR = 1.2) disease; diabetes (OR = 1.4); chronic pneumopathy (OR = 1.4); immunosuppression (OR = 1.3); respiratory symptoms, ranging from respiratory discomfort (OR = 1.4) and dyspnea (OR = 1.3) to oxygen saturation less than 95% (OR = 1.7); hospitalization in a public hospital (OR = 1.2); and self-reported patient illiteracy (OR = 1.1). Validation accuracies (AUC) for predicting mortality and ventilation need reach 79% and 70%, respectively, when using only pre-admission variables. Models that use post-admission disease progression information reach accuracies (AUC) of 86% and 87% for predicting mortality and ventilation use, respectively. Conclusions: The results highlight the predictive power of socioeconomic information in assessing COVID-19 mortality and medical resource allocation, and shed light on existing disparities in the Brazilian health care system during the COVID-19 pandemic.

Suggested Citation

  • Salomón Wollenstein-Betech & Amanda A B Silva & Julia L Fleck & Christos G Cassandras & Ioannis Ch Paschalidis, 2020. "Physiological and socioeconomic characteristics predict COVID-19 mortality and resource utilization in Brazil," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-15, October.
    • Handle: RePEc:plo:pone00:0240346
    DOI: 10.1371/journal.pone.0240346
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0240346
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0240346&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0240346?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Daron Acemoglu & Victor Chernozhukov & Ivàn Werning & Michael D. Whinston, 2020. "A Multi-Risk SIR Model with Optimally Targeted Lockdown," CeMMAP working papers CWP14/20, Centre for Microdata Methods and Practice, Institute for Fiscal Studies.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kiran Saqib & Afaf Saqib Qureshi & Zahid Ahmad Butt, 2023. "COVID-19, Mental Health, and Chronic Illnesses: A Syndemic Perspective," IJERPH, MDPI, vol. 20(4), pages 1-13, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Christian Gollier, 2020. "Cost–benefit analysis of age‐specific deconfinement strategies," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 22(6), pages 1746-1771, December.
    2. Ichino, Andrea & Favero, Carlo A. & Rustichini, Aldo, 2020. "Restarting the economy while saving lives under Covid-19," CEPR Discussion Papers 14664, C.E.P.R. Discussion Papers.
    3. David Baqaee & Emmanuel Farhi, 2020. "Nonlinear Production Networks with an Application to the Covid-19 Crisis," NBER Working Papers 27281, National Bureau of Economic Research, Inc.
    4. Gopal K. Basak & Chandramauli Chakraborty & Pranab Kumar Das, 2021. "Optimal Lockdown Strategy in a Pandemic: An Exploratory Analysis for Covid-19," Papers 2109.02512, arXiv.org.
    5. Pablo D. Fajgelbaum & Amit Khandelwal & Wookun Kim & Cristiano Mantovani & Edouard Schaal, 2021. "Optimal Lockdown in a Commuting Network," American Economic Review: Insights, American Economic Association, vol. 3(4), pages 503-522, December.
    6. Michele Belot & Syngjoo Choi & Egon Tripodi & Eline van den Broek-Altenburg & Julian C. Jamison & Nicholas W. Papageorge, 2020. "Unequal Consequences of Covid 19 across Age and Income: Representative Evidence from Six Countries," Working Paper Series no135, Institute of Economic Research, Seoul National University.
    7. Gollier, Christian, 2021. "The Welfare Cost of Vaccine Misallocation, Delays and Nationalism," Journal of Benefit-Cost Analysis, Cambridge University Press, vol. 12(2), pages 199-226, July.
    8. Terrence Iverson & Edward Barbier, 2021. "National and Sub-National Social Distancing Responses to COVID-19," Economies, MDPI, vol. 9(2), pages 1-15, May.
    9. Chen, Simiao & Prettner, Klaus & Kuhn, Michael & Bloom, David E., 2021. "The economic burden of COVID-19 in the United States: Estimates and projections under an infection-based herd immunity approach," The Journal of the Economics of Ageing, Elsevier, vol. 20(C).
    10. Abel Brodeur & David Gray & Anik Islam & Suraiya Bhuiyan, 2021. "A literature review of the economics of COVID‐19," Journal of Economic Surveys, Wiley Blackwell, vol. 35(4), pages 1007-1044, September.
    11. Jean-Noël Barrot & Basile Grassi & Julien Sauvagnat, 2020. "Estimating the Costs and Benefits of Mandated Business Closures in a Pandemic," Working Papers hal-02896739, HAL.
    12. Darcy W. E. Allen & Chris Berg & Sinclair Davidson & Jason Potts, 2022. "On Coase and COVID-19," European Journal of Law and Economics, Springer, vol. 54(1), pages 107-125, August.
    13. La Torre, Davide & Liuzzi, Danilo & Marsiglio, Simone, 2021. "Epidemics and macroeconomic outcomes: Social distancing intensity and duration," Journal of Mathematical Economics, Elsevier, vol. 93(C).
    14. Jesper Akesson & Sam Ashworth-Hayes & Robert Hahn & Robert Metcalfe & Itzhak Rasooly, 2022. "Fatalism, beliefs, and behaviors during the COVID-19 pandemic," Journal of Risk and Uncertainty, Springer, vol. 64(2), pages 147-190, April.
    15. Marina Azzimonti-Renzo & Alessandra Fogli & Fabrizio Perri & Mark Ponder, 2020. "Pandemic Control in ECON-EPI Networks," Staff Report 609, Federal Reserve Bank of Minneapolis.
    16. Philipp Pfeiffer & Werner Roeger & Jan in ’t Veld, 2020. "The COVID19-Pandemic in the EU: Macroeconomic Transmission and Economic Policy Response," European Economy - Discussion Papers 127, Directorate General Economic and Financial Affairs (DG ECFIN), European Commission.
    17. Teresa Barbieri & Gaetano Basso & Sergio Scicchitano, 2022. "Italian Workers at Risk During the COVID-19 Epidemic," Italian Economic Journal: A Continuation of Rivista Italiana degli Economisti and Giornale degli Economisti, Springer;Società Italiana degli Economisti (Italian Economic Association), vol. 8(1), pages 175-195, March.
    18. Matthias Flückiger & Markus Ludwig, 2023. "Spatial networks and the spread of COVID-19: results and policy implications from Germany," Review of Regional Research: Jahrbuch für Regionalwissenschaft, Springer;Gesellschaft für Regionalforschung (GfR), vol. 43(1), pages 1-27, April.
    19. Decerf, Benoit & Ferreira, Francisco H.G. & Mahler, Daniel G. & Sterck, Olivier, 2021. "Lives and livelihoods: Estimates of the global mortality and poverty effects of the Covid-19 pandemic," World Development, Elsevier, vol. 146(C).
    20. Chen, Xi & Qiu, Yun & Shi, Wei & Yu, Pei, 2022. "Key links in network interactions: Assessing route-specific travel restrictions in China during the Covid-19 pandemic," China Economic Review, Elsevier, vol. 73(C).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0240346. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.