Advances in Rheumatology (Oct 2024)

Socioeconomic factors and COVID-19 mortality in immune-mediated rheumatic diseases patients: regional analysis from Argentina, Mexico and Brazil

  • Marco Ulises Martinez-Martinez,
  • Carolina Ayelen Isnardi,
  • Deshiré Alpizar-Rodriguez,
  • Guillermo Javier Pons-Estel,
  • Belén María Virasoro,
  • María Agustina Alfaro,
  • Ingrid Petkovic,
  • Rosana Quintana,
  • Guillermo Berbotto,
  • María Jezabel Haye Salinas,
  • Sofía Ornella,
  • Mariana Pera,
  • Iris Jazmín Colunga-Pedraza,
  • Fedra Irazoque-Palazuelos,
  • Greta Reyes-Cordero,
  • Tatiana S Rodriguez-Reyna,
  • Jose Antonio Veloz-Aranda,
  • Cassandra Michele Skinner-Taylor,
  • Ingrid Maribel Juárez-Mora,
  • Luis H. Silveira,
  • Claudia Diniz Lopes Marques,
  • Ricardo Machado Xavier,
  • Adriana Maria Kakehasi,
  • Ana Paula Gomides,
  • Edgard Torres dos Reis-Neto,
  • Gecilmara Salviato Pileggi,
  • Gilda Aparecida Ferreira,
  • Licia Maria Henrique da Mota,
  • Marcelo Medeiros Pinheiro,
  • Débora Cerqueira Calderaro

DOI
https://doi.org/10.1186/s42358-024-00418-3
Journal volume & issue
Vol. 64, no. 1
pp. 1 – 15

Abstract

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Abstract Background SARS-CoV-2 infection has become a major international issue, not only from a medical point of view, but also social, economic and political. Most of the available information comes from the United States, Europe, and China, where the population and the socioeconomic status are very different from Latin American countries. This study evaluates the effect of regional socioeconomic characteristics on mortality due SARS-CoV-2 infection in patients with immune-mediated rheumatic diseases (IMRD) from Argentina, Mexico and Brazil. Methods Data from three national registries, SAR-COVID (Argentina), CMR-COVID (Mexico) and ReumaCoV-Brasil (Brazil), were combined. Adult IMRD patients with SARS-CoV-2 infection were recruited. National data for each province/state, including population density, number of physicians per inhabitant, income, unemployment, GINI index, Municipal Human Development Index (MHDI), stringency index, vaccination rate and most frequent viral strains per period were assessed as risk factors for mortality due to COVID-19. Results A total of 4744 patients were included, 2534 (53.4%) from SAR-COVID, 1166 (24.6%) from CMRCOVID and 1044 (22.0%) from ReumaCoV-Brasil. Mortality due to COVID-19 was 5.4%. In the multivariable analysis, higher number of physicians per 1000 inhabitants and being infected during the vaccination period of each country were associated with lower mortality. After adjustment for socioeconomic factors, there was no association with country of residence and mortality. Conclusion These findings corroborate the complex interplay between socioeconomic factors, rheumatic disease activity, and regional disparities as determinants of death due to COVID-19 in Argentina, Brazil and Mexico. Thus, this research provides valuable insights for guiding public health policies and clinical practice in the ongoing fight against the COVID-19 pandemic.

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