Los determinantes sociales y las comorbilidades preexistentes se asocian con la COVID-19 sintomática en un área urbana brasileña.
DOI:
https://doi.org/10.61164/7hmc0n71Palabras clave:
COVID-19Resumen
OBJETIVO: Identificar los determinantes socioeconómicos y las comorbilidades asociadas con la presencia de síntomas de COVID-19 en Fortaleza, Ceará, Brasil.
MÉTODOS: Estudio transversal, basado en una encuesta domiciliaria de base poblacional, realizado entre junio y noviembre de 2020, con una muestra representativa de participantes con diagnóstico confirmado de SARS-CoV-2.
RESULTADOS: Un total de 897 de 1.541 individuos (58,2%) presentó síntomas. Los factores asociados con la enfermedad sintomática fueron: sexo femenino (Razón de Prevalencia [RP] = 1,215; IC95%: 1,098–1,344), edad entre 20–39 años (RP = 1,312; IC95%: 1,170–1,471) y entre 40–59 años (RP = 1,173; IC95%: 1,052–1,308), e ingreso familiar de hasta un salario mínimo (RP = 1,384; IC95%: 1,051–1,821). Las comorbilidades como hipertensión, diabetes, asma, enfermedad respiratoria crónica y enfermedad cardíaca (RP entre 1,34 y 1,54) mostraron asociación significativa con la presentación sintomática. Se observó un mayor porcentaje de casos sintomáticos entre personas indígenas. En el análisis multivariado, el sexo femenino (Odds Ratio ajustada [ORa] = 1,23; IC95%: 1,07–1,41) y las condiciones clínicas hipertensión (ORa = 1,52; IC95%: 1,12–2,06), diabetes (ORa = 1,49; IC95%: 1,00–2,21), asma (ORa = 2,34; IC95%: 1,21–4,50), enfermedades respiratorias crónicas (ORa = 3,23; IC95%: 1,23–8,42), enfermedad cardíaca (ORa = 1,99; IC95%: 1,07–3,70) y otras comorbilidades (ORa = 1,99; IC95%: 1,07–3,70) se asociaron de forma independiente con la enfermedad sintomática.
CONCLUSIÓN: La asociación entre las desigualdades socioeconómicas y las enfermedades preexistentes con la presencia de síntomas en pacientes con COVID-19 refuerza la necesidad de políticas públicas orientadas a la reducción de inequidades en las poblaciones con mayor riesgo.
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ALBUQUERQUE, Mariana Veras de; RIBEIRO, Luiz Henrique Lima. Inequality, geographic situation, and meanings of action in the COVID-19 pandemic in Brazil. Cadernos de Saúde Pública, Rio de Janeiro, v. 36, n. 12, e00208720, 2021.
BAQUI, Pedro et al. Comparing COVID-19 risk factors in Brazil using machine learning. Scientific Reports, London, v. 11, art. 15591, 2021.
BAREK, Md. Ahsanul et al. Impact of age, sex and comorbidities on COVID-19 severity. Heliyon, Amsterdam, v. 6, e05684, 2020.
BRASIL. Ministério da Saúde. COVID-19. Brasília, 2025.
CANGUSSÚ, Luciana Rodrigues et al. Primary health care and COVID-19 dispersion in Northeast Brazil. PLoS ONE, San Francisco, v. 19, n. 3, e0296837, 2024.
GARCÍA-AZORÍN, David et al. Headache in COVID-19: a systematic review and meta-analysis. Scientific Reports, London, v. 11, art. 14674, 2021.
GRACEY, Michael; KING, Malcolm. Indigenous health part 1: determinants and disease patterns. The Lancet, London, v. 374, n. 9683, p. 65–75, 2009.
GUEDES, Mariana Bezerra de Oliveira Guedes et al. COVID-19 in Brazilian cities: impact of social determinants. PLoS ONE, San Francisco, v. 16, n. 9, e0257347, 2021.
HUYSSER, Kelsey R. et al. Social vulnerabilities and Indigenous peoples: implications for COVID-19. International Journal of Environmental Research and Public Health, Basel, v. 19, art. 12409, 2022.
ISLAM, Md. Aminul et al. Prevalence and characteristics of fever in COVID-19 patients. PLoS ONE, San Francisco, v. 16, n. 4, e0249788, 2021.
ISLAM, Md. Aminul et al. Financial and mental health concerns during the COVID-19 pandemic. Frontiers in Psychology, Lausanne, v. 12, art. 663687, 2021.
JIN, Shuai et al. Sex- and age-specific clinical characteristics of COVID-19 patients. PLoS Pathogens, San Francisco, v. 17, n. 3, e1009420, 2021.
KHANIJAHANI, Akram et al. Racial/ethnic and socioeconomic disparities in COVID-19. International Journal for Equity in Health, London, v. 20, art. 248, 2021.
LAAJAJ, Rachid et al. Socioeconomic inequalities and COVID-19 infections. Scientific Reports, London, v. 12, art. 8269, 2022.
LEE, Hedwig et al. Social determinants and racial disparities in COVID-19 outcomes. Social Science & Medicine, Oxford, v. 306, art. 115098, 2022.
MARTINS, João Paulo et al. COVID-19 in Brazil: a 3-year update. Diagnostic Microbiology and Infectious Disease, New York, v. 107, n. 4, art. 116074, 2023.
MASSION, Stephanie P. et al. Gender differences in COVID-19 symptom trajectory. Influenza and Other Respiratory Viruses, Oxford, v. 17, e13235, 2023.
MEISTER, Thomas et al. Clinical characteristics associated with COVID-19 severity. PLoS ONE, San Francisco, v. 17, n. 6, e0270192, 2022.
MENEZES, Ana Maria Baptista et al. High prevalence of symptoms among Brazilian individuals with SARS-CoV-2 antibodies. Scientific Reports, London, v. 11, art. 13279, 2021.
MITCHELL, Matthew B. et al. Smell and taste loss in COVID-19. The Laryngoscope, Hoboken, v. 133, n. 9, p. 2357–2361, 2023.
NASCIMENTO DOS SANTOS, José Heukelbach et al. SARS-CoV-2 pandemic in a small Brazilian municipality. Tropical Medicine and Infectious Disease, Basel, v. 9, n. 5, art. 97, 2024.
ORTOLAN, Alessandro et al. Gender influence on COVID-19 outcomes. International Journal of Infectious Diseases, Amsterdam, v. 99, p. 496–504, 2020.
RAYMUNDO, Carlos Eduardo et al. Spatial-temporal distribution of COVID-19 in Brazil. Scientific Reports, London, v. 13, art. 4139, 2023.
ROCHA, Marcelo Augusto; MATTOS, Cláudia Nunes B.; PATTUSSI, Marcos Pascoal. Social inequalities in SARS-CoV-2 infection in Brazil. Revista Brasileira de Epidemiologia, São Paulo, v. 27, e240042, 2024.
ROCHA, Rudi et al. Effect of socioeconomic inequalities on COVID-19 in Brazil. The Lancet Global Health, London, v. 9, n. 6, p. e782–e792, 2021.
RODRIGUES, Wesley et al. Determinants of mortality in hospitalized COVID-19 patients in Brazil. Frontiers in Public Health, Lausanne, v. 10, art. 856137, 2022.
SOUSA FILHO, José Francisco et al. Urban inequality and COVID-19 mortality in Brazil. PLoS ONE, San Francisco, v. 17, n. 11, e0277441, 2022.
UPSHAW, Tracy L. et al. Social determinants of COVID-19 outcomes. PLoS ONE, San Francisco, v. 16, n. 3, e0248336, 2021.
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Derechos de autor 2026 Adriana Rocha Simião, Juliana Alencar Moreira Borges, Glaura Fernandes Teixeira de Alcântara, Lauro Vieira Perdigão Neto, Everton Paulo Homem de Lavor, Carlos Henrique Alencar, Jorg Heukelbach
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