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Abstract
Background After 8 months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. We aimed to identify the effect of some socioeconomic inequality-related factors on COVID-19 mortality in Colombia.
Methods We conducted a survival analysis in a nation-wide retrospective cohort study of confirmed cases of COVID-19 in Colombia from 2 March 2020 to 26 October 2020. We calculated the time to death or recovery for each confirmed case in the cohort. We used an extended multivariable time-dependent Cox regression model to estimate the HR by age groups, sex, ethnicity, type of health insurance, area of residence and socioeconomic strata.
Results There were 1 033 218 confirmed cases and 30 565 deaths for COVID-19 in Colombia between 2 March and 26 October. The risk of dying for COVID-19 among confirmed cases was higher in males (HR 1.68 95% CI 1.64 to 1.72), in people older than 60 years (HR 296.58 95% CI 199.22 to 441.51), in indigenous people (HR 1.20 95% CI 1.08 to 1.33), in people with subsidised health insurance regime (HR 1.89 95% CI 1.83 to 1.96) and in people living in the very low socioeconomic strata (HR 1.44 95% CI 1.24 to 1.68).
Conclusion Our study provides evidence of socioeconomic inequalities in COVID-19 mortality in terms of age groups, sex, ethnicity, type of health insurance regimen and socioeconomic status.
- COVID-19
- mortality
- social inequalities
- cohort studies
Data availability statement
Data are available in a public, open access repository. Data used for the current study are publicly available as open data on the government website https://www.datos.gov.co/Salud-y-Protecci-n-Social/Casos-positivos-de-COVID-19-en-Colombia/gt2j-8ykr/data.
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Data availability statement
Data are available in a public, open access repository. Data used for the current study are publicly available as open data on the government website https://www.datos.gov.co/Salud-y-Protecci-n-Social/Casos-positivos-de-COVID-19-en-Colombia/gt2j-8ykr/data.
Footnotes
Twitter @laurarovi1, @AlvarezMorenoC, @JFernandeznino
Contributors MPC: methodology design, verification of the underlying data, data analysis, data interpretation, writing-original draft. LAR-V: literature research, data analysis, data interpretation, writing-original draft. MLR-B: verification of the underlying data, data analysis, data interpretation, writing-review and editing. CAA-M: data interpretation, writing-review and editing. JAF-N: conceptualisation, methodology design, data analysis, data interpretation, writing-review and editing.
Funding This study did have a specific funding grant. Study design, data collection, data analysis, data interpretation, and writing the report were conducted as part of the work of the Direction of Epidemiology and Demography of the Ministry of Health and Social Protection of Colombia.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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