Risk factors associated with delay in diagnosis and mortality in patients with COVID-19 in the city of Rio de Janeiro, Brazil

• Published in: Ciência & saude coletiva 2020-10, Vol.25 (suppl 2), p.4131-4140
• Main Authors: Cobre, Alexandre de Fátima, Böger, Beatriz, Fachi, Mariana Millan, Vilhena, Raquel de Oliveira, Domingos, Eric Luiz, Tonin, Fernanda Stumpf, Pontarolo, Roberto
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Aged, 80 and over; Betacoronavirus; Brazil - epidemiology; Clinical Laboratory Techniques; Cohort Studies; Coronavirus Infections - diagnosis; Coronavirus Infections - mortality; COVID-19; COVID-19 Testing; Delayed Diagnosis; Female; Health Policy & Services; Humans; Male; Pandemics; Pneumonia, Viral - diagnosis; Pneumonia, Viral - mortality; Retrospective Studies; Risk Factors; SARS-CoV-2; Sex Factors; Socioeconomic Factors; Time Factors
• ISSN: 1413-8123; 1678-4561; 1678-4561
• DOI: 10.1590/1413-812320202510.2.26882020

We investigated the predictors of delay in the diagnosis and mortality of patients with COVID-19 in Rio de Janeiro, Brazil. A cohort of 3,656 patients were evaluated (Feb-Apr 2020) and patients' sociodemographic characteristics, and social development index (SDI) were used as determinant factors of diagnosis delays and mortality. Kaplan-Meier survival analyses, time-dependent Cox regression models, and multivariate logistic regression analyses were conducted. The median time from symptoms onset to diagnosis was eight days (interquartile range [IQR] 7.23-8.99 days). Half of the patients recovered during the evaluated period, and 8.3% died. Mortality rates were higher in men. Delays in diagnosis were associated with male gender (p = 0.015) and patients living in low SDI areas (p < 0.001). The age groups statistically associated with death were: 70-79 years, 80-89 years, and 90-99 years. Delays to diagnosis greater than eight days were also risk factors for death. Delays in diagnosis and risk factors for death from COVID-19 were associated with male gender, age under 60 years, and patients living in regions with lower SDI. Delays superior to eight days to diagnosis increased mortality rates.