ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2021
Unequal Impact of Structural Health Determinants and Comorbidity on COVID-19 Severity and Lethality in Older Mexican Adults: Considerations Beyond Chronological Aging.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
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The trial behind it
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Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- Contextual nonmedical health factors and critical care-related outcomes: a systematic review.Critical care (London, England) · 2025Pooled it
- Obesity as an independent risk factor for COVID-19 severity and mortality.The Cochrane database of systematic reviews · 2023Pooled it
- Pooled it
- Public Health Policy Responses to Population Aging in Mexico: A Rights-Based and Socio-Legal Approach.Healthcare (Basel, Switzerland) · 2026Review
- Impact of the SARS-CoV-2 pandemic on healthy aging and functionality in older Mexican adults: insights from the MHAS cohort.Aging clinical and experimental research · 2026Article
- Modelling the joint association of socio-economic disadvantage, diabetes, and obesity on COVID-19 mortality in Greater Mexico City.Scientific reports · 2025Article
- Analysis of COPD: Distinguishing Characteristics and Management of Smoking vs Never Smoking Patients.International journal of chronic obstructive pulmonary disease · 2024Article
- Prevalence and factors associated with the death of older people hospitalized due to Covid-19 in the state of Paraná.Revista da Escola de Enfermagem da U S P · 2024Article
- Geroscience and pathology: a new frontier in understanding age-related diseases.Pathology oncology research : POR · 2024Review
- Income inequality and its association with COVID-19 cases and deaths: a cross-country analysis in the Eastern Mediterranean region.BMJ global health · 2023Article
- Effectiveness of a nationwide COVID-19 vaccination program in Mexico against symptomatic COVID-19, hospitalizations, and death: a retrospective analysis of national surveillance data.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023Article
- Critical Perspectives on Expanding Racial/Ethnic Diversity in the HIV Research Workforce: Comorbidities and Mentoring.Health education & behavior : the official publication of the Society for Public Health Education · 2023Article
- Impact of COVID-19 lockdown on air quality analyzed through machine learning techniques.PeerJ. Computer science · 2023Article
- Prevalence of food insecurity and its association with depressive and anxiety symptoms in older adults during the COVID-19 pandemic in Mexico: A secondary analysis of ENCOVID-19 survey.Frontiers in medicine · 2023Article
- Disparities and resilience: analyzing online Health information provision, behaviors and needs of LBGTQ + elders during COVID-19.BMC public health · 2022Article
- Diabetes-Related Excess Mortality in Mexico: A Comparative Analysis of National Death Registries Between 2017-2019 and 2020.Diabetes care · 2022Article
- Epidemiological Profile and Social Welfare Index as Factors Associated with COVID-19 Hospitalization and Severity in Mexico City: A Retrospective Analysis.International journal of environmental research and public health · 2022Article
- Impact of environmental and individual factors on COVID-19 mortality in children and adolescents in Mexico: An observational study.Lancet regional health. Americas · 2022Article
- Genomic Characterization of SARS-CoV-2 Isolated from Patients with Distinct Disease Outcomes in Mexico.Microbiology spectrum · 2022Article
- The income gradient in COVID-19 mortality and hospitalisation: An observational study with social security administrative records in Mexico.Lancet regional health. Americas · 2022Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCOVID-19 has had a disproportionate impact on older adults. Mexico's population is younger, yet COVID-19's impact on older adults is comparable to countries with older population structures. Here, we aim to identify health and structural determinants that increase susceptibility to COVID-19 in older Mexican adults beyond chronological aging.
methodsWe analyzed confirmed COVID-19 cases in older adults using data from the General Directorate of Epidemiology of Mexican Ministry of Health. We modeled risk factors for increased COVID-19 severity and mortality, using mixed models to incorporate multilevel data concerning healthcare access and marginalization. We also evaluated structural factors and comorbidity profiles compared to chronological age for COVID-19 mortality risk prediction.
resultsWe analyzed 20 804 confirmed SARS-CoV-2 cases in adults aged 60 and older. Male sex, smoking, diabetes, and obesity were associated with pneumonia, hospitalization, and intensive care unit (ICU) admission in older adults, CKD and COPD were associated with hospitalization. High social lag indexes and access to private care were predictors of COVID-19 severity and mortality. Age was not a predictor of COVID-19 severity in individuals without comorbidities and combination of structural factors and comorbidities were better predictors of COVID-19 lethality and severity compared to chronological age alone. COVID-19 baseline lethality hazards were heterogeneously distributed across Mexican municipalities, particularly when comparing urban and rural areas.
conclusionsStructural factors and comorbidity explain excess risk for COVID-19 severity and mortality over chronological age in older Mexican adults. Clinical decision-making related to COVID-19 should focus away from chronological aging onto more a comprehensive geriatric care approach.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.