Risk factors associated with delayed diagnosis and mortality in confirmed cases of Covid-19 in the Northern Macro-region of the State of Rio Grande do Sul

Abstract

The objective of this study was to verify the factors associated with delay in diagnosis and mortality in confirmed cases of Covid-19 in the Northern Macro-region of Rio Grande do Sul, during the first two years of the pandemic. This is a historical cohort study with 286.779 cases of Covid-19 delimited chronologically from March 2020 to March 2022. The social and demographic characteristics analyzed were sex, age, socioeconomic development index of the municipalities in the State of Rio Grande do Sul (IDESE income) and the outcomes were delay in diagnosis and death. Kaplan-Meier survival analyses, Cox regression analyzes and logistic regression were performed. The median time from symptom onset to diagnosis was 3.0 (IQR: 2.0-5.0) days. Low-income IDESE and death were associated with delayed diagnosis (HR = 1.162 [CI95%: 1.087 – 1.241] and HR = 2.689 [CI95%: 2.521 – 2.867], respectively). Mortality was associated with delay in diagnosis (RR = 3.462 [95%CI: 3.208 – 3.736]). The highest occurrence of infection was in adults and the highest lethality occurred in the elderly. Delay in diagnosis of more than three days and mortality were associated with a low social indicator. This delay was also associated with mortality. The results reiterate the challenges in controlling Covid-19, in providing fast and effective tests in real time, in addition to implementing preventive measures, especially in vulnerable population groups.