AB0084 EFFECT OF SOCIOECONOMIC CHARACTERISTICS ON MORTALITY DUE TO COVID-19 IN PATIENTS WITH RHEUMATIC IMMUNE-MEDIATED INFLAMMATORY DISEASES IN THREE COUNTRIES OF LATIN AMERICA
Authors: M. Martínez-Martínez, D. Alpizar-Rodriguez, C. A. Isnardi, G. Pons-Estel, M. A. Alfaro, B. M. Virasoro, I. E. Petkovic, R. Quintana, G. Berbotto, M. Haye Salinas, S. Ornella, M. Pera, I. J. Colunga-Pedraza, F. Irazoque-Palazuelos, G. Reyes-Cordero, T. S. Rodriguez-Reyna, J. A. Veloz Aranda, C. M. Skinner-Taylor, I. M. Juarez Mora, L. Silveira, R. Machado Xavier, A. M. Kakehasi, A. P. Gomides, E. Torres, G. Salviato Pileggi, G. A. Ferreira, L. Mota, M. Pinheiro, C. Marques, D. Calderaro
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Host, viral and environmental factors have been associated with severe clinical outcome of COVID-19. A large body of accumulating evidence supports the idea that age, ethnicity, sex, comorbidities, immunological history, viral factors and low socioeconomic status (SES) are risk factors for severe COVID-19 outcomes. Studies addressing the impact of these factors in Latin American patients with rheumatic immune-mediated inflammatory diseases (IMIDs) are scarce. <h3>Objectives:</h3> To assess the effect of socioeconomic characteristics on mortality due SARS-CoV-2 infection in patients with IMIDs from Argentina, Brazil and Mexico. <h3>Methods:</h3> Data from three national registries, SAR-COVID (Argentina), CMR-COVID (Mexico) and ReumaCoV-Brasil (Brazil), were combined. Adult IMIDs patients with SARS-CoV-2 infection were recruited between 08.2020 and 09.2022 in SAR-COVID, between 04.2020 and 06.2022 in CMR-COVID and between 05.2020 and 11.2020 in ReumaCoV-Brasil. National data for each province/state including population density, number of physicians per inhabitant, income, unemployment, GINI index, Human Development Index (HDI), vaccination rate and most frequent viral strains per time period were assessed as risk factors for mortality due to COVID-19. <h3>Results:</h3> A total of 4744 patients were included, 2534 (53.4%) from SAR-COVID, 1166 (24.6%) from CMR-COVID and 1044 (22.0%) from ReumaCoV-Brasil. Hospitalization was reported in 22.7% of the patients and 5.3% died due to COVID-19. Bivariable analysis showed higher mortality in Mexican, older, male, users of glucocorticoids, users of CD20 inhibitors and diabetic patients; having chronic kidney disease, and higher disease activity also showed a higher mortality. Worse socioeconomic status, doctors per 1000 inhabitants, delta variant and non-vaccination were factors associated with mortality in the bivariate analysis (Table 1).In the multivariable analysis, living in Mexico, higher GINI index (increased inequity), lower monthly income, higher population density, lower HDI, and higher unemployment rate, were independently associated with increased mortality, while belonging to a fully vaccinated population, or developing COVID-19 during Omicron virus variant spread period were associated with decreased mortality (Table 1, Figure 1). <h3>Conclusion:</h3> These findings corroborate the association of some host, viral,environmental and socioeconomic factors with death due to COVID-19 in Argentina, Brazil and Mexico. The increased mortality in patients living in Mexico may be attributable to factors not evaluated in this study, such as ethnicity or not prioritizing vaccination for IMIDs patients. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>