# Impact of comorbidities on COVID-19 mortality in hospitalized women: Insights from the metropolitan area of the Valley of Mexico from 2020 to 2022

## TL;DR

This study found that comorbidities like pneumonia, diabetes, and intubation significantly increased mortality in hospitalized women with COVID-19 in the Valley of Mexico from 2020 to 2022.

## Contribution

The study identifies specific comorbidities and their time-dependent impact on mortality in hospitalized women with COVID-19.

## Key findings

- 38% of hospitalized women with COVID-19 died, with higher mortality in older age groups.
- Pneumonia, diabetes, and chronic kidney disease were significant risk factors for early mortality.
- Intubation and ICU admission were strongly associated with increased mortality, especially after the first week.

## Abstract

•Nearly 38% of hospitalized women with COVID-19 died.•The major comorbidities were pneumonia, hypertension, diabetes, obesity, and intubation.•In the general wards, 56.6% died within the 1st week; in the intensive care unit wards, 65.7% died during the 2nd week.•First week mortality risk factors were diabetes, pneumonia, and chronic kidney disease.•The intensive care unit mortality drivers were intubation, chronic kidney disease, and pneumonia.

Nearly 38% of hospitalized women with COVID-19 died.

The major comorbidities were pneumonia, hypertension, diabetes, obesity, and intubation.

In the general wards, 56.6% died within the 1st week; in the intensive care unit wards, 65.7% died during the 2nd week.

First week mortality risk factors were diabetes, pneumonia, and chronic kidney disease.

The intensive care unit mortality drivers were intubation, chronic kidney disease, and pneumonia.

This research summarizes the impact of the major comorbidities impacting hospitalized women with COVID-19 and their relation to death.

Public data from national databases (2020-2022) for hospitalized women, including identification data, hospitalization time, comorbidities, and intensive care unit (ICU) admissions, were analyzed. Women were stratified by age (split at 50 years). Binary regression models determined the correlation between comorbidities and COVID-19 with mortality, expressed as odds ratios.

A total of 46,492 women were hospitalized, with 70.1% aged above 50 years. A total of 17,728 fatalities occurred, with 86.5% in the older age group. A total of 5.82% women required intensive care. The common comorbidities were pneumonia, hypertension, diabetes, obesity, and intubation. A total of 56.6% died within the 1st week; in the ICU, 65.7% died by week 2. In the logistic regression, diabetes and chronic kidney disease (CKD) were initially significant, followed by pneumonia and CKD (days 8-14), intubation and, ICU stay (beyond the 15th day). In the ICU, intubation impact worsened over time.

Our study highlights the significant impact of comorbidities on COVID-19 mortality in women in the Valley of Mexico. Pneumonia, diabetes, CKD, and intubation were notably prevalent and correlated strongly with death in older women. Timely intubation improves survival, whereas delayed intubation increases mortality risk, particularly, in the ICU. Urgent targeted interventions are required, especially for older hospitalized women.