COVID-19 infection and hospitalization according to the burden of chronic noncommunicable diseases in Brazil

Chronic diseases, worse socioeconomic conditions and old age can increase infection and hospitalization rate due to Coronavirus disease (COVID-19). We assessed the association between the burden of NCDs and the occurrence of infections and hospitalizations of COVID-19 in Brazil in a large COVID-19 national survey data. We analyzed only data collected between July and November 2020 ( n = 1,071,782). The frequencies of positive COVID-19 diagnosis and NCD burden were estimated according to age, sex, socioeconomic strata and skin color categories. We estimated hazard ratios and 95% confidence intervals using Cox regression models. There is a non-linear dose-response inverse association between per capita income and the rates of infection and hospitalization due to COVID-19. The presence of NCDs was associated with a higher incidence of COVID-19 infection (HR 1NCD = 1.34; 95% CI: 1.26; 1.43; HR 2 or more NCD = 1.54 95% CI: 1.39; 1.71) and incidence of hospitalization (HR 1NCD = 3.08 95% CI: 2.26; 4.19; HR 2or more NCD = 6.81 95% CI: 4.88; 9.49).The difference between the risks of infection or hospitalization of COVID-19 attributable to the burden of NCDs is non-linearly associated with the income.