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?:abstract
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OBJECTIVE: In Europe there is a great variability in mortality by Covid-19 among different countries While some countries, such as Greece, Belarus or Ukraine, have a mortality rate of less than 5 cases/100,000 inhabitants, other countries such as Belgium, Spain or the United Kingdom have a mortality rate of well over 50 cases/100,000 inhabitants It is generally considered that the reason for this variability is multifactorial (including political reasons), but there are few studies that associate factors related to this variability The objective of this work was to analyse political risk factors/markers that could explain the variability in mortality due to Covid-19 among different European countries METHODS: This is a retrospective, multinational, ecological study based on the exploitation of the database provided by the European Centre for Disease Prevention and Control which collects daily information worldwide on new cases and deaths The accumulated mortality of Covid-19 in European countries (with more than 100 deaths on 01/05/2020) was calculated up to 29/05/2020 Political variables were compiled from different sources in the countries included in the study The variables analysed were: the democracy index and the different factors included in it, the country\'s political system and the country\'s corruption index On the other hand, specific political measures implemented in the different countries were collected, such as the number of days elapsed from the notification of the first infected person to 100 infected persons, to lockdown, to the closure of schools or the cancelation of meetings The number of people infected up to the date of lockdown was also registered For the statistical analysis of the association between the dependent variable (mortality) and the factors studied, correlation index were calculated, and the association was studied through univariate and multivariate linear regression models RESULTS: At May 1 2020, 27 European countries had at least 100 deaths The mean mortality was 19 83 cases/100,000 inhabitants (SD 22 4) and a median of 7 95 Mortality varied from a minimum of 1 49 cases/100,000 population in Ukraine to 82 19 cases/100,000 population in Belgium About factors analyzed both the democracy index (as well as the factors included in it), the political system (full democracy vs no) and the corruption index were statistically associated with mortality Also, the time until the implementation of the political measures was associated with mortality CONCLUSIONS: In Europe, there is a west to east (from highest to lowest) gradient in the mortality of Covid-19 Some of the observed mortality variability can be explained by political factors OBJETIVO: En Europa hay una gran variabilidad en la mortalidad por Covid-19 entre los diferentes paises Mientras que algunos paises, como Grecia, Bielorrusia o Ucrania, la mortalidad no alcanza los 5 casos por cada 100 000 habitantes actualmente, otros paises como Belgica, Espana o Reino Unido sobrepasan marcadamente los 50 casos por cada 100 000 habitantes En general, se especula en que el motivo de esta variabilidad es multifactorial (entre ellos, motivos de indole politica), pero existen escasos estudios que asocien factores relacionados con esta variabilidad El objetivo de este trabajo fue analizar los factores/marcadores de riesgo de indole politico que pudieran explicar la variabilidad en la mortalidad por Covid-19 entre los diferentes paises europeos METODOS: Estudio ecologico, observacional retrospectivo, de ambito multinacional, basado en la explotacion de la base de datos proporcionada por el European Centre for Disease Prevention and Control que recoge la informacion diaria a nivel mundial de los nuevos casos y fallecidos Se calculo la mortalidad acumulada de Covid-19 en paises europeos (con mas de 100 fallecidos a fecha de 1 de mayo de 2020), hasta el 29 de mayo de 2020 Se recogieron variables de caracter politico de los paises incluidos en el estudio de diferentes fuentes Las variables analizadas fueron: indice de demo racia y los diferentes factores incluidos en el, sistema politico del pais e indice de corrupcion del pais Por otra parte, se recogieron medidas politicas especificas implementadas en los distintos paises, como los dias transcurridos desde la notificacion del primer infectado hasta llegar a los 100 infectados, asi como los dias transcurridos hasta el confinamiento, hasta el cierre de colegios o hasta el cese de reuniones Tambien se recogio el numero de infectados hasta la fecha de confinamiento Para el analisis estadistico de la asociacion entre la variable dependiente (mortalidad) y los factores estudiados se calcularon indices de correlacion, y la asociacion se estudio a traves de modelos de regresion lineal univariante y multivariante RESULTADOS: A fecha de 1 de mayo de 2020, 27 paises europeos contaban con al menos 100 fallecidos La media de la mortalidad fue de 19,83 casos por cada 100 000 hab (DE 22,4) y una mediana de 7,95 La mortalidad vario desde un minimo de 1,49 casos por cada 100 000 hab en Ucrania hasta 82,19 casos por cada 100 000 hab en Belgica De los factores analizados, tanto el indice de democracia (como los factores incluidos en el) como el sistema politico (democracia plena frente a no) y el indice de corrupcion se asociaron estadisticamente con la mortalidad Tambien, el tiempo transcurrido hasta la implantacion de las medidas politicas se asocio con mortalidad CONCLUSIONES: En Europa, existe un degradado de oeste a este (de mayor a menor) en la mortalidad por Covid-19 Parte de la variabilidad de la mortalidad observada puede explicarse por factores de indole politica
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