Syndemic aspects between COVID-19 pandemic and social inequalities

Table 1 Relation between individual characteristics and the coronavirus disease 2019 pandemic

Individual characteristic	Risk factors	Repercussion
Gender	Higher expression of ACE2 and ARs in males[20,25,26]	Higher mortality among men[20,28]
	Greater rates of alcoholism, smoking, and hypertension in men[20,28]
	Women as most of the essential care employees[20,29]	Increased risk of exposure among women[20,31]
Socioeconomic conditions	Delay in seeking help and higher rates of comorbidities[37,39]	Higher infection rates and worse clinical outcomes[36,37]
	Use of public transportation, household overcrowding, lack of personal protective equipment, smoking, alcoholism, poor diet, and being an immigrant[36,37,40,41]	Higher exposure and mortality[36,37,40,41]
Ethnicity	High rates of comorbidities in the minority ethnic groups[51]	Risk of severe forms of COVID-19[22,45]
	Household crowding, language barriers, and difficulties in accessing healthcare systems[22,52]	Increased mortality for COVID-19[50]
	Usually workers in essential industries[51,52]	Higher exposure to the virus[51,52]
Health service accessibility	Resources reallocation to COVID-19 management[76]	Delay in the realization of elective surgeries[78]; reduction of managing chronic disease[84], services of sexual education[82] and family planning[79,82,83]
	High cost of vaccines against COVID-19[92] and discrepancies in the immunization strategies[93]	Reduction of the vaccine access, increase in the infection and death rates[92,93]
	Language Barriers[97]	Low knowledge about the vaccination process[97]
	Mistrust with the health systems[95,96], immigrants with pending documentation, negativism, and having to work during the vaccination process[94]	Reduction of vaccine access by minority groups[94,96,97]
Labor vulnerability	Frontline or essential work[100]	Higher exposition rates, sleep disturbances, suicide anxiety, depression, PTSD[104]
	Marginalized population, low level education[99], and lockdown policies[104]	Unemployment, reduced family income, food insecurity[98]
	Work at home[116]	Sedentary lifestyle, risk of cardiovascular events[115,117]
Domestic violence	Less social interaction and opportunities for denouncing, and socioeconomic problems[119,125]	Physical and psychological consequences (anxiety, depression, and stress)[132]

COVID-19: Coronavirus disease 2019; ACE2: Angiotensin-converting enzyme 2; ARs: Androgen receptors; PTSD: Post-traumatic stress disorder.