Perceived fatalism regarding possible COVID-19 infection and its association with self-reported comorbidities in 12 Latin American countries

Abstract Introduction The COVID-19 pandemic has had substantial mental health consequences worldwide. However, evidence on perceived fatalism regarding possible COVID-19 infection, particularly in relation to self-reported comorbidities, remains limited in Latin America. Objective To assess perceived fatalism regarding possible COVID-19 infection and its association with self-reported comorbidities among participants recruited in 12 Latin American countries. Methods This multicenter analytical cross-sectional study used a non-probability online snowball sampling strategy from June to August 2020. The study included 6,530 participants from Peru, Chile, Paraguay, Mexico, Colombia, Bolivia, Panama, Ecuador, Costa Rica, El Salvador, Honduras, and Guatemala. Perceived fatalism was assessed using five items from a previously developed COVID-19 fatalism scale. The five-item overall score was the primary measure, whereas domain-specific analyses were considered exploratory because of their lower reliability. Self-reported respiratory disease, cardiac disease, diabetes mellitus, obesity, and other illnesses were analyzed as exposure variables. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated using generalized linear models from the Poisson family with log link and robust variance. Results The median age was 22 years (IQR: 19–28), 58.8% of participants were female, 25.3% reported at least one comorbidity, and 55.0% of the sample was recruited in Peru. The five-item fatalism scale showed acceptable internal consistency (Cronbach’s alpha = 0.707; McDonald’s omega/Raykov’s rho = 0.721). In adjusted models, high overall fatalism was more prevalent among participants reporting respiratory disease (aPR 1.17, 95% CI 1.05–1.30), cardiac disease (aPR 1.25, 95% CI 1.08–1.44), diabetes mellitus (aPR 1.32, 95% CI 1.09–1.61), obesity (aPR 1.23, 95% CI 1.10–1.37), and other illnesses (aPR 1.26, 95% CI 1.15–1.39). Men had a lower prevalence of high overall fatalism (aPR 0.88, 95% CI 0.83–0.94). Sensitivity analyses yielded materially similar estimates. Conclusions In this non-probabilistic sample from 12 Latin American countries, self-reported comorbidities were associated with a modestly higher prevalence of perceived fatalism regarding possible COVID-19 infection. These findings should be interpreted as exploratory and hypothesis-generating, given the cross-sectional design, self-reported exposures, potential residual confounding, and the young, Peru-predominant, non-probability sample. They should not be interpreted as nationally representative estimates or as evidence of causal relationships.