Article ; Online: High risk groups for severe COVID-19 in a whole of population cohort in Australia.
BMC infectious diseases
2021 Volume 21, Issue 1, Page(s) 685
Abstract: ... COVID-19 case ascertainment and almost complete case follow-up, we found the risk of very severe disease ... Background: Increasing age is the strongest known risk factor for severe COVID-19 disease ... October 2020 in New South Wales Australia were followed for COVID-19-related hospitalisations ...
| Abstract | Background: Increasing age is the strongest known risk factor for severe COVID-19 disease but information on other factors is more limited. Methods: All cases of COVID-19 diagnosed from January-October 2020 in New South Wales Australia were followed for COVID-19-related hospitalisations, intensive care unit (ICU) admissions and deaths through record linkage. Adjusted hazard ratios (aHR) for severe COVID-19 disease, measured by hospitalisation or death, or very severe COVID-19, measured by ICU admission or death according to age, sex, socioeconomic status and co-morbidities were estimated. Results: Of 4054 confirmed cases, 468 (11.5%) were classified as having severe COVID-19 and 190 (4.7%) as having very severe disease. After adjusting for sex, socioeconomic status and comorbidities, increasing age led to the greatest risk of very severe disease. Compared to those 30-39 years, the aHR for ICU or death from COVID-19 was 4.45 in those 70-79 years; 8.43 in those 80-89 years; 16.19 in those 90+ years. After age, relative risks for very severe disease associated with other factors were more moderate: males vs females aHR 1.40 (95%CI 1.04-1.88); immunosuppressive conditions vs none aHR 2.20 (1.35-3.57); diabetes vs none aHR 1.88 (1.33-2.67); chronic lung disease vs none aHR 1.68 (1.18-2.38); obesity vs not obese aHR 1.52 (1.05-2.21). More comorbidities was associated with significantly greater risk; comparing those with 3+ comorbidities to those with none, aHR 5.34 (3.15-9.04). Conclusions: In a setting with high COVID-19 case ascertainment and almost complete case follow-up, we found the risk of very severe disease varies by age, sex and presence of comorbidities. This variation should be considered in targeting prevention strategies. |
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| MeSH term(s) | Adult ; Aged ; Aged, 80 and over ; Aging ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19/mortality ; COVID-19/virology ; Cohort Studies ; Comorbidity ; Female ; Hospitalization/statistics & numerical data ; Humans ; Intensive Care Units ; Male ; Middle Aged ; New South Wales/epidemiology ; Proportional Hazards Models ; Risk Factors ; SARS-CoV-2/pathogenicity ; Sex Characteristics ; Survival Analysis |
| Language | English |
| Publishing date | 2021-07-16 |
| Publishing country | England |
| Document type | Journal Article |
| ISSN | 1471-2334 |
| ISSN (online) | 1471-2334 |
| DOI | 10.1186/s12879-021-06378-z |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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