Characteristics and predictors of hospitalization and death in the first 11 122 cases with a positive RT-PCR test for SARS-CoV-2 in Denmark: a nationwide cohort

International Journal of Epidemiology - Tập 49 Số 5 - Trang 1468-1481 - 2020
Mette Reilev1, Kasper Bruun Kristensen1, Anton Pottegård1,2, Lars Christian Lund1, Jesper Hallas1,3, Martin Ernst1, Christian Fynbo Christiansen4, Henrik Toft Sørensen5,4, Nanna B. Johansen6, Nikolai C. Brun6, Marianne Voldstedlund7, Henrik Støvring1,8, Marianne Kragh Thomsen9, Steffen Christensen10, Sophie Gubbels7, Tyra Grove Krause7, Kåre Mølbak7, Reimar W. Thomsen4
1Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark
2Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark
3Department of Clinical Biochemistry and Clinical Pharmacology, Odense University Hospital, Odense, Denmark
4Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
5Center for Population Health and Sciences, Stanford University, Stanford, CA, USA
6Department of Medical Evaluation and Biostatistics, Danish Medicines Agency, Copenhagen, Denmark
7Statens Serum Institut, Copenhagen, Denmark
8Department of Public Health—Biostatistics, Aarhus University, Aarhus, Denmark
9Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
10Department of Anaesthesia and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark

Tóm tắt

Abstract Background Population-level knowledge on individuals at high risk of severe and fatal coronavirus disease 2019 (COVID-19) is urgently needed to inform targeted protection strategies in the general population. Methods We examined characteristics and predictors of hospitalization and death in a nationwide cohort of all Danish individuals tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from 27 February 2020 until 19 May 2020. Results We identified 11 122 SARS-CoV-2 polymerase chain reaction-positive cases of whom 80% were community-managed and 20% were hospitalized. Thirty-day all-cause mortality was 5.2%. Age was strongly associated with fatal disease {odds ratio [OR] 15 [95% confidence interval (CI): 9–26] for 70–79 years, increasing to OR 90 (95% CI: 50–162) for ≥90 years, when compared with cases aged 50–59 years and adjusted for sex and number of co-morbidities}. Similarly, the number of co-morbidities was associated with fatal disease [OR 5.2 (95% CI: 3.4–8.0), for cases with at least four co-morbidities vs no co-morbidities] and 79% of fatal cases had at least two co-morbidities. Most major chronic diseases were associated with hospitalization, with ORs ranging from 1.3–1.4 (e.g. stroke, ischaemic heart disease) to 2.6–3.4 (e.g. heart failure, hospital-diagnosed kidney disease, organ transplantation) and with mortality with ORs ranging from 1.1–1.3 (e.g. ischaemic heart disease, hypertension) to 2.5–3.2 (e.g. major psychiatric disorder, organ transplantation). In the absence of co-morbidities, mortality was <5% in persons aged ≤80 years. Conclusions In this nationwide population-based COVID-19 study, increasing age and multimorbidity were strongly associated with hospitalization and death. In the absence of co-morbidities, the mortality was, however, <5% until the age of 80 years.

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International Journal of Epidemiology

Tập 49 Số 5

1468-1481

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