COVID-19 in people aged 18–64 in Sweden in the first year of the pandemic: Key factors for severe disease and death
Artikel i vetenskaplig tidskrift, 2022
Background: Studies on risk factors for severe COVID-19 in people of working age have generally not included non-working persons or established population attributable fractions (PAFs) for occupational and other factors. Objectives: We describe the effect of job-related, sociodemographic, and other exposures on the incidence, relative risks and PAFs of severe COVID-19 in individuals aged 18–64. Methods: We conducted a registry-based study in Swedish citizens aged 18–64 from 1 January 2020 to 1 February 2021 with respect to COVID-19-related hospitalizations and death. Results: Of 6,205,459 persons, 272,043 (7.5%) were registered as infected, 3399 (0.05%) needed intensive care, and 620 (0.01%) died, with an estimated case fatality rate of 0.06% over the last 4-month period when testing was adequate. Non-Nordic origin was associated with a RR for need of intensive care of 3·13, 95%CI 2·91–3·36, and a PAF of 32·2% after adjustment for age, sex, work, region and comorbidities. In a second model with occupation as main exposure, and adjusted for age, sex, region, comorbidities and origin, essential workers had an RR of 1·51, 95%CI, 1·35–1·6, blue-collar workers 1·18, 95%CI 1·06–1·31, school staff 1·21, 95%CI 1·01–1·46, and health and social care workers 1·89, 95%CI 1·67–2·135) compared with people able to work from home, with altogether about 13% of the PAF associated with these occupations. Essential workers and blue-collar workers, but no other job categories had higher risk of death, adjusted RRs of 1·79, 95%CI 1·34–2·38 and 1·37, 95%CI 1·04–1·81, with adjusted PAFs of altogether 9%. Conclusion: Among people of working age in Sweden, overall mortality and case fatality were low. Occupations that require physical presence at work were associated with elevated risk of needing intensive care for COVID-19, with 14% cases attributable to this factor, and 9% of deaths.
Mortality
Intensive care
Comorbidity
COVID-19
Occupation
Population study
Författare
Annika Rosengren
Göteborgs universitet
Sahlgrenska universitetssjukhuset
Mia Söderberg
Göteborgs universitet
Christina E. Lundberg
Göteborgs universitet
Martin Lindgren
Göteborgs universitet
Sahlgrenska universitetssjukhuset
Ailiana Santosa
Göteborgs universitet
Jon Edqvist
Göteborgs universitet
Maria Åberg
Regionhälsan
Göteborgs universitet
Magnus Gisslen
Sahlgrenska universitetssjukhuset
Göteborgs universitet
Josefina Robertson
Göteborgs universitet
Sahlgrenska universitetssjukhuset
Ottmar Cronie
Chalmers, Matematiska vetenskaper, Tillämpad matematik och statistik
Naveed Sattar
College of Medical, Veterinary & Life Sciences
Göteborgs universitet
Jesper Lagergren
Karolinska universitetssjukhuset
King's College London
Maria Brandén
Stockholms universitet
Linköpings universitet
J. Bjork
Skånes universitetssjukhus (SUS)
Lunds universitet
Martin Adiels
Göteborgs universitet
Global Epidemiology
25901133 (eISSN)
Vol. 4 100095Ämneskategorier
Geriatrik
Miljömedicin och yrkesmedicin
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
DOI
10.1016/j.gloepi.2022.100095