Severe COVID-19 in people 55 and older during the first year of the pandemic in Sweden
Artikel i vetenskaplig tidskrift, 2022
Background
Exposure to many contacts is the main risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while risk of serious disease and death is chiefly determined by old age and comorbidities. Relative and population-attributable fractions (PAFs) of multiple medical and social exposures for COVID-19 outcomes have not been evaluated among older adults.
Objectives
We describe the effect of multiple exposures on the odds of testing positive for the virus and of severe disease (hospital care or death) and PAFs in Swedish citizens aged 55 years and above.
Methods
We used national registers to follow all citizens aged 55 years and above with respect to (1) testing positive, (2) hospitalization, and (3) death between 31 January 2020 and 1 February 2021.
Results
Of 3,410,241 persons, 156,017 (4.6%, mean age 68.3 years) tested positive for SARS-CoV-2, while 35,999 (1.1%, mean age 76.7 years) were hospitalized or died (12,384 deaths, 0.4%, mean age 84.0 years). Among the total cohort, the proportion living without home care or long-term care was 98.8% among persons aged 55–64 and 22.1% of those aged 95 and above. After multiple adjustment, home care and long-term care were associated with odds ratios of 7.9 (95% confidence interval [CI] 6.8–9.1) and 22.5 (95% CI 19.6–25.7) for mortality, with PAFs of 21.9% (95% CI 20.9–22.9) and 33.3% (95% CI 32.4–34.3), respectively.
Conclusion
Among Swedish residents aged 55 years and above, those with home care or long-term care had markedly increased risk for COVID-19 death during the first year of the pandemic, with over 50% of deaths attributable to these factors.
Exposure to many contacts is the main risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while risk of serious disease and death is chiefly determined by old age and comorbidities. Relative and population-attributable fractions (PAFs) of multiple medical and social exposures for COVID-19 outcomes have not been evaluated among older adults.
Objectives
We describe the effect of multiple exposures on the odds of testing positive for the virus and of severe disease (hospital care or death) and PAFs in Swedish citizens aged 55 years and above.
Methods
We used national registers to follow all citizens aged 55 years and above with respect to (1) testing positive, (2) hospitalization, and (3) death between 31 January 2020 and 1 February 2021.
Results
Of 3,410,241 persons, 156,017 (4.6%, mean age 68.3 years) tested positive for SARS-CoV-2, while 35,999 (1.1%, mean age 76.7 years) were hospitalized or died (12,384 deaths, 0.4%, mean age 84.0 years). Among the total cohort, the proportion living without home care or long-term care was 98.8% among persons aged 55–64 and 22.1% of those aged 95 and above. After multiple adjustment, home care and long-term care were associated with odds ratios of 7.9 (95% confidence interval [CI] 6.8–9.1) and 22.5 (95% CI 19.6–25.7) for mortality, with PAFs of 21.9% (95% CI 20.9–22.9) and 33.3% (95% CI 32.4–34.3), respectively.
Conclusion
Among Swedish residents aged 55 years and above, those with home care or long-term care had markedly increased risk for COVID-19 death during the first year of the pandemic, with over 50% of deaths attributable to these factors.
Författare
Annika Rosengren
Göteborgs universitet
Christina E. Lundberg
Göteborgs universitet
Mia Söderberg
Göteborgs universitet
Ailiana Santosa
Göteborgs universitet
Jon Edqvist
Göteborgs universitet
Martin Lindgren
Göteborgs universitet
Maria Åberg
Västra Götalandsregionen
Göteborgs universitet
Magnus Gisslen
Sahlgrenska universitetssjukhuset
Göteborgs universitet
Josefina Robertson
Göteborgs universitet
Sahlgrenska universitetssjukhuset
Ottmar Cronie
Chalmers, Matematiska vetenskaper, Tillämpad matematik och statistik
Göteborgs universitet
Naveed Sattar
Göteborgs universitet
University of Glasgow
Jesper Lagergren
King's College London
Karolinska universitetssjukhuset
Maria Brandén
Linköpings universitet
Stockholms universitet
Jonas Björk
Lunds universitet
Skånes universitetssjukhus (SUS)
Martin Adiels
Göteborgs universitet
Journal of Internal Medicine, Supplement
0955-7873 (ISSN)
Vol. 292 4 641-653Ämneskategorier
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
DOI
10.1111/joim.13522