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Int J Epidemiol . Characteristics and predictors of hospitalization and death in the first 11 122 cases with a positive RT-PCR test for SARS-CoV-2 i

tetano

Editor, Senior Moderator
Int J Epidemiol


. 2020 Sep 5;dyaa140.
doi: 10.1093/ije/dyaa140. Online ahead of print.
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


Mette Reilev[SUP] 1 [/SUP], Kasper Bruun Kristensen[SUP] 1 [/SUP], Anton Potteg?rd[SUP] 1 2 [/SUP], Lars Christian Lund[SUP] 1 [/SUP], Jesper Hallas[SUP] 1 3 [/SUP], Martin Thomsen Ernst[SUP] 1 [/SUP], Christian Fynbo Christiansen[SUP] 4 [/SUP], Henrik Toft S?rensen[SUP] 4 5 [/SUP], Nanna Borup Johansen[SUP] 6 [/SUP], Nikolai Constantin Brun[SUP] 6 [/SUP], Marianne Voldstedlund[SUP] 7 [/SUP], Henrik St?vring[SUP] 1 8 [/SUP], Marianne Kragh Thomsen[SUP] 9 [/SUP], Steffen Christensen[SUP] 10 [/SUP], Sophie Gubbels[SUP] 7 [/SUP], Tyra Grove Krause[SUP] 7 [/SUP], K?re M?lbak[SUP] 7 [/SUP], Reimar Wernich Thomsen[SUP] 4 [/SUP]



Affiliations

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.

Keywords: COVID-19; SARS-CoV-2; death; epidemiology; hospitalization; infectious disease; population-based; predictors.
 
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