Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden a nationwide study

We conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all...

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Bibliographic Details
Published in:European journal of epidemiology Vol. 36; no. 3; pp. 287 - 298
Main Authors: Bergman, Jonathan, Ballin, Marcel, Nordström, Anna, Nordström, Peter
Format: Journal Article
Language:English
Published: Dordrecht Springer Science + Business Media 01.03.2021
Springer Netherlands
Springer Nature B.V
Subjects:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Asthma
Cancer
Cardiology
Cardiovascular diseases
Case–control study
Cohort analysis
Cohort study
Comorbidity
Coronavirus
Coronaviruses
COVID-19
COVID-19 - diagnosis
COVID-19 - epidemiology
COVID-19 - mortality
Diagnosis
Down syndrome
Down's syndrome
Epidemiology
Female
Hospitalization
Hospitalization - statistics & numerical data
Humans
Hypertension
Infectious Diseases
Intensive Care Units - statistics & numerical data
Long term health care
Long-term care
Male
Medicine
Medicine & Public Health
Middle Aged
Mortality
Mortality - trends
Oncology
Population control
Population studies
Public Health
Residential Facilities - statistics & numerical data
Risk analysis
Risk Factors
Risk management
SARS-CoV-2
Sex
Sex Factors
Socioeconomic Factors
Sweden - epidemiology
Viral diseases
Young Adult
Sweden
COVID-19
SARS-CoV-2
Coronavirus
Case–control study
Epidemiology
Cohort study
ISSN:0393-2990, 1573-7284, 1573-7284
Online Access:Get full text
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Summary:We conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled generalpopulation controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.
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ISSN:0393-2990
1573-7284
1573-7284
DOI:10.1007/s10654-021-00732-w