Abstract
We conducted a prospective population-based cohort study to assess risk factors for infection, hospitalization, and death from SARS-CoV-2. The study comprised the people covered by the Health Service of Navarre, Spain. Sociodemographic variables and chronic conditions were obtained from electronic healthcare databases. Confirmed infections, hospitalizations, and deaths from SARS-CoV-2 were obtained from the enhanced epidemiological surveillance during the second SARS-CoV-2 epidemic surge (July–December 2020), in which diagnostic tests were widely available. Among 643,757 people, 5497 confirmed infections, 323 hospitalizations, 38 intensive care unit admissions, and 72 deaths from SARS-CoV-2 per 100,000 inhabitants were observed. A higher incidence of confirmed infection was associated with people aged 15–29 years, nursing home residents, healthcare workers, people born in Latin America or Africa, as well as in those diagnosed with diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD), chronic kidney disease, dementia, severe obesity, hypertension and functional dependence. The risk of hospitalization in the population was associated with males, higher age, nursing home residents, Latin American or African origin, and those diagnosed with immunodeficiency, diabetes, cardiovascular disease, COPD, asthma, kidney disease, cerebrovascular disease, cirrhosis, dementia, severe obesity, hypertension and functional dependence. The risk of death was associated with males, higher age, nursing home residents, Latin American origin, low income level, immunodeficiency, diabetes, cardiovascular disease, COPD, kidney disease, dementia, and functional dependence. This study supports the prioritization of the older population, nursing home residents, and people with chronic conditions and functional dependence for SARS-CoV-2 prevention and vaccination, and highlights the need for additional preventive support for immigrants.
Highlights
SARS-CoV-2 has produced more than one epidemic surge of COVID-19 during 2020 in many countries [1]
The cohort included 643,757 people: 35,387 of them were confirmed for SARS-CoV-2 infection in the study period, 2080 were hospitalized, 246 were admitted to the intensive care unit, and 466 died from COVID-19 (Figure 1)
An increased risk of death from COVID-19 in the population was independently observed in males, higher ages, nursing home residents, people born in Latin America, those with very low and low incomes, and those hospitalized in the prior 12 months, as well as in people with immunodeficiency, diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD), chronic kidney disease, dementia and functional dependence (Table 4)
Summary
SARS-CoV-2 has produced more than one epidemic surge of COVID-19 during 2020 in many countries [1]. COVID-19 is a mild condition in most individuals, it can be life threatening for others [2]. Knowing the risk factors for infection, hospitalization and death from COVID-19 in the population may be useful for addressing clinical management, preventive measures, and vaccination programs [3]. Many studies have reported the association of sociodemographic characteristics and pre-existing conditions with severe disease and mortality from COVID-19 in clinical series or epidemiological surveillance [4,5,6,7]. Studies describing risk factors for COVID-19 outcomes in the general population are scarce [10,11,12], they are necessary to assess the risk affecting individuals in the population
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