4.7 Article

Risk Factors of Infection, Hospitalization and Death from SARS-CoV-2: A Population-Based Cohort Study

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 10, Issue 12, Pages -

Publisher

MDPI
DOI: 10.3390/jcm10122608

Keywords

SARS-CoV-2 infection; COVID-19; cohort study; COVID-19 hospitalization; COVID-19 severity; mortality; risk factor; epidemiology; inequality; Spain

Funding

  1. Horizon 2020 program of the European Commission, project I-MOVE-COVID-19 [101003673]
  2. Heath Department of the Navarre Government [Pyto 2018/43]
  3. Carlos III Institute of Health
  4. European Regional Development Fund [COV20/00542, PI20/01323]

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This prospective study in Spain found that certain demographic factors and chronic conditions were associated with higher risks of SARS-CoV-2 infection, hospitalization, and death. It identified groups such as the older population, nursing home residents, and individuals with specific health conditions as priorities for COVID-19 prevention and vaccination. The study also highlighted the need for additional support for immigrants in terms of preventive measures.
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.

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