期刊
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
卷 49, 期 6, 页码 1930-1939出版社
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyaa190
关键词
COVID-19; epidemiology; coronavirus; fatality; hospital admission
资金
- Health Department from the Generalitat de Catalunya
- National Institute for Health Research (NIHR) Senior Research Fellowship [SRF-2018-11-ST2-004]
- Fundacion Alfonso Martin Escudero
- Medical Research Council [MR/K501256/1, MR/N013468/1]
- Bill & Melinda Gates Foundation [INV-016201]
- Bill and Melinda Gates Foundation [INV-016201] Funding Source: Bill and Melinda Gates Foundation
- MRC [2122671] Funding Source: UKRI
Background: Currently, there is a missing link in the natural history of COVID-19, from first (usually milder) symptoms to hospitalization and/or death. To fill in this gap, we characterized COVID-19 patients at the time at which they were diagnosed in outpatient settings and estimated 30-day hospital admission and fatality rates. Methods: This was a population-based cohort study.Data were obtained from Information System for Research in Primary Care (SIDIAP)-a primary-care records database covering >6 million people (>80% of the population of Catalonia), linked to COVID-19 reverse transcriptase polymerase chain reaction (RT-PCR) tests and hospital emergency, inpatient and mortality registers. We included all patients in the database who were >= 15 years old and diagnosed with COVID-19 in outpatient settings between 15 March and 24 April 2020 (10 April for outcome studies). Baseline characteristics included socio-demographics, co-morbidity and previous drug use at the time of diagnosis, and polymerase chain reaction (PCR) testing and results.Study outcomes included 30-day hospitalization for COVID-19 and all-cause fatality. Results: We identified 118 150 and 95 467 COVID-19 patients for characterization and outcome studies, respectively. Most were women (58.7%) and young-to-middle-aged (e. 21.1% were 45-54 years old). Of the 44 575 who were tested with PCR, 32723 (73.4%) tested positive. In the month after diagnosis, 14.8% (14.6-15.0) were hospitalized, with a greater proportion of men and older people, peaking at age 75-84 years. Thirty-day fatality was 3.5% (95% confidence interval: 3.4% to 3.6%), higher in men, increasing with age and highest in those residing in nursing homes [24.5% (23.4% to 25.6%)]. Conclusion: COVID-19 infections were widespread in the community, including all age-sex strata. However, severe forms of the disease clustered in older men and nursing-home residents. Although initially managed in outpatient settings, 15% of cases required hospitalization and 4% died within a month of first symptoms. These data are instrumental for designing deconfinement strategies and will inform healthcare planning and hospital-bed allocation in current and future COVID-19 outbreaks.
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