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

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  • Mette Reilev, University of Southern Denmark
  • ,
  • Kasper Bruun Kristensen, University of Southern Denmark
  • ,
  • Anton Pottegård, University of Southern Denmark
  • ,
  • Lars Christian Lund, University of Southern Denmark
  • ,
  • Jesper Hallas, University of Southern Denmark
  • ,
  • Martin Thomsen Ernst, University of Southern Denmark
  • ,
  • Christian Fynbo Christiansen
  • Henrik Toft Sørensen
  • Nanna Borup Johansen, The Danish Medicines Agency,
  • Nikolai Constantin Brun, The Danish Medicines Agency,
  • Marianne Voldstedlund, Statens Serum Institut
  • ,
  • Henrik Støvring
  • Marianne Kragh Thomsen
  • Steffen Christensen
  • Sophie Gubbels, Statens Serum Institut
  • ,
  • Tyra Grove Krause, Statens Serum Institut
  • ,
  • Kåre Mølbak, Statens Serum Institut
  • ,
  • Reimar Wernich Thomsen

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.

Original languageEnglish
JournalInternational Journal of Epidemiology
Volume49
Issue5
Pages (from-to)1468-1481
Number of pages14
ISSN0300-5771
DOIs
Publication statusPublished - Oct 2020

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