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Determinants for hospitalisations, intensive care unit admission and death among 20,293 reported COVID-19 cases in Portugal, March to April 2020

2021-08-19Artigo científico Acesso aberto
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dc.contributor.authorPeixoto, Vasco Ricoca
dc.contributor.authorVieira, André
dc.contributor.authorAguiar, Pedro
dc.contributor.authorSousa, Paulo
dc.contributor.authorCarvalho, Carlos
dc.contributor.authorThomas, Daniel
dc.contributor.authorAbrantes, Alexandre
dc.contributor.authorNunes, Carla
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - Pólo ENSP
dc.contributor.institutionEscola Nacional de Saúde Pública (ENSP)
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.pblEuropean Centre for Disease Prevention and Control
dc.date.accessioned2021-10-06T23:21:53Z
dc.date.available2021-10-06T23:21:53Z
dc.date.issued2021-08-19
dc.descriptionPublisher Copyright: © 2021 European Centre for Disease Prevention and Control (ECDC). All rights reserved.
dc.description.abstractBackground: Determinants of hospitalisation, intensive care unit (ICU) admission and death are still unclear for COVID-19. Few studies have adjusted for confounding for different clinical outcomes including all reported cases within a country. Aim: We used routine surveillance data from Portugal to identify risk factors for severe COVID-19 outcomes, and to support risk stratification, public health interventions, and planning of healthcare resources. Methods: We conducted a retrospective cohort study including 20,293 laboratory- confirmed cases of COVID-19 reported between 1 March and 28 April 2020 through the national epidemiological surveillance system. We calculated absolute risk, relative risk (RR) and adjusted relative risk (aRR) to identify demographic and clinical factors associated with hospitalisation, ICU admission and death using Poisson regressions. Results: Increasing age (≥ 60 years) was the major determinant for all outcomes. Age ≥ 90 years was the strongest determinant of hospital admission (aRR: 6.1), and 70-79 years for ICU (aRR: 10.4). Comorbidities of cardiovascular, immunodeficiency, kidney and lung disease (aRR: 4.3, 2.8, 2.4, 2.0, respectively) had stronger associations with ICU admission, while for death they were kidney, cardiovascular and chronic neurological disease (aRR: 2.9, 2.6, 2.0). Conclusions: Older age was the strongest risk factor for all severe outcomes. These findings from the early stages of the COVID-19 pandemic support risk-stratified public health measures that should prioritise protecting older people. Epidemiological scenarios and clinical guidelines should consider this, even though under-ascertainment should also be considered.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent322003
dc.identifier.doi10.2807/1560-7917.ES.2021.26.33.2001059
dc.identifier.issn1025-496X
dc.identifier.otherPURE: 34123055
dc.identifier.otherPURE UUID: 5c188b36-d0e2-4e4e-9d32-ada88fda1b0d
dc.identifier.otherScopus: 85114404060
dc.identifier.otherPubMed: 34414882
dc.identifier.otherWOS: 000686880800001
dc.identifier.otherPubMedCentral: PMC8380973
dc.identifier.otherORCID: /0000-0001-9502-6075/work/130929499
dc.identifier.otherORCID: /0000-0002-0074-7732/work/139077047
dc.identifier.otherORCID: /0000-0002-7529-8206/work/153838248
dc.identifier.urihttp://hdl.handle.net/10362/125708
dc.identifier.urlhttps://www.scopus.com/pages/publications/85114404060
dc.language.isoeng
dc.peerreviewedyes
dc.subjectEpidemiology
dc.subjectPublic Health, Environmental and Occupational Health
dc.subjectVirology
dc.subjectSDG 3 - Good Health and Well-being
dc.titleDeterminants for hospitalisations, intensive care unit admission and death among 20,293 reported COVID-19 cases in Portugal, March to April 2020en
dc.typejournal article
degois.publication.issue33
degois.publication.titleEurosurveillance
degois.publication.volume26
dspace.entity.typePublication
rcaap.rightsopenAccess

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