| Autor: |
Funk T; European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden., Innocenti F; European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.; Epidemiology Unit, Regional Health Agency of Tuscany, Florence, Italy., Gomes Dias J; European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden., Nerlander L; European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden., Melillo T; Infectious Disease Prevention and Control Unit, Superintendence of Public Health, Gwardamanġa, Malta., Gauci C; Superintendence of Public Health, Valletta, Malta., Melillo JM; Infectious Disease Prevention and Control Unit, Superintendence of Public Health, Gwardamanġa, Malta., Lenz P; Department of Biostatistics, National Institute of Public Health, Prague, Czechia., Sebestova H; Department of Biostatistics, National Institute of Public Health, Prague, Czechia., Slezak P; Department of Infectious Diseases Epidemiology, National Institute of Public Health, Prague, Czechia., Vlckova I; Department of Biostatistics, National Institute of Public Health, Prague, Czechia., Berild JD; Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway., Mauroy C; Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway., Seppälä E; Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway.; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden., Tønnessen R; Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway.; European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden., Vergison A; Health Directorate, Luxembourg, Luxembourg., Mossong J; Health Directorate, Luxembourg, Luxembourg., Masi S; Health Directorate, Luxembourg, Luxembourg., Huiart L; Health Directorate, Luxembourg, Luxembourg., Cullen G; HSE - Health Protection Surveillance Centre, Dublin, Ireland., Murphy N; HSE - Health Protection Surveillance Centre, Dublin, Ireland., O'Connor L; HSE - Health Protection Surveillance Centre, Dublin, Ireland., O'Donnell J; HSE - Health Protection Surveillance Centre, Dublin, Ireland., Mook P; World Health Organization Regional Office for Europe, Copenhagen, Denmark., Pebody RG; World Health Organization Regional Office for Europe, Copenhagen, Denmark., Bundle N; European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden. |
| Abstrakt: |
BackgroundUnderlying conditions are risk factors for severe COVID-19 outcomes but evidence is limited about how risks differ with age.AimWe sought to estimate age-specific associations between underlying conditions and hospitalisation, death and in-hospital death among COVID-19 cases.MethodsWe analysed case-based COVID-19 data submitted to The European Surveillance System between 2 June and 13 December 2020 by nine European countries. Eleven underlying conditions among cases with only one condition and the number of underlying conditions among multimorbid cases were used as exposures. Adjusted odds ratios (aOR) were estimated using 39 different age-adjusted and age-interaction multivariable logistic regression models, with marginal means from the latter used to estimate probabilities of severe outcome for each condition-age group combination.ResultsCancer, cardiac disorder, diabetes, immunodeficiency, kidney, liver and lung disease, neurological disorders and obesity were associated with elevated risk (aOR: 1.5-5.6) of hospitalisation and death, after controlling for age, sex, reporting period and country. As age increased, age-specific aOR were lower and predicted probabilities higher. However, for some conditions, predicted probabilities were at least as high in younger individuals with the condition as in older cases without it. In multimorbid patients, the aOR for severe disease increased with number of conditions for all outcomes and in all age groups.ConclusionWhile supporting age-based vaccine roll-out, our findings could inform a more nuanced, age- and condition-specific approach to vaccine prioritisation. This is relevant as countries consider vaccination of younger people, boosters and dosing intervals in response to vaccine escape variants. |
