Burden and prevalence of risk factors for severe COVID-19 disease in the ageing European population – A SHARE-based analysis

Abstract

Aim: International health authorities suggest that individuals aged 65 years and above and people with underlying comorbidities such as hypertension, chronic lung disease, cardiovascular disease, cancer, diabetes, and obesity are at increased risk of severe Coronavirus Disease 2019 (COVID-19); however, the prevalence of risk factors is unknown in many countries. Therefore, we aim to describe the distribution of these risk factors across Europe. Subject and Methods: Prevalence of risk factors for severe COVID-19 was identified based on interview for 73,274 Europeans aged 50+ participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2017. Burden of disease was estimated using population data from Eurostat. Results: A total of 75.3% of the study population (corresponding to app. 60 million European men and 71 million women) had at least one risk factor for severe COVID-19, 45.9% (app. 36 million men and 43 million women) had at least two factors and 21.2% (app. 17 million men and 20 million women) had at least three risk factors. The prevalences of underlying medical conditions ranged from 4.5% for cancer to 41.4% for hypertension, and the region-specific prevalence of having at least three risk factors ranged from 18.9% in Northern Europe to 24.6% in Eastern Europe. Conclusions: Information about the prevalences of risk factors might help authorities to identify the most vulnerable subpopulations with multiple risk factors of severe COVID-19 disease and thus to decide appropriate strategies to mitigate the pandemic.

Sex and age differences in COVID-19 mortality in Europe

“…Although recent evidence suggests that European women overall have slightly more comorbidities than European men [21], men are generally reported to have more life-threatening conditions, such as cardiovascular diseases, whereas women tend to have more non-fatal chronic diseases, such as migraine, musculoskeletal and autoimmune diseases as well as physical limitations [22][23][24][25]. Thus, the higher risk of death from COVID-19 among men may to some extent be explained by the relatively higher prevalence of underlying comorbidities such as cardiovascular disease, hypertension, diabetes and chronic lung disease [10,26,27]. Nevertheless, sex differences in health depend on the selected health dimension and the age group studied, and not all outcomes show differences between sexes or show very little differences [28,29].…”

Chronic respiratory diseases are predictors of severe outcome in COVID-19 hospitalised patients: a nationwide study

“…Patients suffering from chronic respiratory diseases (CRD) such as chronic respiratory failure, asthma, chronic obstructive pulmonary disease (COPD), interstitial lung diseases (ILD), pulmonary hypertension (PH), sarcoidosis or cystic fibrosis (CF), were immediately considered to be at risk of severe forms of COVID-19 (1). Indeed, COVID-19 is responsible for various respiratory symptoms, from cough with dyspnea to acute respiratory distress syndrome (ARDS) in its most severe presentation (2,3).…”

“…There is concern that the respiratory complications of COVID-19 could be deleterious in patients with prior CRD. However, clinical experience and published data covering the outbreak period have suggested that there was a surprisingly low proportion of patients with CRD among patients with COVID-19, especially in its most severe forms (1,5,6).…”

Cardiovascular Disease Complicating COVID-19 in the Elderly

“…About 20% of COVID-19 patients are hypertensive, but some older COVID-19 populations have high blood pressure (HBP) rates exceeding 50%, consistent with the prevalence of hypertension in persons of advancing age ( Table 1 ) [ 22 , 23 , 24 ]. The status of hypertension as an independent risk factor for morbidity and mortality in COVID-19 is unclear.…”