Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States

Adams, Mildred; Katz, David L.; Grandpre, Joseph

doi:10.3201/eid2608.200679

Cited by 117 publications

(111 citation statements)

References 7 publications

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“…First, because the population size decreases with age, and, secondly, because the prevalence of chronic diseases reaches its peak around the age of 70 (probably because people with the condition of interest are more likely to be selected out of the population). 18 These results are in line with the already mentioned studies performed in the United States by Adams ML et al, 12 and with what has been observed so far in the COVID-19 age distribution in Portugal. The proportion of population at the highest risk found in this study is below what others have estimated for population at increased/high risk, 19,20 including Adams ML et al and Koma W et al (45.4% and 37.6% of US adults, respectively), 11,21 which is mostly the result of adopting another definition of risk (i.e.…”

Section: Discussionsupporting

confidence: 85%

“…10 In order to project the potential population at highest risk for COVID-19, we used the latest available official demographic estimates from the National Institute of Statistics (INE 2018). 11 In this study, we adopted a definition of high risk, based on two different approaches: 1) similar to the one used by Adams ML et al, 12 which was based on the presence of specific chronic conditions; 2) age criteria, by using the cutoff of ≥ 65 years old, as defined by the CDC. 13 Thus, we used a more conservative definition of high risk than Adams ML et al This definition of highest risk, combining comorbidities and old age criteria, is thus a more restrictive one and has the potential to underestimate the population at risk [Appendix 1 illustrates results using a less conservative definition by considering old-age as just another risk factor along with the analyzed comorbidities (see Appendix 1: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14222/Appendix_01.pdf)].…”

Section: Methodsmentioning

confidence: 99%

“…Following the methodology used by Adams ML et al, 12 the key comorbidity variable was a composite measure including those reporting that they had cardio and cerebrovascular disease (heart attack, angina, coronary heart disease, or stroke), diabetes, chronic obstructive pulmonary disease (COPD), or hypertension. We counted the number of chronic conditions for each respondent who reported at least one condition and was considered to be at heightened risk for complications from COVID-19.…”

Section: Methodsmentioning

confidence: 99%

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Population-based Estimates for High Risk of Severe COVID-19 Disease due to Age and Underlying Health Conditions

Laires

Nunes

2020

Acta Med Port

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Introduction: COVID-19 is a viral respiratory disease, which became a global threat to public health. Specific subsets of the population are more vulnerable, namely those with chronic diseases. We aimed to estimate the share of the Portuguese population at the highest risk for complications following COVID-19 infection due to both old age and specific comorbidities.Material and Methods: Our sample included all people aged 65 years and above (2215 men and 3486 women) who participated in the fifth Portuguese National Health Interview Survey, conducted in 2014. In order to project the potential population at highest risk for COVID-19, we used the latest available official demographic estimates from the National Institute of Statistics - INE 2018. We used a more restrictive definition of risk combining old age criteria and the following chronic conditions as potential risk factors for COVID-19 according to the available literature: hypertension, diabetes, chronic obstructive pulmonary disease, cardio- and cerebrovascular disease.Results: We estimated that 15.5% (n = 1 560 667) of the Portuguese population might be at increased risk for complications from COVID-19 because of old age and existing chronic conditions. Such estimates vary across the country (from 1.7% in Azores to 33.7% in Northern Portugal). Northern Portugal not only has the highest prevalence of selected morbidity (72.8%) within mainland Portugal, but also has the largest population at risk for COVID-19 (n = 526 607). This was followed by the Lisbon and Tagus Valley region (n = 408 564) and Central Portugal (n = 388 867).Discussion: Our results should encourage authorities to continue protecting those more vulnerable to the pandemic threat, particularly on those areas of the country which are more likely to be further affected.Conclusion: We projected a considerable number of Portuguese people at the highest risk for severe COVID-19 disease due to both old age and pre-existing chronic conditions. Such estimates vary across the country.

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Section: Discussionsupporting

confidence: 85%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Population-based Estimates for High Risk of Severe COVID-19 Disease due to Age and Underlying Health Conditions

Laires

Nunes

2020

Acta Med Port

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“…Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have a wide variety of clinical manifestations. While > 80% of infected patients experience only mild illness [ 1 ], mortality rates of Coronavirus Disease 2019 (COVID-19) have been estimated to be 5–27% [ 2 , 3 ] in vulnerable populations, including older adults and patients with multiple co-morbidities [ 4 , 5 ]. For patients with mild disease, supportive care has been the preferred management strategy [ 6 ]; pharmacological treatments with possible anti-viral effects have been primarily used for patients with moderate-to-severe disease [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Pharmacotherapy for Hospitalized Patients with COVID-19: Treatment Patterns by Disease Severity

Lin

Schneeweiß

Tesfaye

et al. 2020

Drugs

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Background Treatment decisions for Coronavirus Disease 2019 (COVID-19) depend on disease severity, but the prescribing pattern by severity and drivers of therapeutic choices remain unclear. Objectives The objectives of the study were to evaluate pharmacological treatment patterns by COVID-19 severity and identify the determinants of prescribing for COVID-19. Methods Using electronic health record data from a large Massachusetts-based healthcare system, we identified all patients aged ≥ 18 years hospitalized with laboratory-confirmed COVID-19 from 1 March to 24 May, 2020. We defined five levels of COVID-19 severity at hospital admission: (1) hospitalized but not requiring supplemental oxygen; (2–4) hospitalized and requiring oxygen ≤ 2, 3–4, and ≥ 5 L per minute, respectively; and (5) intubated or admitted to an intensive care unit. We assessed the medications used to treat COVID-19 or as supportive care during hospitalization. Results Among 2821 patients hospitalized for COVID-19, we found inpatient mortality increased by severity from 5% for level 1 to 23% for level 5. As compared to patients with severity level 1, those with severity level 5 were 3.53 times (95% confidence interval 2.73–4.57) more likely to receive a medication used to treat COVID-19. Other predictors of treatment were fever, low oxygen saturation, presence of co-morbidities, and elevated inflammatory biomarkers. The use of most COVID-19 relevant medications has dropped substantially while the use of remdesivir and therapeutic anticoagulants has increased over the study period. Conclusions Careful consideration of disease severity and other determinants of COVID-19 drug use is necessary for appropriate conduct and interpretation of non-randomized studies evaluating outcomes of COVID-19 treatments. Electronic supplementary material The online version of this article (10.1007/s40265-020-01424-7) contains supplementary material, which is available to authorized users.

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“…A few recent studies have identified non-radiologic demographic and clinical predictors of mortality in COVID-19 pneumonia, including but not limited to patients’ age, ethnicity, and various underlying medical conditions [ [2] , [3] , [4] , [5] ]. Although the disease was primarily thought to be an entirely nonfatal illness in nonelderly healthy patients without underlying medical conditions, the reports from around the world have been opposing [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Predictive value of CT in the short-term mortality of Coronavirus Disease 2019 (COVID-19) pneumonia in nonelderly patients: A case-control study

Tabatabaei

Rahimi

Moghaddas

et al. 2020

European Journal of Radiology

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Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States

Cited by 117 publications

References 7 publications

Population-based Estimates for High Risk of Severe COVID-19 Disease due to Age and Underlying Health Conditions

Population-based Estimates for High Risk of Severe COVID-19 Disease due to Age and Underlying Health Conditions

Pharmacotherapy for Hospitalized Patients with COVID-19: Treatment Patterns by Disease Severity

Predictive value of CT in the short-term mortality of Coronavirus Disease 2019 (COVID-19) pneumonia in nonelderly patients: A case-control study

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