The Association Between Chronic Disease and Serious COVID-19 Outcomes and Its Influence on Risk Perception: Survey Study and Database Analysis

Abstract

Background COVID-19, a viral respiratory disease first reported in December 2019, quickly became a threat to global public health. Further understanding of the epidemiology of the SARS-CoV-2 virus and the risk perception of the community may better inform targeted interventions to reduce the impact and spread of COVID-19. Objective In this study, we aimed to examine the association between chronic diseases and serious outcomes following COVID-19 infection, and to explore its influence on people’s self-perception of risk for worse COVID-19 outcomes. Methods This study draws data from two databases: (1) the nationwide database of all confirmed COVID-19 cases in Portugal, extracted on April 28, 2020 (n=20,293); and (2) the community-based COVID-19 Barometer survey, which contains data on health status, perceptions, and behaviors during the first wave of COVID-19 (n=171,087). We assessed the association between relevant chronic diseases (ie, respiratory, cardiovascular, and renal diseases; diabetes; and cancer) and death and intensive care unit (ICU) admission following COVID-19 infection. We identified determinants of self-perception of risk for severe COVID-19 outcomes using logistic regression models. Results Respiratory, cardiovascular, and renal diseases were associated with mortality and ICU admission among patients hospitalized due to COVID-19 infection (odds ratio [OR] 1.48, 95% CI 1.11-1.98; OR 3.39, 95% CI 1.80-6.40; and OR 2.25, 95% CI 1.66-3.06, respectively). Diabetes and cancer were associated with serious outcomes only when considering the full sample of COVID-19–infected cases in the country (OR 1.30, 95% CI 1.03-1.64; and OR 1.40, 95% CI 1.03-1.89, respectively). Older age and male sex were both associated with mortality and ICU admission. The perception of risk for severe COVID-19 disease in the study population was 23.9% (n=40,890). This was markedly higher for older adults (n=5235, 46.4%), those with at least one chronic disease (n=17,647, 51.6%), or those in both of these categories (n=3212, 67.7%). All included diseases were associated with self-perceptions of high risk in this population. Conclusions Our results demonstrate the association between some prevalent chronic diseases and increased risk of worse COVID-19 outcomes. It also brings forth a greater understanding of the community’s risk perceptions of serious COVID-19 disease. Hence, this study may aid health authorities to better adapt measures to the real needs of the population and to identify vulnerable individuals requiring further education and awareness of preventive measures.

Mental distress of parents with chronic diseases during the COVID-19 pandemic in Australia: A prospective cohort study

“…For those with chronic conditions such appraisal of threat could be linked to the heightened vulnerability to worse health outcomes after contracting the virus, including higher mortality rates [ 26 , 76 , 87 , 90 , 92 , 96 , 105 , 113 ]. Our findings are in line with other pandemic research, showing that COVID risk perception among individuals both with and without chronic conditions has been associated with worse self-rated mental health [ 45 , 58 ]. For parents and especially single parents such appraisal of threat might be additionally aggravated since getting infected with COVID could hold more dire consequences such as financial repercussions or temporary diminished support within the family.…”

Difficulties faced by older Rohingya (forcibly displaced Myanmar nationals) adults in accessing medical services amid the COVID-19 pandemic in Bangladesh

“…An extensive review of available studies guided the selection of explanatory variables. 5 22 26 27 Explanatory variables included age (categorised as 60–69, 70–79, and ≥80 years), sex (male/female), marital status (married/widowed), family size (≤4 and more than 4), literacy (unable to read and write/able to read and write), living arrangements (living with family /living alone), memory or concentration problem (no problem/low memory or concentration), walking distance from to the nearest health centre (<30 min/≥30 min), frequency of communication during COVID-19 (less than previous/same as previous), feeling of loneliness (hardly/sometimes to often), perceived that older adults required additional care during COVID-19 (yes/no), pre-existing non-communicable chronic conditions (yes/no) and perceived that older adults at highest risk of COVID-19 (yes/no).…”

Characterization of Individuals Interested in Participating in a Phase I SARS-CoV-2 Vaccine Trial

“…In a Germany-wide survey of around 1000 participants in December 2020, 64% mentioned television and radio as one of their preferred source for information about vaccines against SARS-CoV-2 [ 2 ]. Even though the local case numbers were decreasing at the beginning of our observed time period, the pandemic represents an exceptional and unprecedented situation which is perceived as an acute threat by a significant proportion of the population, specifically persons at risk for a severe disease course [ 8 , 9 ]. We noted that a considerable number of interested individuals belonged to a group with a disproportionate risk either for a severe disease course (i.e., older age or specific pre-conditions) or for acquisition/transmission of disease (i.e., health care workers or individuals with frequent social interactions).…”