Vila-Córcoles Ángel, Ochoa-Gondar Olga, Torrente-Fraga Cristina, Vila-Rovira Ángel, Satué-Gracia Eva, Hospital-Guardiola Immaculada, de Diego-Cabanes Cinta, Gómez-Bertomeu Frederic, Basora-Gallisà Josep
Servicio de Atención Primaria Camp de Tarragona. Institut Català de la Salut. Tarragona. España.
Unitat de suport a la Recerca Tarragona-Reus. IDIAP Jordi Gol. Barcelona. España.
Rev Esp Salud Publica. 2020 Jun 26;94:e202006065.
Population-based data on the current Covid-19 pandemic is scarce. This study investigated incidence and risk to suffer Covid-19 by baseline underlying conditions in people ≥50 years in Tarragona region across march-april 2020.
Population-based retrospective cohort study involving 79,071 adults ≥50 years-old in Tarragona region (Southern Catalonia, Spain). Cohort characteristics (age, sex, residence, vaccinations history and comorbidities) were established at baseline, and Covid-19 cases occurring between 01/03/2020-30/04/2020 were registered. Cox regression analysis calculating Hazard ratios (HRs) adjusted by age, sex and comorbidities was used to estimate risk for Covid-19.
Across study period, 1,547 cohort members were PCR tested (22.6% positive) and 367 were presumptive cases without PCR tested. Considering PCR-confirmed Covid-19, incidence (per 100,000 persons-period) was 441 overall (248, 141, 424, 1,303 and 3,135 in 50-59, 60-69, 70-79, 80-89 and ≥90 years-old, respectively; 380 in men and 497 in women; 259 in community-dwelling and 10,571 in nursing-home). By comorbidities, maximum incidence emerged among persons with neurological disease (2,723), atrial fibrillation (1,348), chronic renal failure (1,050), cardiac disease (856), respiratory disease (798) and diabetes (706). Lower incidence appeared in rheumatic diseases (230) and smokers (180). In multivariable analysis focused on community-dwelling individuals (N=77,671), only cardiac disease (HR: 1.47; 95% CI: 1.01-2.15; p=0.045) and respiratory disease (HR: 1.75; 95% CI: 1.00-3.02; p=0.051) were associated with an increased risk, whereas smoking (HR:0.43; 95% CI: 0.25-0.74; p=0.002) and influenza vaccinated (HR: 0.63; 95% CI: 0.43-0.92; p=0.015) appeared associated with a decreased risk.
Apart of increasing age and nursing-home residence, chronic respiratory and cardiac disease appear at increased risk for suffering covid19. This study investigated population-based incidence of Covid-19 infection by underlying conditions among adults ≥50 years in Tarragona (Southern Catalonia, Spain) across two first months pandemic period.
目前关于新冠疫情的基于人群的数据匮乏。本研究调查了2020年3月至4月期间,塔拉戈纳地区50岁及以上人群中,新冠病毒感染的发病率以及因基线基础疾病而感染新冠的风险。
基于人群的回顾性队列研究,涉及塔拉戈纳地区(西班牙加泰罗尼亚南部)79,071名50岁及以上的成年人。在基线时确定队列特征(年龄、性别、居住地、疫苗接种史和合并症),并记录2020年3月1日至4月30日期间发生的新冠病例。使用经年龄、性别和合并症调整的Cox回归分析计算风险比(HR),以估计感染新冠的风险。
在研究期间,1,547名队列成员接受了PCR检测(22.6%呈阳性),367名是未经PCR检测的推定病例。考虑PCR确诊的新冠病例,总体发病率(每10万人-时期)为441例(50-59岁、60-69岁、70-79岁、80-89岁和90岁及以上分别为248例、141例、424例、1,303例和3,135例;男性为380例,女性为497例;社区居民为259例,养老院居民为10,571例)。按合并症分类,神经系统疾病患者(2,723例)、心房颤动患者(1,348例)、慢性肾衰竭患者(1,050例)、心脏病患者(856例)、呼吸系统疾病患者(798例)和糖尿病患者(706例)的发病率最高。风湿病患者(230例)和吸烟者(180例)的发病率较低。在针对社区居民(N=77,671)的多变量分析中,只有心脏病(HR:1.47;95%CI:1.01-2.15;p=0.045)和呼吸系统疾病(HR:1.75;95%CI:1.00-3.02;p=0.051)与风险增加相关,而吸烟(HR:0.43;95%CI:0.25-0.74;p=0.002)和接种流感疫苗(HR:0.63;95%CI:0.43-0.92;p=0.015)与风险降低相关。
除了年龄增长和居住在养老院外,慢性呼吸系统和心脏病患者感染新冠的风险似乎增加。本研究调查了西班牙加泰罗尼亚南部塔拉戈纳地区50岁及以上成年人在疫情头两个月期间,基于基础疾病的新冠病毒感染人群发病率。