Nersesjan Vardan, Amiri Moshgan, Christensen Hanne K, Benros Michael E, Kondziella Daniel
Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
Front Med (Lausanne). 2020 Nov 30;7:598272. doi: 10.3389/fmed.2020.598272. eCollection 2020.
As of October 2020, COVID-19 has caused 1,000,000 deaths worldwide. However, large-scale studies of COVID-19 mortality and new-onset comorbidity compared to individuals tested negative for COVID-19 and individuals tested for influenza A/B are lacking. We investigated COVID-19 30-day mortality and new-onset comorbidity compared to individuals with negative COVID-19 test results and individuals tested for influenza A/B. This population-based cohort study utilized electronic health records covering roughly half ( = 2,647,229) of Denmark's population, with nationwide linkage of microbiology test results and death records. All individuals ≥18 years tested for COVID-19 and individuals tested for influenza A/B were followed from 11/2017 to 06/2020. Main outcome was 30-day mortality after a test for either COVID-19 or influenza. Secondary outcomes were major comorbidity diagnoses 30-days after the test for either COVID-19 or influenza A/B. In total, 224,639 individuals were tested for COVID-19. To enhance comparability, we stratified the population for in- and outpatient status at the time of testing. Among inpatients positive for COVID-19, 356 of 1,657 (21%) died within 30 days, which was a 3.0 to 3.1-fold increased 30-day mortality rate, when compared to influenza and COVID-19-negative inpatients (all < 0.001). For outpatients, 128 of 6,263 (2%) COVID-19-positive patients died within 30 days, which was a 5.5 to 6.9-fold increased mortality rate compared to individuals tested negative for COVID-19 or individuals tested positive or negative for influenza, respectively (all < 0.001). Compared to hospitalized patients with influenza A/B, new-onset ischemic stroke, diabetes and nephropathy occurred more frequently in inpatients with COVID-19 (all < 0.05). In this population-based study comparing COVID-19 positive with COVID-19 negative individuals and individuals tested for influenza, COVID-19 was associated with increased rates of major systemic and vascular comorbidity and substantially higher mortality. Results should be interpreted with caution because of differences in test strategies for COVID-19 and influenza, use of aggregated data, the limited 30-day follow-up and the possibility for changing mortality rates as the pandemic unfolds. However, the true COVID-19 mortality may even be higher than the stated 3.0 to 5.5-fold increase, owing to more extensive testing for COVID-19.
截至2020年10月，新型冠状病毒肺炎已在全球造成100万人死亡。然而，与新型冠状病毒肺炎检测呈阴性的个体以及甲型/乙型流感检测个体相比，关于新型冠状病毒肺炎死亡率和新发合并症的大规模研究尚属空白。我们对新型冠状病毒肺炎检测呈阴性的个体以及甲型/乙型流感检测个体进行了研究，比较了新型冠状病毒肺炎30天死亡率和新发合并症情况。这项基于人群的队列研究利用了涵盖丹麦约一半人口（=2,647,229）的电子健康记录，并将微生物检测结果与死亡记录进行了全国范围的关联。所有年龄≥18岁的新型冠状病毒肺炎检测个体以及甲型/乙型流感检测个体均从2017年11月至2020年6月进行随访。主要结局是新型冠状病毒肺炎或流感检测后30天死亡率。次要结局是新型冠状病毒肺炎或甲型/乙型流感检测后30天的主要合并症诊断。总共有224,639人接受了新型冠状病毒肺炎检测。为了提高可比性，我们对检测时的住院和门诊状态进行了分层。在新型冠状病毒肺炎检测呈阳性的住院患者中，1,
