Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal.
Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal.
JMIR Public Health Surveill. 2021 Jan 12;7(1):e22794. doi: 10.2196/22794.
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.
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.
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.
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.
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.
COVID-19 是一种于 2019 年 12 月首次报告的病毒性呼吸道疾病，迅速成为全球公共卫生的威胁。进一步了解 SARS-CoV-2 病毒的流行病学和社区的风险感知，可能会更好地为减少 COVID-19 的影响和传播提供有针对性的干预措施。
本研究旨在探讨 COVID-19 感染后慢性疾病与严重结局之间的关系，并探讨其对人们对 COVID-19 不良结局自我感知风险的影响。
本研究的数据来自两个数据库：（1）2020 年 4 月 28 日提取的葡萄牙全国所有确诊 COVID-19 病例数据库（n=20293）；（2）基于社区的 COVID-19 晴雨表调查，其中包含 COVID-19 第一波期间健康状况、认知和行为的数据（n=171087）。我们评估了相关慢性疾病（即呼吸系统疾病、心血管疾病和肾脏疾病；糖尿病；以及癌症）与 COVID-19 感染后死亡和重症监护病房（ICU）入院之间的关系。我们使用逻辑回归模型确定了对严重 COVID-19 结局自我感知风险的决定因素。
在因 COVID-19 住院的患者中，呼吸系统、心血管和肾脏疾病与死亡率和 ICU 入院相关（比值比 [OR] 1.48，95%置信区间 [CI] 1.11-1.98；OR 3.39，95% CI 1.80-6.40；OR 2.25，95% CI 1.66-3.06，分别）。糖尿病和癌症仅在考虑全国 COVID-19 感染病例的全样本时与严重结局相关（OR 1.30，95% CI 1.03-1.64；OR 1.40，95% CI 1.03-1.89，分别）。年龄较大和男性均与死亡率和 ICU 入院相关。研究人群对严重 COVID-19 疾病的风险感知为 23.9%（n=40890）。这在老年人（n=5235，46.4%）、至少有一种慢性疾病的人群（n=17647，51.6%）或同时存在这两种情况的人群（n=3212，67.7%）中明显更高。在该人群中，所有纳入的疾病都与自我感知的高风险相关。
我们的研究结果表明，一些常见的慢性疾病与 COVID-19 不良结局的风险增加之间存在关联。这也使我们更深入地了解社区对严重 COVID-19 疾病的风险认知。因此，本研究可能有助于卫生当局更好地根据人口的实际需求调整措施，并识别需要进一步教育和预防措施意识的脆弱人群。
