Primary Care Department Camp de Tarragona, Institut Català de la Salut (ICS), Unitat de Suport a la Recerca (USR), Camí de Riudoms, 53-55, 43202 Reus (Tarragona), Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAP J Gol), Gran Via Corts Catalanes, 587, 08007 Barcelona, Spain.
Primary Care Department Camp de Tarragona, Institut Català de la Salut (ICS), Unitat de Suport a la Recerca (USR), Camí de Riudoms, 53-55, 43202 Reus (Tarragona), Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAP J Gol), Gran Via Corts Catalanes, 587, 08007 Barcelona, Spain.
Med Clin (Barc). 2022 Mar 25;158(6):251-259. doi: 10.1016/j.medcli.2021.03.027. Epub 2021 May 7.
To analyse susceptibility/risk of suffering COVID-19 among adults with distinct underlying medical conditions.
Population-based cohort study involving 79,083 individuals ≥50 years old in Tarragona (Southern Catalonia, Spain). Baseline cohort characteristics (demographic, pre-existing comorbidities, chronic medications and vaccinations history) were established at study start (01/03/2020) and primary outcome was laboratory-confirmed COVID-19 occurred among cohort members throughout 01/03/2020-30/06/2020. Risk of suffering COVID-19 was evaluated by Cox regression, estimating multivariable hazard ratios (HRs) adjusted for age/sex and pre-existing comorbidities.
Across study period, 536 laboratory-confirmed COVID-19 cases were observed (mean incidence: 39.5 cases per 100,000 persons-week). In multivariable-analysis, increasing age/years (HR: 1.01; 95% CI: 1.00-1.02), nursing-home (HR: 20.19; 95% CI: 15.98-25.51), neurological disease (HR: 1.35; 95% CI: 1.03-1.77), taking diuretics (HR: 1.39; 95% CI: 1.10-1.75), antiplatelet (HR: 1.36; 95% CI: 1.05-1.76) and benzodiazepines (HR: 1.24; 95% CI: 1.00-1.53) increased risk; conversely, taking angiotensin-converting-enzyme inhibitors (HR: 0.78; 95% CI: 0.61-1.00), angiotensin-receptor-blockers (HR: 0.70; 95%CI: 0.51-0.96) and statins (HR: 0.75; 95% CI: 0.58-0.96) were associated with reduced risk. Among community-dwelling individuals, pre-existing cancer, renal and cardiac disease appeared also related with an increased risk, whereas influenza vaccination was associated with reduced risk.
In a setting with relatively low incidence of COVID-19 across the first wave of pandemic period, increasing age, nursing-home residence and multiple comorbidities appear predisposing for COVID-19 among middle-aged/older adults. Conversely, statins, angiotensin-receptor blockers/inhibitors and influenza vaccination were related with decreased risk.
分析不同基础医学条件下成年人罹患 COVID-19 的易感性/风险。
本研究为基于人群的队列研究，纳入了西班牙塔拉戈纳（加泰罗尼亚南部）79083 名≥50 岁的个体。在研究开始时（2020 年 3 月 1 日）确定了基线队列特征（人口统计学、既往合并症、慢性药物治疗和疫苗接种史），主要结局是队列成员在 2020 年 3 月 1 日至 6 月 30 日期间确诊的 COVID-19。采用 Cox 回归评估罹患 COVID-19 的风险，通过调整年龄/性别和既往合并症，估算多变量风险比（HR）。
在研究期间，观察到 536 例实验室确诊的 COVID-19 病例（平均发病率：每 100000 人周 39.5 例）。多变量分析显示，年龄/岁的增加（HR：1.01；95%CI：1.00-1.02）、养老院（HR：20.19；95%CI：15.98-25.51）、神经系统疾病（HR：1.35；95%CI：1.03-1.77）、使用利尿剂（HR：1.39；95%CI：1.10-1.75）、抗血小板药物（HR：1.36；95%CI：1.05-1.76）和苯二氮䓬类药物（HR：1.24；95%CI：1.00-1.53）会增加风险；相反，使用血管紧张素转换酶抑制剂（HR：0.78；95%CI：0.61-1.00）、血管紧张素受体阻滞剂（HR：0.70；95%CI：0.51-0.96）和他汀类药物（HR：0.75；95%CI：0.58-0.96）与风险降低相关。在居住于社区的个体中，既往癌症、肾脏和心脏疾病也与风险增加相关，而流感疫苗接种与风险降低相关。
在第一波大流行期间 COVID-19 发病率相对较低的情况下，年龄增长、养老院居住和多种合并症似乎会增加中年/老年人罹患 COVID-19 的风险。相反，他汀类药物、血管紧张素受体阻滞剂/抑制剂和流感疫苗接种与风险降低相关。
