Satué-Gracia Eva M, Vila-Córcoles Angel, de Diego-Cabanes Cinta, Vila-Rovira Angel, Torrente-Fraga Cristina, Gómez-Bertomeu Frederic, Hospital-Guardiola Imma, Ochoa-Gondar Olga, Martín-Luján Francisco
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 (Engl Ed). 2022 Mar 25;158(6):251-259. doi: 10.1016/j.medcle.2021.03.034. Epub 2022 Apr 23.
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.
分析患有不同基础疾病的成年人感染2019冠状病毒病（COVID-19）的易感性/风险。
基于人群的队列研究，涉及西班牙加泰罗尼亚南部塔拉戈纳的79083名年龄≥50岁的个体。在研究开始时（2020年3月1日）确定队列的基线特征（人口统计学、既往合并症、慢性药物治疗和疫苗接种史），主要结局是在2020年3月1日至2020年6月30日期间队列成员中实验室确诊的COVID-19。通过Cox回归评估感染COVID-19的风险，估计调整年龄/性别和既往合并症后的多变量风险比（HRs）。
在整个研究期间，观察到536例实验室确诊的COVID-19病例（平均发病率：每10万人周39.5例）。在多变量分析中，年龄增加/岁（HR：1.01；95%置信区间：1.00-1.02）、养老院（HR：20.19；95%置信区间：15.98-25.51）、神经系统疾病（HR：1.35；95%置信区间：1.03-1.77）、服用利尿剂（HR：1.39；95%置信区间：1.10-1.75）、抗血小板药物（HR：1.36；95%置信区间：1.05-1.76）和苯二氮䓬类药物（HR：1.24；95%置信区间：1.00-1.53）会增加风险；相反，服用血管紧张素转换酶抑制剂（HR：0.78；95%置信区间：0.61-1.00）、血管紧张素受体阻滞剂（HR：0.70；95%置信区间：0.51-0.96）和他汀类药物（HR：0.75；95%置信区间：0.58-0.96）与风险降低相关。在社区居住的个体中，既往癌症、肾脏和心脏疾病也似乎与风险增加有关，而流感疫苗接种与风险降低有关。
在大流行第一波期间COVID-19发病率相对较低的情况下，年龄增加、居住在养老院和多种合并症似乎是中年/老年人感染COVID-19的易感因素。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有关。
