Weill Cornell Medicine-Qatar Cornell University Doha Qatar.
Mathematics Program Department of Mathematics, Statistics, and Physics College of Arts and Sciences Qatar University Doha Qatar.
Influenza Other Respir Viruses. 2023 Nov;17(11):e13224. doi: 10.1111/irv.13224.
We investigated the contribution of age, coexisting medical conditions, sex, and vaccination to incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and of severe, critical, or fatal COVID-19 in older adults since pandemic onset.
A national retrospective cohort study was conducted in the population of Qatar aged ≥50 years between February 5, 2020 and June 15, 2023. Adjusted hazard ratios (AHRs) for infection and for severe coronavirus disease 2019 (COVID-19) outcomes were estimated through Cox regression models.
Cumulative incidence was 25.01% (95% confidence interval [CI]: 24.86-25.15%) for infection and 1.59% (95% CI: 1.55-1.64%) for severe, critical, or fatal COVID-19 after a follow-up duration of 40.9 months. Risk of infection varied minimally by age and sex but increased significantly with coexisting conditions. Risk of infection was reduced with primary-series vaccination (AHR: 0.91, 95% CI: 0.90-0.93) and further with first booster vaccination (AHR: 0.75, 95% CI: 0.74-0.77). Risk of severe, critical, or fatal COVID-19 increased exponentially with age and linearly with coexisting conditions. AHRs for severe, critical, or fatal COVID-19 were 0.86 (95% CI: 0.7-0.97) for one dose, 0.15 (95% CI: 0.13-0.17) for primary-series vaccination, and 0.11 (95% CI: 0.08-0.14) for first booster vaccination. Sensitivity analysis restricted to only Qataris yielded similar results.
Incidence of severe COVID-19 in older adults followed a dynamic pattern shaped by infection incidence, variant severity, and population immunity. Age, sex, and coexisting conditions were strong determinants of infection severity. Vaccine protection against severe outcomes showed a dose-response relationship, highlighting the importance of booster vaccination for older adults.
自大流行开始以来，我们研究了年龄、并存的医疗条件、性别和疫苗接种对 50 岁以上成年人严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染以及严重、危重症或致命 COVID-19 的发生率的影响。
这是一项在卡塔尔≥50 岁人群中进行的全国性回顾性队列研究，研究时间为 2020 年 2 月 5 日至 2023 年 6 月 15 日。通过 Cox 回归模型估计感染和严重冠状病毒病 2019（COVID-19）结局的调整后风险比（AHR）。
在 40.9 个月的随访期间，感染的累积发生率为 25.01%（95%置信区间[CI]：24.86%-25.15%），严重、危重症或致命 COVID-19 的发生率为 1.59%（95%CI：1.55%-1.64%）。感染风险随年龄和性别变化极小，但随并存疾病显著增加。基础系列疫苗接种可降低感染风险（AHR：0.91，95%CI：0.90-0.93），首次加强针接种进一步降低风险（AHR：0.75，95%CI：0.74-0.77）。严重、危重症或致命 COVID-19 的风险随年龄呈指数增长，随并存疾病呈线性增长。一剂疫苗的严重、危重症或致命 COVID-19 的 AHR 为 0.86（95%CI：0.7-0.97），基础系列疫苗接种的 AHR 为 0.15（95%CI：0.13-0.17），首次加强针接种的 AHR 为 0.11（95%CI：0.08-0.14）。仅针对卡塔尔人的敏感性分析得出了类似的结果。
年龄较大成年人严重 COVID-19 的发生率遵循一种动态模式，由感染发生率、变异严重程度和人群免疫力决定。年龄、性别和并存疾病是感染严重程度的重要决定因素。疫苗对严重结局的保护作用呈剂量反应关系，这突出表明加强针接种对老年人的重要性。
