Bavarian State Office for Statistics, Division: Population Statistics and Demography, Fürth, Germany.
Bavarian Health and Food Safety Authority, State Institute for Health II - Task Force for Infectious Diseases Infectious Disease Epidemiology, Surveillance and Modelling Unit (GI-TFI2), Oberschleißheim, Germany.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 Aug;67(8):939-946. doi: 10.1007/s00103-024-03914-5. Epub 2024 Jul 16.
Older age is a risk factor for a fatal course of SARS-CoV‑2 infection, possibly due to comorbidities whose exact role in this context, however, is not yet well understood. In this paper, the characteristics and comorbidities of persons who had died of COVID-19 in Bavaria by July 2022 are shown and compared with the characteristics of other fatalities during the pandemic.
Based on data from multiple cause of death statistics, odds ratios for dying from COVID-19 (compared to dying from other nonexternal causes of death) were calculated by using logistic regression models, stratified by age, sex, and pandemic waves.
In Bavaria, a total of 24,479 persons (6.5% of all deaths) officially died from COVID-19 between March 2020 and July 2022. In addition to increasing age and male sex, preexisting diseases and comorbidities such as obesity, degenerative diseases of the nervous system, dementia, renal insufficiency, chronic lower respiratory diseases, and diabetes mellitus were significantly associated with COVID-19-related deaths. Dementia was mainly associated with increased COVID-19 mortality during the first and second waves, while obesity was strongly associated during the fourth wave.
The frequency of specific comorbidities in COVID-19 deaths varied over the course of the pandemic. This suggests that wave-specific results also need to be interpreted against the background of circulating virus variants, changing immunisation levels, and nonpharmaceutical interventions in place at the time.
年龄较大是 SARS-CoV-2 感染导致致命病程的一个危险因素，这可能是由于合并症所致，但目前尚不清楚这些合并症在这方面的确切作用。本文展示了截至 2022 年 7 月在巴伐利亚州因 COVID-19 而死亡的患者的特征和合并症，并将其与大流行期间其他死亡病例的特征进行了比较。
基于多死因统计数据，使用逻辑回归模型计算了 COVID-19 死亡率（与因其他非外部原因死亡相比）的优势比，按年龄、性别和大流行波分层。
在巴伐利亚州，2020 年 3 月至 2022 年 7 月期间，共有 24479 人（所有死亡人数的 6.5%）正式死于 COVID-19。除了年龄增长和男性性别外，肥胖、神经系统退行性疾病、痴呆、肾功能不全、慢性下呼吸道疾病和糖尿病等先前存在的疾病和合并症也与 COVID-19 相关死亡显著相关。痴呆症主要与第一波和第二波期间 COVID-19 死亡率增加相关，而肥胖症在第四波期间与 COVID-19 死亡率增加密切相关。
COVID-19 死亡病例中特定合并症的频率在大流行期间有所变化。这表明，在解释特定波次的结果时，还需要考虑当时流行的病毒变异、不断变化的免疫水平和非药物干预措施等背景。
