Factors associated with hospitalization, invasive mechanical ventilation treatment and death among all confirmed COVID-19 cases in Norway: Prospective cohort study

Scand J Public Health. 2021 Feb;49(1):41-47. doi: 10.1177/1403494820985172. Epub 2021 Jan 18.

Abstract

Aims: For everyone with a positive test for SARS-CoV-2 in Norway, we studied whether age, sex, comorbidity, continent of birth and nursing home residency were risk factors for hospitalization, invasive mechanical ventilation treatment and death. Methods: Data for everyone who had tested positive for SARS-CoV-2 in Norway by end of June 2020 (N = 8569) were linked at the individual level to hospitalization, receipt of invasive mechanical ventilation treatment and death measured to end of July 2020. Underlying comorbidity was proxied by hospital-based in- or outpatient treatment during the two months before the SARS-CoV-2 test. Multivariable generalized linear models were used to assess risk ratios (RRs). Results: Risk of hospitalization was particularly high for elderly (for those aged 90 and above: RR 9.5; 95% confidence interval (CI) 7.1-12.7; comparison group aged below 50), Norwegian residents born in Asia, Africa or Latin-America (RR 2.1; 95% CI 1.9-2.4; comparison group born in Norway), patients with underlying comorbidity (RR 1.6; 95% CI 1.4-1.8) and men (RR 1.3; 95% CI 1.2-1.5). Men and residents born in Africa, Asia and Latin-America were also at higher risk of receiving ventilation treatment and dying, but the mortality risk was especially high for the elderly (for those aged 90 and above: RR 607.9; 95% CI 145.5-2540.1; comparison group aged below 50) and residents in nursing homes (RR 4.2; 95% CI 3.1-5.7). Conclusions: High age was the most important predictor of severe disease and death if infected with SARS-CoV-2, and nursing home residents were at particularly high risk of death.

Keywords: COVID-19; SARS virus; SARS-CoV-2; epidemics; health services research; quality of health care; risk factors.

MeSH terms

  • Aged
  • Aged, 80 and over
  • COVID-19 Testing
  • COVID-19* / diagnosis
  • COVID-19* / mortality
  • COVID-19* / therapy
  • Comorbidity
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Nursing Homes / statistics & numerical data
  • Prospective Studies
  • Residence Characteristics / statistics & numerical data
  • Respiration, Artificial / statistics & numerical data*
  • Risk Factors
  • SARS-CoV-2 / isolation & purification*