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Inicio Medicina Clínica (English Edition) Susceptibility and risk of SARS-COV-2 infection among middle-aged and older adul...
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Vol. 158. Issue 6.
Pages 251-259 (March 2022)
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Vol. 158. Issue 6.
Pages 251-259 (March 2022)
Original article
Susceptibility and risk of SARS-COV-2 infection among middle-aged and older adults in Tarragona area, Spain
Susceptibilidad y riesgo de infección por SARS-CoV-2 en adultos mayores de 50 años en el área de Tarragona
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Eva M. Satué-Graciaa,b,
Corresponding author
esatue.tgn.ics@gencat.cat

Corresponding author.
, Angel Vila-Córcolesa,b, Cinta de Diego-Cabanesc, Angel Vila-Rovirab, Cristina Torrente-Fragad, Frederic Gómez-Bertomeue, Imma Hospital-Guardiolaf, Olga Ochoa-Gondarb,g, Francisco Martín-Lujána,b
a 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
b 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
c Primary Care Department Camp de Tarragona, Institut Català de la Salut (ICS), Centre d’Alta Resolució (CAR) Salou, Tarragona, Spain
d Technology and Informatic Department Camp de Tarragona, Institut Català de la Salut (ICS), Tarragona, Spain
e Universitary Hospital Joan XXIII, Institut Català de la Salut (ICS), Microbiology Department, Tarragona, Spain
f Primary Care Department Camp de Tarragona, Institut Catala de la Salut (ICS), Centre d’Atenció Primària (CAP) Dr. Sarró-Valls Urbà, Tarragona, Spain
g Primary Care Department Camp de Tarragona, Institut Català de la Salut (ICS), Centre d’Atenció Primària (CAP), Sant Pere i Sant Pau-Tarragona 5, Tarragona, Spain
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Tables (2)
Table 1. Incidence of laboratory-confirmed COVID-19 cases according to baseline demographical and clinical characteristics in the total study cohort (N=79,083). Tarragona region (Southern Catalonia, Spain), from 01/03/2020 to 30/06/2020.
Table 2. Cox regression analyses assessing unadjusted, age & sex adjusted and multivariable-adjusted risks to suffer laboratory-confirmed COVID-19 in the total study cohort (N=79,083). Tarragona region (Southern Catalonia, Spain) from 01/03/2020 to 30/06/2020.
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Abstract
Objective

To analyse susceptibility/risk of suffering COVID-19 among adults with distinct underlying medical conditions.

Methods

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.

Results

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.

Conclusion

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.

Keywords:
Coronavirus
SARS-COV-2
COVID-19
Incidence
Risk
Resumen
Objetivo

Analizar incidencia y riesgo/susceptibilidad de sufrir la COVID-19 en adultos según distintas condiciones médicas preexistentes.

Métodos

Cohorte de base poblacional que incluyó 79.083 personas ≥50 años en Tarragona. Características basales de la cohorte (edad/sexo, comorbilidades, medicaciones crónicas) se establecieron a 01-03-2020 y se registraron todos los casos de COVID-19 confirmada ocurridos en miembros de la cohorte hasta el 30-06-2020. Para estimación de riesgos se realizó regresión de Cox, con cálculo de hazard ratio (HR) ajustados por edad, sexo y comorbilidad.

Resultados

Se observaron 536 casos confirmados de COVID-19 (incidencia media: 39,5 casos por 100.000 personas-semana). En análisis multivariante, edad/años (HR: 1,01; IC el 95%: 1,00-1,02; p=0,050), estar institucionalizado/residencia (HR: 20,19; IC 95%: 15,98-25,51; p<0,001), enfermedad neurológica (HR: 1,35; IC el 95%: 1,03-1,77), diuréticos (HR: 1,39; IC 95%: 1,10-1,75), antiagregantes plaquetarios (HR: 1,36; IC 95%: 1,05-1,76) y benzodiacepinas (HR: 1,24; IC 95%: 1,00-1,53) se asociaron con un riesgo aumentado de la COVID-19 analizando la totalidad de la cohorte; contrariamente, medicación IECA (HR: 0,78; IC el 95%: 0,61-1,00), ARA-II (HR: 0,70; IC el 95%: 0,51-0,96) y estatinas (HR: 0,75; IC el 95%: 0,58-0,96) se asociaron con menor riesgo. Entre personas no institucionalizadas, cáncer, nefropatía y cardiopatía se asociaron con mayor riesgo y vacunación antigripal con menor riesgo.

Conclusión

En un área con relativamente baja incidencia de COVID-19, edad, institucionalización y múltiples comorbilidades aumentaron el riesgo/susceptibilidad de sufrir la COVID-19. Contrariamente, estatinas, inhibidores del sistema renina-angiotensina y vacunación antigripal se asociaron con menor riesgo.

Palabras clave:
Coronavirus
SARS-CoV-2
COVID-19
Incidencia
Riesgo

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