Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain

Objectives To investigate which were the most relevant sociodemographic and clinical variables associated with COVID-19 severity, and uncover how their inter-relations may have affected such severity.Design A retrospective observational study based on electronic health record data.Participants Indiv...

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Main Authors: Mónica Machón, Maider Mateo-Abad, Kalliopi Vrotsou, Itziar Vergara, Rafael Rotaeche
Format: Article
Language:English
Published: BMJ Publishing Group 2021-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/4/e049066.full
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author Mónica Machón
Maider Mateo-Abad
Kalliopi Vrotsou
Itziar Vergara
Rafael Rotaeche
author_facet Mónica Machón
Maider Mateo-Abad
Kalliopi Vrotsou
Itziar Vergara
Rafael Rotaeche
author_sort Mónica Machón
collection DOAJ
description Objectives To investigate which were the most relevant sociodemographic and clinical variables associated with COVID-19 severity, and uncover how their inter-relations may have affected such severity.Design A retrospective observational study based on electronic health record data.Participants Individuals ≥14 years old with a positive PCR or serology test, between 28 February and 31 May 2020, belonging to the Basque Country (Spain) public health system. Institutionalised and individuals admitted to a hospital at home unit were excluded from the study.Main outcome measure Three severity categories were established: primary care, hospital/intensive care unit admission and death.Results A total of n=14 197 cases fulfilled the inclusion criteria. Most variables presented statistically significant associations with the outcome (p<0.0001). The Classification and Regression Trees recursive partitioning methodology (based on n=13 792) suggested that among all associations, those with, age, sex, stratification of patient healthcare complexity, chronic consumption of blood and blood-forming organ, and nervous system drugs, as well as the total number of chronic Anatomical Therapeutic Chemical types were the most relevant. Psychosis also emerged as a potential factor.Conclusions Older cases are more likely to experience more severe outcomes. However, the sex, underlying health status and chronic drug consumption may interfere and alter the ageing effect. Understanding the factors related to the outcome severity is of key importance when designing and promoting public health intervention plans for the COVID-19 pandemic.
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spelling doaj-art-6fcbe371f8b049328b917f87d400e82a2024-11-21T21:25:10ZengBMJ Publishing GroupBMJ Open2044-60552021-04-0111410.1136/bmjopen-2021-049066Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, SpainMónica Machón0Maider Mateo-Abad1Kalliopi Vrotsou2Itziar Vergara3Rafael Rotaeche4Primary Care Group, Biodonostia Institute for Health Research, Donostia-San Sebastián, SpainResearch Network in Health Services in Chronic Diseases (REDISSEC), Kronikgune Health Services Research Institute, Baracaldo, SpainPrimary Care Group, Biodonostia Institute for Health Research, Donostia-San Sebastián, SpainPrimary Care Group, Biodonostia Institute for Health Research, Donostia-San Sebastián, Spain9 Primary Care Research Unit of Gipuzkoa, Organization of Integrated Health Services of Gipuzkoa, Osakidetza-Basque Health Service, Biogipuzkoa Health Research Institute, Donostia-San Sebastian, SpainObjectives To investigate which were the most relevant sociodemographic and clinical variables associated with COVID-19 severity, and uncover how their inter-relations may have affected such severity.Design A retrospective observational study based on electronic health record data.Participants Individuals ≥14 years old with a positive PCR or serology test, between 28 February and 31 May 2020, belonging to the Basque Country (Spain) public health system. Institutionalised and individuals admitted to a hospital at home unit were excluded from the study.Main outcome measure Three severity categories were established: primary care, hospital/intensive care unit admission and death.Results A total of n=14 197 cases fulfilled the inclusion criteria. Most variables presented statistically significant associations with the outcome (p<0.0001). The Classification and Regression Trees recursive partitioning methodology (based on n=13 792) suggested that among all associations, those with, age, sex, stratification of patient healthcare complexity, chronic consumption of blood and blood-forming organ, and nervous system drugs, as well as the total number of chronic Anatomical Therapeutic Chemical types were the most relevant. Psychosis also emerged as a potential factor.Conclusions Older cases are more likely to experience more severe outcomes. However, the sex, underlying health status and chronic drug consumption may interfere and alter the ageing effect. Understanding the factors related to the outcome severity is of key importance when designing and promoting public health intervention plans for the COVID-19 pandemic.https://bmjopen.bmj.com/content/11/4/e049066.full
spellingShingle Mónica Machón
Maider Mateo-Abad
Kalliopi Vrotsou
Itziar Vergara
Rafael Rotaeche
Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain
BMJ Open
title Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain
title_full Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain
title_fullStr Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain
title_full_unstemmed Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain
title_short Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain
title_sort variables associated with covid 19 severity an observational study of non paediatric confirmed cases from the general population of the basque country spain
url https://bmjopen.bmj.com/content/11/4/e049066.full
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