Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jul 28, 2020
Date Accepted: Dec 14, 2020
Date Submitted to PubMed: Dec 21, 2020
THE ASSOCIATION OF CHRONIC DISEASES WITH COVID-19 OUTCOMES AND ITS ROLE ON RISK PERCEPTION: NATIONWIDE COVID-19 DATABASE & ONLINE COMMUNITY-BASED SURVEY
ABSTRACT
Background:
COVID-19 is a viral respiratory disease, which became a global threat to public health. Further understanding of the epidemiology of this virus and on the risk perception of the community may better inform health authorities for targeted interventions to reduce the impact and spread of COVID-19.
Objective:
In this study we aimed to examine the association between chronic diseases and worse outcomes following COVID-19 infection, and to explore its role on the self-perception of risk for worse COVID-19 outcomes.
Methods:
This study draws from 2 databases: 1) The nationwide database of all confirmed COVID-19 cases in Portugal, extracted in 28th of April 2020 (n=20,293); and 2) the community-based survey “COVID-19 Barometer”, which contains data on health status, perceptions and behaviors during the first wave of COVID-19 (n=171,087). We assessed the association of relevant chronic diseases (i.e. respiratory, cardiovascular, renal disease, diabetes, and cancer) with death and ICU use following COVID-19 infection, and identified determinants of self-perception of risk for severe COVID-19 disease using logistic regression models.
Results:
Respiratory, cardiovascular, and renal diseases were associated with mortality and ICU use among patients hospitalized due to COVID-19 infection (ORs [95%CI]: 1.48 [1.11-1.98]; 3.39 [1.80-6.40]; 2.25 [1.66-3.06]). Diabetes and cancer are associated with such outcomes but only when considered the full sample of COVID-19 infected cases in the country (ORs: 1.30 [1.03-1.64]; 1.40 [1.03-1.89], respectively). Older age and male sex were both associated with mortality and ICU use. The prevalence of at least one of the analyzed health conditions is high in the country’s population, particularly on those aged 65 years old or over (19.6% and 44.6%, respectively). Self-awareness of risk for severe COVID-19 disease in the country’s population is 23.9%, which is markedly increased on older people (46.4%), those with at least one chronic disease (51.7%), or those under both conditions (67.7%). All the analyzed diseases were associated with self-perception of high risk in the population.
Conclusions:
Our study results demonstrate the association of some prevalent chronic diseases with increased risk of worse COVID-19 outcomes. It also brings further understanding on the current population risk perception for COVID-19 severe disease and useful insights into factors influencing if, in particular morbidity. Hence, this study may aid health authorities to better adapt measures to the real needs of the population and to identify those more vulnerable requiring further education and awareness on due preventive measures. Clinical Trial: NA
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