Respiratory failure & ventilation
Risk factors for severe COVID-19 in the young—before and after ICU admission
Authors' conclusion
Chronic kidney failure, type 2 diabetes, hypertension, rheumatoid arthritis, obesity, heart failure, and asthma were the strongest risk factors associated with severe COVID-19 requiring ICU-care in individuals < 50 years compared to the older population. However, after ICU admission, previous thromboembolism, chronic kidney failure, and type 2 diabetes were associated with increased 90-day mortality. The risk associations for co-morbidities were generally stronger among younger individuals compared to older and in women compared to men.
Study context
- Population
- Patients with severe COVID-19 requiring ICU and mechanical ventilation and matched population controls; focus on women and men <50 yearsmedian age 63 years, 71% men
- Participants
- 4,921 vs 49,210
- Comparison
- Cases vs Controls
- Casesn = 4,921
- Controlsn = 49,210reference
- Outcome
- Severe COVID-19 requiring intensive care; 90-day mortality among ICU patients
Methodological detailsmatched (age, sex, district of residence), national registers, multivariate logistic regression
- Matched (age, sex, district of residence)
- National registers
- Multivariate logistic regression
Main finding
As reported in the abstract
- Chronic kidney disease, OR
- 6.80 [3.61-12.83] (95% CI)
- Type 2 diabetes, OR
- 6.31 [4.48-8.88] (95% CI)
- Hypertension, OR
- 5.09 [3.79-6.84] (95% CI)
- Rheumatoid arthritis, OR
- 4.76 [2.29-9.89] (95% CI)
- Obesity, OR
- 3.76 [2.88-4.92] (95% CI)
- Heart failure, OR
- 3.06 [1.36-6.89] (95% CI)
- Asthma, OR
- 3.04 [2.22-4.16] (95% CI)
Observational data: associations, not effects.
Further findings
Severe COVID-19 by sex, <50 years (women vs men) (subgroup)
- Type 2 diabetes, OR women vs men
- 11.25 [6.00-21.08] vs 4.97 [3.25-7.60]
- Hypertension, OR women vs men
- 8.76 [5.10-15.01] vs 4.09 [2.86-5.86]
90-day mortality after ICU admission, <50 years
- Previous VTE, OR
- 5.50 [2.13-14.22] (95% CI)
- Chronic kidney disease, OR
- 4.40 [1.64-11.78] (95% CI)
- Type 2 diabetes, OR
- 2.71 [1.39-5.29] (95% CI)
- Associations foremost driven by the female population
Original publication
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