The natural history of symptomatic COVID-19 during the first wave in Catalonia

  1. Edward Burn
  2. Cristian Tebé
  3. Sergio Fernandez-Bertolin
  4. Maria Aragon
  5. Martina Recalde
  6. Elena Roel
  7. Albert Prats-Uribe
  8. Daniel Prieto-Alhambra
  9. Talita Duarte-Salles

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Abstract

The natural history of coronavirus disease 2019 (COVID-19) has yet to be fully described. Here, we use patient-level data from the Information System for Research in Primary Care (SIDIAP) to summarise COVID-19 outcomes in Catalonia, Spain. We included 5,586,521 individuals from the general population. Of these, 102,002 had an outpatient diagnosis of COVID-19, 16,901 were hospitalised with COVID-19, and 5273 died after either being diagnosed or hospitalised with COVID-19 between 1st March and 6th May 2020. Older age, being male, and having comorbidities were all generally associated with worse outcomes. These findings demonstrate the continued need to protect those at high risk of poor outcomes, particularly older people, from COVID-19 and provide appropriate care for those who develop symptomatic disease. While risks of hospitalisation and death were lower for younger populations, there is a need to limit their role in community transmission.

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  1. Version published to 10.1038/s41467-021-21100-y
  2. ScreenIT

    SciScore for 10.1101/2020.07.13.20152454: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableTo consider whether associations between age and outcomes varied by gender, models were also estimated separately for males and females.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your code.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Study limitations: Our study is informed by routinely-collected health care data with various interactions between individuals and the health system identified, covering outpatient diagnoses, COVID-19 testing, and hospitalisations, and with linked mortality data. This though unavoidably misses health outcomes experienced by individuals that do not lead to any interaction with the health care system, with both asymptomatic individuals and a sizeable proportion of mild symptomatic cases unlikely to be seen. Some of the clinical diagnoses observed in the study may also represent false positives, given the uncertainty surrounding the presentation of the disease during the study period. We did not require clinical diagnoses to be confirmed by the presence of a positive PT-PCR test given the limited amount of testing being performed during the study period. Deaths from COVID-19 where individuals were not tested or diagnosed beforehand will also not have been identified. While providing a broad picture of clinical trajectories, each of the studied states and transitions can, and should, be considered in further detail. Analyses of the provision of intensive care admissions during hospitalisation is one such example, but would require further data with sufficient granularity on inpatient treatment which was beyond the scope of this study. Similarly, the set of comorbidities considered here are only a subset of the myriad set of conditions that are of interest when considering potenti...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.07.13.20152454v1 on medRxiv