The risk of severe COVID-19: hospital and ICU admission rates in Norway

  1. Morten Munkvik
  2. Ingvild Vatten Alsnes
  3. Lars Vatten

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Abstract

Background

Epidemiological studies of COVID-19 with population based information may add to the knowledge needed to prioritise resources and advice on how restrictive measures should be targeted. This study provides admission rates to hospitals and intensive care units (ICU) in Norway, aiming to better understand the risk of severe COVID-19 infection.

Methods

Data from official reports from The Norwegian Institute of Public Health (NIPH) and the Norwegian Directorate of Health were used to calculate admission rates to hospitals and to ICU per 100 000 inhabitants. We compared rates of hospitalisation between the four health regions and provide separate rates for Oslo. We also assessed national admissions to ICU stratified by age.

Results

The admission rate in the south-eastern region was 3.1 per 100 000, and the rate for Oslo was 5.8. Compared to the western region (reference), the Oslo rate was 4.0 times (confidence interval (CI) 3.0-5.5) higher. In Norway as a whole, the rate of ICU admissions was 3.9 per 100 000, and in the age groups 60-69 and 70-79, ICU rates were 10.3 and 11.5, respectively. These rates were 9.5 (CI 6.3-14.3) and 10.6 (CI 6.9-16.2) times higher compared to people younger than 50 years.

Conclusion

Hospital admissions due to Covid-19 are much higher in Oslo than anywhere else in Norway, and in the country as a whole, ICU admissions are highest among people 60-79 years of age. These results and more detailed data could provide better advice on how restrictions can be safely lessened.

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  1. ScreenIT

    SciScore for 10.1101/2020.07.16.20155358: (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 variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Thus, the authorities′ unwillingness to share information with the public is a limitation of this study. Nonetheless, we are not aware of comparable epidemiological studies on hospital and ICU admission rates due to COVID-19. Many international studies are based on prediction models and rely on assumptions that might not be readily applicable to Norway. The number of admitted patients has now shown a consistent decrease, and the death rate has flattened out, and therefore, it has been argued that the situation in Norway is under control. However, our findings suggest that the situation in Oslo deviates strongly from the rest of the country, and that the capital requires special attention. As the society is opening up – schools have started to re-open and social distancing restrictions are lessened – the situation in Oslo needs to be monitored very carefully. Oslo is the obvious epi-center of the epidemic in Norway, from where new waves of infection are likely to arise. Therefore, targeted testing and contact tracing should be prioritized in Oslo, whereas in other regions, with modest transmission of SARS-CoV2, strategic testing of health care workers or others with close contacts with individuals at increased risk, may be sufficient. It is especially important to limit infections among people older than 60 years of age, with particular emphasis on shielding those 80 years or older. We would need more detailed data than what is presently available in order to provide reliable ...

    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

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.07.16.20155358v1 on medRxiv