Risk of adverse outcomes with COVID-19 in the Republic of Ireland

  1. M Roe
  2. P Wall
  3. P Mallon
  4. M Horgan

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Abstract

Aims

To compare the risk of adverse outcomes (i.e. hospital/intensive care admission, death) in population sub-groups during two periods of the COVID-19 pandemic in the Republic of Ireland.

Methods

We analysed routinely-collected, publicly-available data on 67,900 people with laboratory confirmed COVID-19 infection between 29 th Feb to 14 th Nov 2020. This period encompassed two waves of infection and two corresponding national lockdowns. For two observational periods covering each wave (W1, W2), each ending 17-19 days before implementation of high-level national restrictions, we segmented the population based on age and underlying clinical conditions.

Results

The prevalence of laboratory confirmed COVID-19 was 1.4%. The risk of admission to hospital, admission to intensive care, and death was 7.2%, 0.9%, and 2.5%, respectively. Compared to younger confirmed cases, those aged ≥65 y had increased risk of hospital admission (RR 5.61), ICU admission (RR 3.56), and death (RR 60.8). W2 was associated with more cases and fewer adverse events than W1. The risk of all adverse outcomes was reduced in W2 than in W1.

Conclusions

Ongoing responses should consider the variation in risk of adverse outcomes between specific sub-groups. These findings indicate the need to sustain the prevention, identification and management of noncommunicable diseases to reduce the burden of COVID-19.

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  1. ScreenIT

    SciScore for 10.1101/2020.12.09.20246363: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: Institutional review board approval was not sought for this analysis of publicly available, deidentified data.
    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:
    To achieve this, easy-to-use advanced surveillance and triage systems are required, particularly where immediate access to testing is limited.[11] Our analysis does have limitations. As we did not have access to individual level data we were unable to fully adjust analyses for additional potential confounders and, in particular, to account for interactions between age and underlying comorbidities. In addition, as many comorbidities occur in clusters, we were unable to model which underlying condition(s) most contributed to worse outcomes. Given the high proportion of confirmed infections acquired by healthcare-worker (17%) data on the proportion of cases that were inpatients or close contacts of healthcare-workers would help to more accurately gauge the rate of transmission and risk of adverse outcomes in those acquiring infection in healthcare facilities. Individual level, de-identified data would assist in identifying innovative responses to support targeted strategies to reduce the risk of transmission of SARS-CoV-2 infection in those with co-morbidities, thereby reducing the burden of COVID-19 on the local healthcare systems.

    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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  2. Version published to 10.1101/2020.12.09.20246363v1 on medRxiv