“Susceptibility and risk of suffering SARS-COV-2 infection by demographic characteristics and pre-existing medical conditions among middle-aged and older adults in Tarragona, Spain: results from the COVID19 TARRACO Cohort Study, March-June 2020”

  1. EM. Satué-Gracia
  2. A. Vila-Córcoles
  3. C. de Diego-Cabanes
  4. A. Vila-Rovira
  5. C. Torrente-Fraga
  6. F. Gómez-Bertomeu
  7. I. Hospital-Guardiola
  8. O. Ochoa-Gondar
  9. F. Martín-Luján

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Objective

To analyse susceptibility/risk of suffering COVID19 among adults with distinct underlying medical conditions.

Methods

Cohort study (population-based) including 79,083 people ≥50 years-old in Tarragona (Southern Catalonia, Spain). At study start (01/03/2020) baseline cohort characteristics (demographic, previous comorbidities, chronic medications and vaccinations’ history) were recorded. Primary outcome was laboratory-confirmed COVID19 incurred in cohort members throughout 01/03/2020-30/06/2020. Risk of suffering COVID19 was evaluated by Cox regression, estimating multivariable hazard ratios (HRs) adjusted for age/sex and previous comorbidities.

Results

Across study period, 536 laboratory-confirmed COVID19 cases were observed (mean incidence: 39.5 cases per 100,000 persons-week). In multivariable-analysis, age/years (HR: 1.01; 95% CI: 1.00-1.02; p=0.050), nursing-home (HR: 20.19; 95% CI: 15.98-25.51; p<0.001), neurological disease (HR: 1.35; 95% CI: 1.03-1.77; p=0.029), taking diuretics (HR: 1.39; 95% CI: 1.10-1.75; p=0.006), antiplatelet (HR: 1.36; 95% CI: 1.05-1.76; p=0.021) and benzodiazepines (HR: 1.24; 95% CI:1.00-1.53; p=0.047) significantly increased risk; while smoking (HR: 0.57; 95%CI: 0.41-0.80; p=0.001), angiotensin converting enzyme inhibitors (HR: 0.78; 95% CI: 0.61-1.00; p=0.048), angiotensin II receptor blockers (HR: 0.70; 95%CI: 0.51-0.96; p=0.027) and statins (HR: 0.75; 95% CI: 0.58-0.96; p=0.025) were associated with reduced risk. Among non-institutionalised persons, cancer, renal and cardiac disease appeared also related to increased risk, whereas influenza vaccination was associated with reduced risk.

Conclusion

In a setting with relatively low incidence of COVID19 across the first wave of pandemic period, age, nursing-home residence and multiple comorbidities appear predisposing for COVID19 among middle-aged/older adults. Conversely, statins, angiotensin-receptor blockers/inhibitors and influenza vaccination were related with decreased risk.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2021.02.09.21251398: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the Ethics Committee of the Foundation University Institute for Primary Health Care Research (IDIAP Jordi Gol, Barcelona, file 20/065-PCV) and was conducted according to the Helsinki Declaration and Spanish legislation on biomedical studies, data protection and respect for human rights.
    Consent: [13] Considering public health surveillance emergency, informed consent for all cohort members was waived.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Analyses were performed using IBM SPSS Statistics for Windows, version 24 (IBM Corp., Armonk, N.Y., USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    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:
    [29,30] Major strengths in this study were the representativity (due to large size) of the study cohort, that included almost 80,000 people, which represents about 75% of the entire population over 50 years in the area, [13] and the use of survival analysis to precisely asses susceptibility and risk of suffering a SARS-COV-2 infection adjusting by important potential confounders (as socio-demographic, and medical underlying conditions clinically relevant) Major limitations were related to its partially retrospective design and poor access to PCR tests at the beginning of the epidemic period in our setting, especially considering that the most specific diagnosis for COVID19 is a positive PCR test. Moreover its reliability depends on the correct collection of nasopharyngeal swabs, moment of collection, sensitivity of tests and guidelines for testing followed throughout the study period. Due to above mentioned scarce availability of PCR tests they were mainly performed in hospitalised/severe patients and in nursing homes (after some outbreaks were detected). Thereby, patients with mild symptoms (many of them without PCR done) have been logically underestimated in this study. Even though we did subgroup analyses (community-dwelling/nursing-home) and multivariable-adjustments, residual confounding when estimating risks (common in observational studies), tied to non-included variables such as socio-economical, labor-, lifestyle- or health care-related factors, may not be discarded....

    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 10.1101/2021.02.09.21251398v1 on medRxiv