Risk factors for hospitalisation and death due to COVID-19 during endemic Omicron circulation, a population-based cohort study
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Background
Knowledge about risk factors for hospitalisation and death due to COVID-19 during the Omicron period, beyond the initial Omicron wave, remains limited. Therefore, to support vaccination strategies and antiviral treatment recommendations, we aimed to investigate the significance of various risk factors and their association with hospitalisation and death from COVID-19 during the Omicron period.
Method
Nationwide registry data on the Swedish adult population was compiled for the period June 6, 2022, to March 31, 2023. Frequency of hospitalisation with a primary discharge diagnosis of COVID-19 and death with COVID-19 specified as the underlying cause of death on the death certificate were analysed. Individual data were stratified by age, vaccination status, Charlson Comorbidity Index, and specific comorbidities. Poisson regression was used to estimate incidence risk ratios of independent risk factors for hospitalisation and death including age, sex, comorbidities, care dependency and socioeconomic factors.
Results
Among the more than 8,3 million individuals in the study cohort, 13 941 hospitalisations and 2 309 deaths due to COVID-19 were recorded during the study period. Multivariable analysis revealed that high age was the strongest risk factors for both hospitalisation and death. Advanced comorbidity was the second strongest risk factor for hospitalisation, and care dependency was the second strongest risk factor for death. Among comorbidities, recent chemotherapy, Immune Deficiency, Multiple Sclerosis, and Chronic Kidney Disease stage 5 were the strongest risk factors for hospitalisation and death.
Conclusion
Also in the current Omicron endemicity, advanced age remains the strongest risk factor for hospitalisation and death due to COVID-19, accompanied by advanced comorbidity and care dependency. These findings can guide recommendations for vaccination strategies and antiviral treatment, helping to protect those most at risk.
