Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain

ObjectivesTo investigate which were the most relevant sociodemographic and clinical variables associated with COVID-19 severity, and uncover how their inter-relations may have affected such severity.DesignA retrospective observational study based on electronic health record data.ParticipantsIndividu...

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Published in:BMJ open 2021-04, Vol.11 (4), p.e049066
Main Authors: Vrotsou, Kalliopi, Rotaeche, Rafael, Mateo-Abad, Maider, Machón, Mónica, Vergara, Itziar
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Aged, 80 and over
Big Data
Case management
Classification
Coronaviruses
COVID-19
COVID-19 - epidemiology
COVID-19 - pathology
Datasets
Electronic health records
Epidemiology
Health care
Hospitals
Humans
Immunization
Influenza
Intensive care
Middle Aged
Observational studies
Pandemics
Pediatrics
Primary care
Public health
Severe acute respiratory syndrome coronavirus 2
Spain - epidemiology
Statistical methods
statistics & research methods
Treatment Outcome
Variables
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creator Vrotsou, Kalliopi
Rotaeche, Rafael
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Vergara, Itziar
description ObjectivesTo investigate which were the most relevant sociodemographic and clinical variables associated with COVID-19 severity, and uncover how their inter-relations may have affected such severity.DesignA retrospective observational study based on electronic health record data.ParticipantsIndividuals ≥14 years old with a positive PCR or serology test, between 28 February and 31 May 2020, belonging to the Basque Country (Spain) public health system. Institutionalised and individuals admitted to a hospital at home unit were excluded from the study.Main outcome measureThree severity categories were established: primary care, hospital/intensive care unit admission and death.ResultsA total of n=14 197 cases fulfilled the inclusion criteria. Most variables presented statistically significant associations with the outcome (p
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Institutionalised and individuals admitted to a hospital at home unit were excluded from the study.Main outcome measureThree severity categories were established: primary care, hospital/intensive care unit admission and death.ResultsA total of n=14 197 cases fulfilled the inclusion criteria. Most variables presented statistically significant associations with the outcome (p&lt;0.0001). The Classification and Regression Trees recursive partitioning methodology (based on n=13 792) suggested that among all associations, those with, age, sex, stratification of patient healthcare complexity, chronic consumption of blood and blood-forming organ, and nervous system drugs, as well as the total number of chronic Anatomical Therapeutic Chemical types were the most relevant. Psychosis also emerged as a potential factor.ConclusionsOlder cases are more likely to experience more severe outcomes. However, the sex, underlying health status and chronic drug consumption may interfere and alter the ageing effect. Understanding the factors related to the outcome severity is of key importance when designing and promoting public health intervention plans for the COVID-19 pandemic.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2021-049066</identifier><identifier>PMID: 33795313</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Adult ; Age ; Aged ; Aged, 80 and over ; Big Data ; Case management ; Classification ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; COVID-19 - pathology ; Datasets ; Electronic health records ; Epidemiology ; Health care ; Hospitals ; Humans ; Immunization ; Influenza ; Intensive care ; Middle Aged ; Observational studies ; Pandemics ; Pediatrics ; Primary care ; Public health ; Severe acute respiratory syndrome coronavirus 2 ; Spain - epidemiology ; Statistical methods ; statistics &amp; research methods ; Treatment Outcome ; Variables</subject><ispartof>BMJ open, 2021-04, Vol.11 (4), p.e049066</ispartof><rights>Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2021 Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b578t-e1419cb870243f6aae47c21eaa650a68834f5c8b2393279a85f62630073386773</citedby><cites>FETCH-LOGICAL-b578t-e1419cb870243f6aae47c21eaa650a68834f5c8b2393279a85f62630073386773</cites><orcidid>0000-0002-3296-3923</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2507869610/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2507869610?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>112,113,230,314,727,780,784,885,3194,25753,27549,27550,27924,27925,37012,37013,38516,43895,44590,53791,53793,55341,55350,74412,75126,77594,77595,77596,77597,77601,77632,77660,77686</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33795313$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vrotsou, Kalliopi</creatorcontrib><creatorcontrib>Rotaeche, Rafael</creatorcontrib><creatorcontrib>Mateo-Abad, Maider</creatorcontrib><creatorcontrib>Machón, Mónica</creatorcontrib><creatorcontrib>Vergara, Itziar</creatorcontrib><title>Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><addtitle>BMJ Open</addtitle><description>ObjectivesTo investigate which were the most relevant sociodemographic and clinical variables associated with COVID-19 severity, and uncover how their inter-relations may have affected such severity.DesignA retrospective observational study based on electronic health record data.ParticipantsIndividuals ≥14 years old with a positive PCR or serology test, between 28 February and 31 May 2020, belonging to the Basque Country (Spain) public health system. Institutionalised and individuals admitted to a hospital at home unit were excluded from the study.Main outcome measureThree severity categories were established: primary care, hospital/intensive care unit admission and death.ResultsA total of n=14 197 cases fulfilled the inclusion criteria. Most variables presented statistically significant associations with the outcome (p&lt;0.0001). The Classification and Regression Trees recursive partitioning methodology (based on n=13 792) suggested that among all associations, those with, age, sex, stratification of patient healthcare complexity, chronic consumption of blood and blood-forming organ, and nervous system drugs, as well as the total number of chronic Anatomical Therapeutic Chemical types were the most relevant. Psychosis also emerged as a potential factor.ConclusionsOlder cases are more likely to experience more severe outcomes. However, the sex, underlying health status and chronic drug consumption may interfere and alter the ageing effect. Understanding the factors related to the outcome severity is of key importance when designing and promoting public health intervention plans for the COVID-19 pandemic.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Big Data</subject><subject>Case management</subject><subject>Classification</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - pathology</subject><subject>Datasets</subject><subject>Electronic health records</subject><subject>Epidemiology</subject><subject>Health care</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunization</subject><subject>Influenza</subject><subject>Intensive care</subject><subject>Middle Aged</subject><subject>Observational studies</subject><subject>Pandemics</subject><subject>Pediatrics</subject><subject>Primary care</subject><subject>Public health</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Spain - epidemiology</subject><subject>Statistical methods</subject><subject>statistics &amp; 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research methods</topic><topic>Treatment Outcome</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vrotsou, Kalliopi</creatorcontrib><creatorcontrib>Rotaeche, Rafael</creatorcontrib><creatorcontrib>Mateo-Abad, Maider</creatorcontrib><creatorcontrib>Machón, Mónica</creatorcontrib><creatorcontrib>Vergara, Itziar</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; Allied Health Database</collection><collection>ProQuest_Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health &amp; 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Institutionalised and individuals admitted to a hospital at home unit were excluded from the study.Main outcome measureThree severity categories were established: primary care, hospital/intensive care unit admission and death.ResultsA total of n=14 197 cases fulfilled the inclusion criteria. Most variables presented statistically significant associations with the outcome (p&lt;0.0001). The Classification and Regression Trees recursive partitioning methodology (based on n=13 792) suggested that among all associations, those with, age, sex, stratification of patient healthcare complexity, chronic consumption of blood and blood-forming organ, and nervous system drugs, as well as the total number of chronic Anatomical Therapeutic Chemical types were the most relevant. Psychosis also emerged as a potential factor.ConclusionsOlder cases are more likely to experience more severe outcomes. However, the sex, underlying health status and chronic drug consumption may interfere and alter the ageing effect. Understanding the factors related to the outcome severity is of key importance when designing and promoting public health intervention plans for the COVID-19 pandemic.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>33795313</pmid><doi>10.1136/bmjopen-2021-049066</doi><orcidid>https://orcid.org/0000-0002-3296-3923</orcidid><oa>free_for_read</oa></addata></record>
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source BMJ Open Access Journals; BMJ; Publicly Available Content Database; PubMed Central; Coronavirus Research Database
subjects Adult
Age
Aged
Aged, 80 and over
Big Data
Case management
Classification
Coronaviruses
COVID-19
COVID-19 - epidemiology
COVID-19 - pathology
Datasets
Electronic health records
Epidemiology
Health care
Hospitals
Humans
Immunization
Influenza
Intensive care
Middle Aged
Observational studies
Pandemics
Pediatrics
Primary care
Public health
Severe acute respiratory syndrome coronavirus 2
Spain - epidemiology
Statistical methods
statistics & research methods
Treatment Outcome
Variables
title Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain
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