Age-dependence of healthcare interventions for COVID-19 in Ontario, Canada

BMC Public Health

Irena Papst¹  Benjamin M. Bolker²  Michael Li³  Jonathan Dushoff⁴  David Champredon⁵  David J. D. Earn⁶ 

[1] Center for Applied Mathematics, Cornell University, Ithaca, USA;Department of Biology, McMaster University, Hamilton, Canada;Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Canada;Department of Mathematics & Statistics, McMaster University, Hamilton, Canada;Department of Biology, McMaster University, Hamilton, Canada;South African Centre for Epidemiological Modelling and Analysis, University of Stellenbosch, Stellenbosch, South Africa;Department of Biology, McMaster University, Hamilton, Canada;South African Centre for Epidemiological Modelling and Analysis, University of Stellenbosch, Stellenbosch, South Africa;Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Canada;Department of Pathology and Laboratory Medicine, Western University, London, Canada;Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Canada;Department of Mathematics & Statistics, McMaster University, Hamilton, Canada;Department of Mathematics, University of Toronto, Toronto, Canada;

关键词: Epidemiology;    Infectious disease;    SARS-CoV-2;    COVID-19;    Age distribution;    Hospitalization;   

DOI  :  10.1186/s12889-021-10611-4

来源: Springer

【 摘 要 】

BackgroundPatient age is one of the most salient clinical indicators of risk from COVID-19. Age-specific distributions of known SARS-CoV-2 infections and COVID-19-related deaths are available for many regions. Less attention has been given to the age distributions of serious medical interventions administered to COVID-19 patients, which could reveal sources of potential pressure on the healthcare system should SARS-CoV-2 prevalence increase, and could inform mass vaccination strategies. The aim of this study is to quantify the relationship between COVID-19 patient age and serious outcomes of the disease, beyond fatalities alone.MethodsWe analysed 277,555 known SARS-CoV-2 infection records for Ontario, Canada, from 23 January 2020 to 16 February 2021 and estimated the age distributions of hospitalizations, Intensive Care Unit admissions, intubations, and ventilations. We quantified the probability of hospitalization given known SARS-CoV-2 infection, and of survival given COVID-19-related hospitalization.ResultsThe distribution of hospitalizations peaks with a wide plateau covering ages 60–90, whereas deaths are concentrated in ages 80+. The estimated probability of hospitalization given known infection reaches a maximum of 27.8% at age 80 (95% CI 26.0%–29.7%). The probability of survival given hospitalization is nearly 100% for adults younger than 40, but declines substantially after this age; for example, a hospitalized 54-year-old patient has a 91.7% chance of surviving COVID-19 (95% CI 88.3%–94.4%).ConclusionsOur study demonstrates a significant need for hospitalization in middle-aged individuals and young seniors. This need is not captured by the distribution of deaths, which is heavily concentrated in very old ages. The probability of survival given hospitalization for COVID-19 is lower than is generally perceived for patients over 40. If acute care capacity is exceeded due to an increase in COVID-19 prevalence, the distribution of deaths could expand toward younger ages. These results suggest that vaccine programs should aim to prevent infection not only in old seniors, but also in young seniors and middle-aged individuals, to protect them from serious illness and to limit stress on the healthcare system.

【 授权许可】

CC BY