How many are at increased risk of severe COVID-19 disease? Rapid global, regional and national estimates for 2020

Andrew Clark; Mark Jit; Charlotte Warren-Gash; Bruce Guthrie; Harry HX Wang; Stewart W Mercer; Colin Sanderson; Martin McKee; Christopher Troeger; Kanyin I Ong; Francesco Checchi; Pablo Perel; Sarah Joseph; Hamish P Gibbs; Amitava Banerjee; Rosalind M Eggo

A recent analysis from Sweden 22 provides an opportunity to evaluate our method, and compare GBD prevalence estimates to those derived from electronic health record (EHR) data. When we applied our method, based on the calculation of and , to the prevalence of each condition reported in the study, we were able to reproduce the same percentage share of the population at increased risk. This provides some reassurance that our method will provide a reasonable approximation of the atrisk proportion if the same input data on disease prevalence is used. The GBD prevalence estimates for Sweden were substantially higher than the estimates from the EHR data, and so we estimate a much higher proportion of the population to be at increased risk (35 vs 22%). Many of the prevalent cases estimated by GBD would not have been severe enough to be recorded in EHRs, which is likely the major reason for the difference. For example, over half of the CKD cases included in GBD prevalence estimates represent early stage disease (CKD stage 1 or 2) which is common and rarely has symptoms. 23 Several other underlying conditions estimated by GBD are also likely to be undiagnosed in many individuals e.g. hypertensive heart disease, compensated chronic liver disease, . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.