Burden and prevalence of prognostic factors for severe covid-19 disease in Sweden

Katalin Gemes; Mats Talback; Karin Modig; Anders Ahlbom; Anita Berglund; Maria Feychting; Anthony Matthews

As of 8 th April 2020, the number of confirmed COVID-19 infections surpassed 1.3 million worldwide, and the number of infections leading to death reached 74,000. [1] Guidelines from the World Health Organization and the European Centre for Disease Prevention and Control suggest that individuals aged 70 years and older or with an underlying medical condition such as cardiovascular disease, high blood pressure, cancer, chronic obstructive compulsory disease (COPD), asthma, and diabetes, are considered to be at high risk of developing severe disease, and hence may require critical care. [1, 2] These recommendations are mainly based on studies from the Wuhan region of China and Italy, and generally show that once infected, individuals with at least one of these prognostic factors are more likely to go on to generate severe disease and a resulting higher risk of mortality. [3] [4] [5] [6] [7] [8] Governments around the world have, therefore, recommended that individuals with at least one of these factors self-isolate for prolonged periods of time to not only reduce the risk contracting severe COVID-19, but also prevent any sudden increase in demand for critical care in hospitals, which could overwhelm health systems. If the pandemic developed to affect a large proportion of the population, then critical care capacity could become saturated. However, the prevalence of these prognostic factors for severe disease are to a large extent unknown in many countries. Knowledge of the distribution of individuals considered to be at high risk of severe COVID-19 disease, coupled with the capacity of the health care system, would allow clear strategic planning.