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1.
PLoS One ; 16(11): e0260416, 2021.
Article in English | MEDLINE | ID: covidwho-1793553

ABSTRACT

This study determined the association between respiratory symptoms and death from respiratory causes over a period of 45 years. In four cohorts of random samples of Norwegian populations with 103,881 participants, 43,731 persons had died per 31 December 2016. In total, 5,949 (14%) had died from respiratory diseases; 2,442 (41%) from lung cancer, 1,717 (29%) chronic obstructive pulmonary disease (COPD), 1,348 (23%) pneumonia, 119 (2%) asthma, 147 (2%) interstitial lung disease and 176 (3%) other pulmonary diseases. Compared with persons without respiratory symptoms the multivariable adjusted hazard ratio (HR) for lung cancer deaths increased with score of breathlessness on effort and cough and phlegm, being 2.6 (95% CI 2.1-3.2) for breathlessness score 3 and 2.1 (95% CI 1.7-2.5) for cough and phlegm score 5. The HR of COPD death was 6.4 (95% CI 5.4-7.7) for breathlessness score 3 and 3.0 (2.4-3.6) for cough and phlegm score 5. Attacks of breathlessness and wheeze score 2 had a HR of 1.6 (1.4-1.9) for COPD death. The risk of pneumonia deaths increased also with higher breathlessness on effort score, but not with higher cough and phlegm score, except for score 2 with HR 1.5 (1.2-1.8). In this study with >2.4 million person-years at risk, a positive association was observed between scores of respiratory symptoms and deaths due to COPD and lung cancer. Respiratory symptoms are thus important risk factors, which should be followed thoroughly by health care practitioners for the benefit of public health.


Subject(s)
Lung Diseases/diagnosis , Respiration Disorders/diagnosis , Adolescent , Adult , Asthma/diagnosis , Asthma/epidemiology , Cohort Studies , Cough/diagnosis , Cough/epidemiology , Dyspnea/epidemiology , Female , Forced Expiratory Volume , Humans , Lung Diseases/epidemiology , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Male , Middle Aged , Norway/epidemiology , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Respiration Disorders/epidemiology , Respiratory Sounds , Risk Factors , Young Adult
2.
Front Public Health ; 9: 736624, 2021.
Article in English | MEDLINE | ID: covidwho-1775880

ABSTRACT

Background: Women, and migrant women in particular, are at increased risk of many common mental disorders, which may potentially impact their labor market participation and their work-related income. Previous research found that mental disorders are associated with several work-related outcomes such as loss of income, however, not much is known about how this varies with migrant background. This study investigated the change in work-related income following the uptake of outpatient mental healthcare (OPMH) treatment, a proxy for mental disorder, in young women with and without migrant background. Additionally, we looked at how the association varied by income level. Methods: Using data from four national registries, the study population consisted of women aged 23-40 years residing in Norway for at least three consecutive years between 2006 and 2013 (N = 640,527). By using a stratified linear regression with individual fixed effects, we investigated differences between majority women, descendants and eight migrant groups. Interaction analysis was conducted in order to examine differences in income loss following the uptake of OPMH treatment among women with and without migrant background. Results: Results showed that OPMH treatment was associated with a decrease in income for all groups. However, the negative effect was stronger among those with low income. Only migrant women from Western and EU Eastern Europe with a high income were not significantly affected following OPMH treatment. Conclusion: Experiencing a mental disorder during a critical age for establishment in the labor market can negatively affect not only income, but also future workforce participation, and increase dependency on social welfare services and other health outcomes, regardless of migrant background. Loss of income due to mental disorders can also affect future mental health, resulting in a vicious circle and contributing to more inequalities in the society.


Subject(s)
Mental Disorders , Transients and Migrants , Adult , Female , Humans , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health , Norway/epidemiology , Young Adult
3.
PLoS One ; 17(3): e0265812, 2022.
Article in English | MEDLINE | ID: covidwho-1759963

ABSTRACT

AIM: To explore whether the acute 30-day burden of COVID-19 on health care use has changed from February 2020 to February 2022. METHODS: In all Norwegians (N = 493 520) who tested positive for SARS-CoV-2 in four pandemic waves (February 26th, 2020 -February 16th, 2021 (1st wave dominated by the Wuhan strain), February 17th-July 10th, 2021 (2nd wave dominated by the Alpha variant), July 11th-December 27th, 2021 (3rd wave dominated by the Delta variant), and December 28th, 2021 -January 14th, 2022 (4th wave dominated by the Omicron variant)), we studied the age- and sex-specific share of patients (by age groups 1-19, 20-67, and 68 or more) who had: 1) Relied on self-care, 2) used outpatient care (visiting general practitioners or emergency ward for COVID-19), and 3) used inpatient care (hospitalized ≥24 hours with COVID-19). RESULTS: We find a remarkable decline in the use of health care services among COVID-19 patients for all age/sex groups throughout the pandemic. From 83% [95%CI = 83%-84%] visiting outpatient care in the first wave, to 80% [81%-81%], 69% [69%-69%], and 59% [59%-59%] in the second, third, and fourth wave. Similarly, from 4.9% [95%CI = 4.7%-5.0%] visiting inpatient care in the first wave, to 3.6% [3.4%-3.7%], 1.4% [1.3%-1.4%], and 0.5% [0.4%-0.5%]. Of persons testing positive for SARS-CoV-2, 41% [41%-41%] relied on self-care in the 30 days after testing positive in the fourth wave, compared to 16% [15%-16%] in the first wave. CONCLUSION: From 2020 to 2022, the use of COVID-19 related outpatient care services decreased with 29%, whereas the use of COVID-19 related inpatient care services decreased with 80%.


Subject(s)
COVID-19/therapy , Hospitalization/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Self Care/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Ambulatory Care/statistics & numerical data , COVID-19/epidemiology , Child , Child, Preschool , Cost of Illness , Female , Humans , Infant , Male , Middle Aged , Norway/epidemiology , Sex Factors , Young Adult
4.
Sci Rep ; 12(1): 3837, 2022 03 09.
Article in English | MEDLINE | ID: covidwho-1735271

ABSTRACT

The economic and health consequences of the COVID-19 pandemic are unequally distributed. A growing literature finds evidence that those with low socioeconomic status have carried a greater burden in terms of both unemployment and infection risk. Against this background, it is natural to also expect increasing socioeconomic inequalities in mental health. We report from a population-based longitudinal study, assessing the mental health of more than 100,000 Norwegian adults during a period of more than 20 years, and into the COVID-19 pandemic. We find substantial, and equally high, increases in depressive symptoms across socioeconomic status. In addition, we show that the increase was particularly strong among women and those with lower levels of depressive symptoms prior to COVID-19.


Subject(s)
COVID-19/epidemiology , Mental Health , Socioeconomic Factors , Adult , Anxiety/pathology , COVID-19/virology , Depression/pathology , Female , Humans , Longitudinal Studies , Male , Norway/epidemiology , Pandemics , SARS-CoV-2/isolation & purification , Time Factors
5.
Int J Environ Res Public Health ; 19(5)2022 03 06.
Article in English | MEDLINE | ID: covidwho-1732035

ABSTRACT

The purpose of this cross-sectional study was to map dental students' experience of the study situation throughout the pandemic. All clinical dental students (year 3 to 5) at the Faculty of Medicine, Department of Clinical Dentistry (IKO), University of Bergen (UiB), Norway, were invited. Participation was anonymous and voluntary, and the response rate was 63%. Questions regarding stress-related factors were divided into three categories. In the category «Stressors/learning¼, a statistically significant difference was observed between both the genders (p = 0.001) and years of study (p = 0.028). Statistically significant differences between the genders were also observed in the category «Stressors/infection¼ (p = 0.008). Women were significantly more stressed due to lack of clinical skills (p = 0.048), not receiving as good theoretical teaching as before the pandemic (p = 0.016), and uncertain issues around the exams (p = 0.000). Fourth year students were significantly more stressed due to lack of clinical skills (p = 0.012), for not passing the clinic/skills courses due to lack of study progression (p = 0.005), and worries about not being a good enough dentist after graduation (p = 0.002). In conclusion, the pandemic had a major impact on dental students. The most prominent stressors in relation to the study situation were experienced by students from the fourth year and female students. Clinical and theoretical learning outcomes among students were regarded as worse than before the pandemic. The students preferred in presence lectures, but experienced digital asynchronous video lectures as a good alternative. The pandemic negatively affected the students' social life. Dental schools should be aware that students have been exposed to increased distress and burden through the pandemic and should provide support for those in need.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Norway/epidemiology , SARS-CoV-2 , Students, Dental
6.
Scand J Public Health ; 50(1): 38-45, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1724281

ABSTRACT

Background: Norway and Sweden are similar countries in terms of socioeconomics and health care. Norway implemented extensive COVID-19 measures, such as school closures and lockdowns, whereas Sweden did not. Aims: To compare mortality in Norway and Sweden, two similar countries with very different mitigation measures against COVID-19. Methods: Using real-world data from national registries, we compared all-cause and COVID-19-related mortality rates with 95% confidence intervals (CI) per 100,000 person-weeks and mortality rate ratios (MRR) comparing the five preceding years (2015-2019) with the pandemic year (2020) in Norway and Sweden. Results: In Norway, all-cause mortality was stable from 2015 to 2019 (mortality rate 14.6-15.1 per 100,000 person-weeks; mean mortality rate 14.9) and was lower in 2020 than from 2015 to 2019 (mortality rate 14.4; MRR 0.97; 95% CI 0.96-0.98). In Sweden, all-cause mortality was stable from 2015 to 2018 (mortality rate 17.0-17.8; mean mortality rate 17.1) and similar to that in 2020 (mortality rate 17.6), but lower in 2019 (mortality rate 16.2). Compared with the years 2015-2019, all-cause mortality in the pandemic year was 3% higher due to the lower rate in 2019 (MRR 1.03; 95% CI 1.02-1.04). Excess mortality was confined to people aged ⩾70 years in Sweden compared with previous years. The COVID-19-associated mortality rates per 100,000 person-weeks during the first wave of the pandemic were 0.3 in Norway and 2.9 in Sweden. Conclusions: All-cause mortality in 2020 decreased in Norway and increased in Sweden compared with previous years. The observed excess deaths in Sweden during the pandemic may, in part, be explained by mortality displacement due to the low all-cause mortality in the previous year.


Subject(s)
COVID-19 , Aged , Communicable Disease Control , Humans , Mortality , Norway/epidemiology , Pandemics , SARS-CoV-2 , Sweden/epidemiology
7.
Scand J Public Health ; 50(1): 94-101, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1724278

ABSTRACT

AIMS: The aim of this study was to examine how the Norwegian general adult population was affected by non-pharmaceutical interventions during the first six weeks of the COVID-19 lockdown. We assessed quarantine, symptoms, social distancing, home office/school, work status, social contact and health-care contact through digital access and knowledge. METHODS: A cross-sectional survey was performed of 29,535 adults (aged 18-99) in Norway after six weeks of non-pharmaceutical interventions in March/April 2020. RESULTS: Most participants found the non-pharmaceutical interventions to be manageable, with 20% of all adults and 30% of those aged <30 regarding them as acceptable only to some or a limited degree. Sixteen per cent had been quarantined, 6% had experienced symptoms that could be linked to COVID-19 and 84% practiced social distancing. Eleven per cent reported changes in the use of health and social services. Three-quarters (75%) of those who had mental health or physiotherapy sessions at least monthly before the pandemic reported a reduction in their use of these services. A substantial reduction was also seen for home nursing, hospital services and dentists compared to usage before the non-pharmaceutical interventions. Immigrants were more likely to experience a reduction in follow-up from psychologists and physiotherapy. With regard to the use of general practitioners, the proportions reporting an increase and a reduction were relatively equal. CONCLUSIONS: The non-pharmaceutical interventions were perceived as manageable by the majority of the adult general population in Norway at the beginning of the COVID-19 pandemic. A substantial proportion of adults <30 years old experienced difficulties with social distancing, and those >70 years old lacked the digital tools and knowledge. Further, immigrant access to health services needs monitoring and future attention.


Subject(s)
COVID-19 , Adult , Aged , Communicable Disease Control , Cross-Sectional Studies , Humans , Norway/epidemiology , Pandemics , SARS-CoV-2
8.
Scand J Public Health ; 50(1): 52-60, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1724275

ABSTRACT

AIM: Immigrants in Norway have higher COVID-19 notification and hospitalisation rates than Norwegian-born individuals. The knowledge about the role of socioeconomic factors to explain these differences is limited. We investigate the relationship between socioeconomic indicators at group level and epidemiological data for all notified cases of COVID-19 and related hospitalisations among the 23 largest immigrant groups in Norway. METHODS: We used data on all notified COVID-19 cases in Norway up to 15 November 2020, and associated hospitalisations, from the Norwegian Surveillance System for Communicable Diseases and the emergency preparedness register at the Norwegian Institute of Public Health. We report notified COVID-19 cases and associated hospitalisation rates per 100,000 and their correlation to income, education, unemployment, crowded housing and years of residency at the group level. RESULTS: Crowded housing and low income at a group level were correlated with rates of both notified cases of COVID-19 (Pearson`s correlation coefficient 0.77 and 0.52) and related hospitalisations (0.72, 0.50). In addition, low educational level and unemployment were correlated with a high number of notified cases. CONCLUSIONS: Immigrant groups living in disadvantaged socioeconomic positions are important to target with preventive measures for COVID-19. This must include targeted interventions for low-income families living in overcrowded households.


Subject(s)
COVID-19 , Emigrants and Immigrants , Humans , Norway/epidemiology , SARS-CoV-2 , Socioeconomic Factors
10.
Pediatr Infect Dis J ; 41(3): e95-e101, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1615776

ABSTRACT

BACKGROUND: The clinical impact of common human coronavirus (cHCoV) remains unclear. We studied the clinical manifestations of pediatric cHCoV infections and the possible modifying effects of codetected human rhinovirus (RV) and respiratory syncytial virus (RSV). METHODS: We used data from an 11-year-long prospective study of hospitalized children with community-acquired respiratory tract infections. Nasopharyngeal aspirates were analyzed with real-time polymerase chain reaction assay for cHCoV OC43, NL63, HKU1 and 229E, and 15 other respiratory viruses. We assessed disease severity based on the clinical factors hospitalization length, oxygen requirement, other respiratory support and supplementary fluids. RESULTS: cHCoV was detected in 341 (8%) of 4312 children. Among 104 children with single cHCoV detections, 58 (56%) had lower respiratory tract infection (LRTI) and 20 (19%) developed severe disease. The proportion with severe disease was lower among single cHCoV detections compared with single RSV detections (338 of 870; 39%), but similar to single RV detections (136 of 987; 14%). Compared with single cHCoV, codetected cHCoV-RSV was more often associated with LRTI (86 of 89; 97%) and severe disease (adjusted odds ratio, 3.3; 95% confidence interval: 1.6-6.7). LRTI was more frequent in codetected cHCoV-RV (52 of 68; 76%) than single cHCoV, but the risk of severe disease was lower (adjusted odds ratios, 0.3; 95% confidence interval: 0.1-1.0). CONCLUSIONS: cHCoV was associated with severe LRTI in hospitalized children. Viral codetections were present in two-thirds. Codetections of cHCoV-RV were associated with lower proportions of severe disease, suggesting a modifying effect of RV on HCoV.


Subject(s)
Coinfection/virology , Coronavirus Infections/virology , Picornaviridae Infections/virology , Respiratory Syncytial Virus Infections/virology , Adolescent , Child , Child, Hospitalized , Child, Preschool , Coinfection/epidemiology , Coinfection/therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Female , Humans , Infant , Infant, Newborn , Male , Norway/epidemiology , Picornaviridae Infections/epidemiology , Picornaviridae Infections/therapy , Prospective Studies , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/therapy
11.
PLoS One ; 17(1): e0262846, 2022.
Article in English | MEDLINE | ID: covidwho-1662440

ABSTRACT

In many countries of the world, COVID-19 pandemic has led to exceptional changes in mortality trends. Some studies have tried to quantify the effects of Covid-19 in terms of a reduction in life expectancy at birth in 2020. However, these estimates might need to be updated now that, in most countries, the mortality data for the whole year are available. We used data from the Human Mortality Database (HMD) Short-Term Mortality Fluctuations (STMF) data series to estimate life expectancy in 2020 for several countries. The changes estimated using these data and the appropriate methodology seem to be more pessimistic than those that have been proposed so far: life expectancy dropped in the Russia by 2.16 years, 1.85 in USA, and 1.27 in England and Wales. The differences among countries are substantial: many countries (e.g. Denmark, Island, Norway, New Zealand, South Korea) saw a rather limited drop in life expectancy or have even seen an increase in life expectancy.


Subject(s)
COVID-19/mortality , Life Expectancy , SARS-CoV-2/pathogenicity , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/virology , Child , Child, Preschool , Databases, Factual , Developed Countries , England/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Mortality , New Zealand/epidemiology , Norway/epidemiology , Republic of Korea/epidemiology , Russia/epidemiology , United States/epidemiology , Wales/epidemiology , Young Adult
12.
Nat Hum Behav ; 6(2): 217-228, 2022 02.
Article in English | MEDLINE | ID: covidwho-1641965

ABSTRACT

The COVID-19 pandemic has dramatically restricted adolescents' lives. We used nationwide Norwegian survey data from 2014-2021 (N = 227,258; ages 13-18) to examine psychosocial outcomes in adolescents before and during the pandemic. Multilevel models revealed higher depressive symptoms and less optimistic future life expectations during the pandemic, even when accounting for the measures' time trends. Moreover, alcohol and cannabis use decreased, and screen time increased. However, the effect sizes of all observed changes during the pandemic were small. Overall, conduct problems and satisfaction with social relationships remained stable. Girls, younger adolescents and adolescents from low socio-economic backgrounds showed more adverse changes during the pandemic. Estimated changes in psychosocial outcomes varied little with municipality infection rates and restrictions. These findings can inform means and interventions to reduce negative psychological outcomes associated with the pandemic and identify groups that need particular attention during and after the pandemic.


Subject(s)
Adolescent Behavior , COVID-19 , Communicable Disease Control/methods , Mental Health , Psychology , Screen Time , Social Behavior , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Female , Humans , Male , Needs Assessment , Norway/epidemiology , SARS-CoV-2 , Surveys and Questionnaires
13.
Scand J Public Health ; 49(7): 689-696, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1636098

ABSTRACT

AIMS: In order to prevent a major outbreak of COVID-19 disease in Norway, a series of lockdown measures was announced on 12 March 2020. The aim of the present paper was to describe the impact of this lockdown on the treatment of injuries. METHODS: We collected hospital data on injury diagnoses from a national emergency preparedness register established during the pandemic. We identified the number of injured patients per day in the period 1 January-30 June 2020, and analysed the change in patient volumes over two three-week periods before and during the lockdown by sex, age, level of care, level of urgency, type of contact and type of injury. RESULTS: Compared to pre-lockdown levels, there was an overall reduction of 43% in injured patients during the first three weeks of lockdown. The decrease in patient contacts did not differ by sex, but was most pronounced among young people. Substantial reductions were observed for both acute and elective treatment and across all levels of care and types of contact, with the exception of indirect patient contacts. The change in patient contacts varied considerably by injury type, with the largest reduction observed for dislocations/sprains/strains. The decrease was much lower for burns/corrosions and poisoning. CONCLUSIONS: A substantial reduction in the treatment of injuries was observed during lockdown in Norway. Possible explanations for this finding include an overall decrease in injury risk, a redistribution of hospital resources and a higher threshold for seeking medical attention as a result of the pandemic.


Subject(s)
COVID-19 , Pandemics , Adolescent , Communicable Disease Control , Humans , Norway/epidemiology , SARS-CoV-2
14.
Scand J Public Health ; 49(7): 766-773, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1633074

ABSTRACT

AIMS: There are concerns that lockdown measures taken during the current COVID-19 pandemic lead to a rise in loneliness, especially in vulnerable groups. We explore trends in loneliness before and during the pandemic and differences across population subgroups. METHODS: Data were collected via online questionnaires in June 2020 and four to eight months prior in two Norwegian counties (N=10,740; 54% women; age 19-92 years). Baseline data come from the Norwegian Counties Public Health Survey (participation rate 46%, of which 59% took part in a COVID-19 follow-up study). RESULTS: Overall loneliness was stable or falling during the lockdown. However, some subgroups, single individuals and older women, reported slightly increased loneliness during lockdown. Interestingly, individuals with low social support and high levels of psychological distress and loneliness before the pandemic experienced decreasing loneliness during the pandemic. CONCLUSIONS: Although data limitations preclude strong conclusions, our findings suggest that, overall, Norwegians seem to have managed the lockdown without alarming increases in loneliness. It is important to provide support and to continue investigating the psychological impact of the pandemic over time and across regions differentially affected by the pandemic.


Subject(s)
COVID-19 , Pandemics , Adult , Aged , Aged, 80 and over , Communicable Disease Control , Female , Follow-Up Studies , Humans , Loneliness , Male , Middle Aged , Norway/epidemiology , SARS-CoV-2 , Young Adult
15.
Epidemiol Infect ; 150: e28, 2022 01 13.
Article in English | MEDLINE | ID: covidwho-1621175

ABSTRACT

We studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence among pregnant women in Norway by including all women who were first trimester pregnant (n = 6520), each month from December 2019 through December 2020, in the catchment region of Norway's second-largest hospital. We used sera that had been frozen stored after compulsory testing for syphilis antibodies in antenatal care. The sera were analysed with the Elecsys® Anti-SARS-CoV-2 immunoassay (Roche Diagnostics, Cobas e801). This immunoassay detects IgG/IgM against SARS-CoV-2 nucleocapsid antigen. Sera with equivocal or positive test results were retested with the Liaison® SARS-CoV-2 S1/S2 IgG (DiaSorin), which detects IgG against the spike (S)1 and S2 protein on the SARS-CoV-2 virus. In total, 98 women (adjusted prevalence 1.7%) had SARS CoV-2 antibodies. The adjusted seroprevalence increased from 0.3% (1/445) in December 2019 to 5.7% (21/418) in December 2020. Out of the 98 seropositive women, 36 (36.7%) had serological signs of current SARS-CoV-2 infection at the time of serum sampling, and the incidence remained low during the study period. This study suggests that SARS CoV-2 was present in the first half of December 2019, 6 weeks before the first case was recognised in Norway. The low occurrence of SARS-CoV-2 infection during 2020, may be explained by high compliance to extensive preventive measures implemented early in the epidemic.


Subject(s)
Antibodies, Viral/blood , COVID-19/epidemiology , Pregnancy Complications, Infectious/epidemiology , SARS-CoV-2/immunology , Adult , COVID-19/immunology , Cryopreservation , Female , Humans , Norway/epidemiology , Pregnancy , Pregnancy Complications, Infectious/immunology , Pregnancy Complications, Infectious/virology , Seroepidemiologic Studies
16.
BJOG ; 129(1): 101-109, 2022 01.
Article in English | MEDLINE | ID: covidwho-1612815

ABSTRACT

OBJECTIVE: To compare the risk of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and contact with specialist healthcare services for coronavirus disease 2019 (COVID-19) between pregnant and non-pregnant women. POPULATION OR SAMPLE: All women ages 15-45 living in Norway on 1 March 2020 (n = 1 033 699). METHODS: We linked information from the national birth, patient, communicable diseases and education databases using unique national identifiers. MAIN OUTCOME MEASURE: We estimated hazard ratios (HR) among pregnant compared to non-pregnant women of having a positive test for SARS-CoV-2, a diagnosis of COVID-19 in specialist healthcare, or hospitalisation with COVID-19 using Cox regression. Multivariable analyses adjusted for age, marital status, education, income, country of birth and underlying medical conditions. RESULTS: Pregnant women were not more likely to be tested for or to a have a positive SARS-CoV-2 test (adjusted HR 0.99; 95% CI 0.92-1.07). Pregnant women had higher risk of hospitalisation with COVID-19 (HR 4.70, 95% CI 3.51-6.30) and any type of specialist care for COVID-19 (HR 3.46, 95% CI 2.89-4.14). Pregnant women born outside Scandinavia were less likely to be tested, and at higher risk of a positive test (HR 2.37, 95% CI 2.51-8.87). Compared with pregnant Scandinavian-born women, pregnant women with minority background had a higher risk of hospitalisation with COVID-19 (HR 4.72, 95% CI 2.51-8.87). CONCLUSION: Pregnant women were not more likely to be infected with SARS-CoV-2. Still, pregnant women with COVID-19, especially those born outside of Scandinavia, were more likely to be hospitalised. TWEETABLE ABSTRACT: Pregnant women are at increased risk of hospitalisation for COVID-19.


Subject(s)
COVID-19/epidemiology , Pregnancy Complications, Infectious/epidemiology , Prenatal Care , SARS-CoV-2 , Adolescent , Adult , COVID-19/etiology , Female , Humans , Middle Aged , Norway/epidemiology , Pregnancy , Pregnancy Complications, Infectious/etiology , Pregnancy Outcome , Registries , Risk Factors , Young Adult
17.
Int J Infect Dis ; 115: 178-184, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1598965

ABSTRACT

OBJECTIVES: To estimate the risk of hospitalization among reported cases of the Delta variant of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) compared with the Alpha variant in Norway, and the risk of hospitalization by vaccination status. METHODS: A cohort study was conducted on laboratory-confirmed cases of SARS-CoV-2 in Norway, diagnosed between 3 May and 15 August 2021. Adjusted risk ratios (aRR) with 95% confidence intervals (CI) were calculated using multi-variable log-binomial regression, accounting for variant, vaccination status, demographic characteristics, week of sampling and underlying comorbidities. RESULTS: In total, 7977 cases of the Delta variant and 12,078 cases of the Alpha variant were included in this study. Overall, 347 (1.7%) cases were hospitalized. The aRR of hospitalization for the Delta variant compared with the Alpha variant was 0.97 (95% CI 0.76-1.23). Partially vaccinated cases had a 72% reduced risk of hospitalization (95% CI 59-82%), and fully vaccinated cases had a 76% reduced risk of hospitalization (95% CI 61-85%) compared with unvaccinated cases. CONCLUSIONS: No difference was found between the risk of hospitalization for Delta cases and Alpha cases in Norway. The results of this study support the notion that partially and fully vaccinated cases are highly protected against hospitalization with coronavirus disease 2019.


Subject(s)
COVID-19 , SARS-CoV-2 , Cohort Studies , Hospitalization , Humans , Norway/epidemiology
18.
Euro Surveill ; 26(50)2021 Dec.
Article in English | MEDLINE | ID: covidwho-1591908

ABSTRACT

In late November 2021, an outbreak of Omicron SARS-CoV-2 following a Christmas party with 117 attendees was detected in Oslo, Norway. We observed an attack rate of 74% and most cases developed symptoms. As at 13 December, none have been hospitalised. Most participants were 30-50 years old. Ninety-six percent of them were fully vaccinated. These findings corroborate reports that the Omicron variant may be more transmissible, and that vaccination may be less effective in preventing infection compared with Delta.


Subject(s)
COVID-19 , SARS-CoV-2 , Adult , Disease Outbreaks , Humans , Middle Aged , Norway/epidemiology
19.
BMJ Open ; 11(12): e050525, 2021 12 14.
Article in English | MEDLINE | ID: covidwho-1583110

ABSTRACT

OBJECTIVE: To explore the potential impact of the first wave of COVID-19 pandemic on all cause and cause-specific mortality in Norway. DESIGN: Population-based register study. SETTING: The Norwegian cause of Death Registry and the National Population Register of Norway. PARTICIPANTS: All recorded deaths in Norway from March to May from 2010 to 2020. MAIN OUTCOME MEASURES: Rate (per 100 000) of all-cause mortality and causes of death in the European Shortlist for Causes of Death from March to May 2020. The rates were age standardised and adjusted to a 100% register coverage and compared with a 95% prediction interval (PI) from linear regression based on corresponding rates for 2010-2019. RESULTS: 113 710 deaths were included, of which 10 226 were from 2020. We did not observe any deviation from predicted total mortality. There were fewer than predicted deaths from chronic lower respiratory diseases excluding asthma (11.4, 95% PI 11.8 to 15.2) and from other non-ischaemic, non-rheumatic heart diseases (13.9, 95% PI 14.5 to 20.2). The death rates were higher than predicted for Alzheimer's disease (7.3, 95% PI 5.5 to 7.3) and diabetes mellitus (4.1, 95% PI 2.1 to 3.4). CONCLUSIONS: There was no significant difference in the frequency of the major causes of death in the first wave of the 2020 COVID-19 pandemic in Norway compared with corresponding periods 2010-2019. There was an increase in diabetes mellitus and Alzheimer's deaths. Reduced mortality due to some heart and lung conditions may be linked to infection control measures.


Subject(s)
COVID-19 , Pandemics , Cause of Death , Communicable Disease Control , Humans , Norway/epidemiology , SARS-CoV-2
20.
Open Heart ; 8(2)2021 12.
Article in English | MEDLINE | ID: covidwho-1582998

ABSTRACT

OBJECTIVE: Soluble ST2 (sST2) reflects inflammation, endothelial dysfunction and myocardial fibrosis, is produced in the lungs and is an established biomarker in heart failure. We sought to determine the role of sST2 in COVID-19 by assessing pathophysiological correlates and its association to in-hospital outcomes. METHODS: We enrolled 123 consecutive, hospitalised patients with COVID-19 in the prospective, observational COVID-19 MECH study. Biobank samples were collected at baseline, day 3 and day 9. The key exposure variable was sST2, and the outcome was ICU treatment with mechanical ventilation or in-hospital death. RESULTS: Concentrations of sST2 at baseline was median 48 (IQR 37-67) ng/mL, and 74% had elevated concentrations (>37.9 ng/mL). Higher baseline sST2 concentrations were associated with older age, male sex, white race, smoking, diabetes, hypertension and chronic kidney disease. Baseline sST2 also associated with the presence of SARS-CoV-2 viraemia, lower oxygen saturation, higher respiratory rate and increasing concentrations of biomarkers reflecting inflammation, thrombosis and cardiovascular disease. During the hospitalisation, 8 (7%) patients died and 27 (22%) survivors received intensive care unit (ICU) treatment. Baseline sST2 concentrations demonstrated a graded association with disease severity (median, IQR): medical ward 43 (36-59) ng/mL; ICU 67 (39-104) ng/mL and non-survivors 107 (72-116) ng/mL (p<0.001 for all comparisons). These associations persisted at day 3 and day 9 . CONCLUSIONS: sST2 concentrations associate with SARS-CoV-2 viraemia, hypoxaemia and concentrations of inflammatory and cardiovascular biomarkers. There was a robust association between baseline sST2 and disease severity that was independent of, and superior to, established risk factors. sST2 reflects key pathophysiology and may be a promising biomarker in COVID-19. TRIAL REGISTRATION NUMBER: NCT04314232.


Subject(s)
COVID-19 , Hypoxia , Interleukin-1 Receptor-Like 1 Protein/analysis , SARS-CoV-2/isolation & purification , Viremia , Aged , Biomarkers/analysis , COVID-19/blood , COVID-19/mortality , COVID-19/physiopathology , Comorbidity , Correlation of Data , Female , Hospital Mortality , Humans , Hypoxia/diagnosis , Hypoxia/etiology , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Norway/epidemiology , Prognosis , Risk Factors , Severity of Illness Index , Smoking/epidemiology , Viremia/diagnosis , Viremia/etiology
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