Susceptibility and risk of SARS-COV-2 infection among middle-aged and older adults in Tarragona area, Spain Susceptibilidad y riesgo de infección por SARS-CoV-2 en adultos mayores de 50 años en el área de Tarragona

ABSTRACT

Objective To analyse susceptibility/risk of suffering COVID-19 among adults with distinct underlying medical conditions. Methods Population-based cohort study involving 79,083 individuals ≥50 years old in Tarragona (Southern Catalonia, Spain). Baseline cohort characteristics (demographic, pre-existing comorbidities, chronic medications and vaccinations history) were established at study start (01/03/2020) and primary outcome was laboratory-confirmed COVID-19 occurred among cohort members throughout 01/03/2020–30/06/2020. Risk of suffering COVID-19 was evaluated by Cox regression, estimating multivariable hazard ratios (HRs) adjusted for age/sex and pre-existing comorbidities. Results Across study period, 536 laboratory-confirmed COVID-19 cases were observed (mean incidence 39.5 cases per 100,000 persons-week). In multivariable-analysis, increasing age/years (HR 1.01;95% CI 1.00–1.02), nursing-home (HR 20.19;95% CI 15.98–25.51), neurological disease (HR 1.35;95% CI 1.03–1.77), taking diuretics (HR 1.39;95% CI 1.10–1.75), antiplatelet (HR 1.36;95% CI 1.05–1.76) and benzodiazepines (HR 1.24;95% CI 1.00–1.53) increased risk;conversely, taking angiotensin-converting-enzyme inhibitors (HR 0.78;95% CI 0.61–1.00), angiotensin-receptor-blockers (HR 0.70;95%CI 0.51–0.96) and statins (HR 0.75;95% CI 0.58–0.96) were associated with reduced risk. Among community-dwelling individuals, pre-existing cancer, renal and cardiac disease appeared also related with an increased risk, whereas influenza vaccination was associated with reduced risk. Conclusion In a setting with relatively low incidence of COVID-19 across the first wave of pandemic period, increasing age, nursing-home residence and multiple comorbidities appear predisposing for COVID-19 among middle-aged/older adults. Conversely, statins, angiotensin-receptor blockers/inhibitors and influenza vaccination were related with decreased risk.