Dataset Information

Clinical spectrum of coronavirus disease 2019 in Iceland: population based cohort study.

ABSTRACT: Objective: To characterise the symptoms of coronavirus disease 2019 (covid-19).

Design: Population based cohort study.

Setting: Iceland.

Participants: All individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) between 17 March and 30 April 2020. Cases were identified by three testing strategies: targeted testing guided by clinical suspicion, open invitation population screening based on self referral, and random population screening. All identified cases were enrolled in a telehealth monitoring service, and symptoms were systematically monitored from diagnosis to recovery.

Main outcome measures: Occurrence of one or more of 19 predefined symptoms during follow-up.

Results: Among 1564 people positive for SARS-CoV-2, the most common presenting symptoms were myalgia (55%), headache (51%), and non-productive cough (49%). At the time of diagnosis, 83 (5.3%) individuals reported no symptoms, of whom 49 (59%) remained asymptomatic during follow-up. At diagnosis, 216 (14%) and 349 (22%) people did not meet the case definition of the Centers for Disease Control and Prevention and the World Health Organization, respectively. Most (67%) of the SARS-CoV-2-positive patients had mild symptoms throughout the course of their disease.

Conclusion: In the setting of broad access to RT-PCR testing, most SARS-CoV-2-positive people were found to have mild symptoms. Fever and dyspnoea were less common than previously reported. A substantial proportion of SARS-CoV-2-positive people did not meet recommended case definitions at the time of diagnosis.

SUBMITTER: Eythorsson E

PROVIDER: S-EPMC7708618 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Clinical spectrum of coronavirus disease 2019 in Iceland: population based cohort study.

Eythorsson Elias E Helgason Dadi D Ingvarsson Ragnar Freyr RF Bjornsson Helgi K HK Olafsdottir Lovisa Bjork LB Bjarnadottir Valgerdur V Runolfsdottir Hrafnhildur Linnet HL Bjarnadottir Solveig S Agustsson Arnar Snaer AS Oskarsdottir Kristin K Thorvaldsson Hrafn Hliddal HH Kristjansdottir Gudrun G Armannsdottir Brynja B Bjarnason Agnar A Johannsson Birgir B Gudlaugsson Olafur O Gottfredsson Magnus M Sigurdsson Martin I MI Indridason Olafur S OS Palsson Runolfur R

BMJ (Clinical research ed.) 20201202

<h4>Objective</h4>To characterise the symptoms of coronavirus disease 2019 (covid-19).<h4>Design</h4>Population based cohort study.<h4>Setting</h4>Iceland.<h4>Participants</h4>All individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription polymerase chain reaction (RT-PCR) between 17 March and 30 April 2020. Cases were identified by three testing strategies: targeted testing guided by clinical suspicion, open invitation population sc ...[more]

PMID: 33268329

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Project description:BackgroundLimited data exist regarding the disease course of coronavirus disease 2019 (COVID-19) and its relationship with immunosuppressants among patients with immune-mediated inflammatory diseases (IMIDs). Therefore, this study aims to investigate the association between COVID-19, frequent rheumatological, dermatological, gastrointestinal, and neurological IMIDs and immunosuppressants.MethodsWe conducted a Danish population-based cohort study including all residents living within Capital Region of Denmark and Region Zealand from January 28th, 2020 until September 15th, 2020 with the only eligibility criterion being a test for SARS-CoV-2 via reverse transcription-polymerase chain-reaction. Main outcomes included development of COVID-19, COVID-19-related hospitalization and mortality.ResultsCOVID-19 was less common among patients with IMIDs than the background population (n = 328/20,513 (1.60%) and n = 10,792/583,788(1.85%), p < 0.01, respectively). However, those with IMIDs had a significantly higher risk of COVID-19-related hospitalization (31.1% and 18.6%, p < 0.01, respectively) and mortality (9.8% and 4.3%, p < 0.01, respectively), which were associated with patients older than 65 years, and presence of comorbidities. Furthermore, systemic steroids were independently associated with a severe course of COVID-19 (Odds ratio (OR) = 3.56 (95%CI 1.83-7.10), p < 0.01), while biologic therapies were associated with a reduced risk hereof (OR = 0.47 (95%CI 0.22-0.95), p = 0.04). Patients suspending immunosuppressants due to COVID-19 had an increased risk of subsequent hospitalization (OR = 3.59 (95%CI 1.31-10.78), p = 0.02).ConclusionThis study found a lower occurrence, but a more severe disease course, of COVID-19 among patients with IMIDs, which was associated with the use of systemic steroids for IMIDs and suspension of other immunosuppressants. This study emphasizes the importance of weighing risks before suspending immunosuppressants during COVID-19.

Dataset Information

Clinical spectrum of coronavirus disease 2019 in Iceland: population based cohort study.

Publications

Clinical spectrum of coronavirus disease 2019 in Iceland: population based cohort study.

Similar Datasets

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