{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T20:30:29Z","timestamp":1754598629240,"version":"3.37.3"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2022-05608"],"award-info":[{"award-number":["2022-05608"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010805","name":"Forskningsr\u00e5det i Syd\u00f6stra Sverige","doi-asserted-by":"publisher","award":["FORSS-940915"],"award-info":[{"award-number":["FORSS-940915"]}],"id":[{"id":"10.13039\/100010805","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In preparation of future pandemics, it is important to recognise population-level determinants associated with development of severe illness before efficient vaccines and evidence-based therapeutic measures are available. The aim of this study was to identify pre-pandemic diagnoses recorded in a middle-aged and elderly population that were associated with development of severe COVID-19 during the first pandemic year.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A cohort study design was used. Severe COVID-19 was defined as a course of illness that resulted in hospital admission or death. A retrospective analysis was performed that comprised all individuals aged 39 years and older (N\u2009=\u2009189,951) living in J\u00f6nk\u00f6ping County, Sweden. All diagnosed morbidity recorded in contacts with health care during the pre-pandemic year 2019 was used to identify which diagnoses that were associated with development of severe COVID-19 in the first pandemic year 2020. The analyses were performed separately for each diagnosis using binary logistic regression with adjustment for sex and age.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Severe COVID-19 was suffered by 0.67% (N\u2009=\u20091,280) of the middle-aged and elderly population in the first pandemic year. Individuals previously diagnosed with dementia, cerebral palsy, kidney failure, type 2 diabetes mellitus, hypertension, and obesity were at higher risk of developing severe COVID-19. For patients with Type 2 diabetes mellitus, the odds ratio (OR) was 2.18 (95% confidence interval, 1.92\u20132.48). Type 1 diabetes mellitus was not associated with increased risk.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Diagnoses suggesting service provision at long-term healthcare facilities and co-morbidity with components of the metabolic syndrome were associated with an increased risk of developing severe COVID-19 in a middle-aged and elderly population before vaccines were available.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-023-08115-0","type":"journal-article","created":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T20:31:19Z","timestamp":1679862679000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Co-morbidity associated with development of severe COVID-19 before vaccine availability: a retrospective cohort study in the first pandemic year among the middle-aged and elderly in J\u00f6nk\u00f6ping county, Sweden"],"prefix":"10.1186","volume":"23","author":[{"given":"Dennis","family":"Nordvall","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Drobin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toomas","family":"Timpka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1528-3803","authenticated-orcid":false,"given":"Robert G.","family":"Hahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"8115_CR1","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1002\/jmv.26232","volume":"93","author":"B Hu","year":"2021","unstructured":"Hu B, Huang S, Yin L. The cytokine storm and COVID-19. J Med Virol. 2021;93:250\u20136.","journal-title":"J Med Virol"},{"key":"8115_CR2","doi-asserted-by":"publisher","first-page":"e0260733","DOI":"10.1371\/journal.pone.0260733","volume":"17","author":"SK Korang","year":"2022","unstructured":"Korang SK, von Rohden E, Veroniki AA, Ong G, Ngalamika O, Siddiqui F, Juul S, Nielsen EE, Feinberg JB, Petersen JJ, Legart C, Kokogho A, Maagaard M, Klingenberg S, Thabane L, Bardach A, Ciapponi A, Thomsen AR, Jakobsen JC, Gluud C. Vaccines to prevent COVID-19: a living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials. PLoS ONE. 2022;17:e0260733.","journal-title":"PLoS ONE"},{"doi-asserted-by":"crossref","unstructured":"Shah MM, Joyce B, Plumb ID, Sahakian S, Feldstein LR, Barkley E, Paccione M, Deckert J, Sandmann D, Gerhart JL, Hagen MB. Paxlovid Associated with Decreased Hospitalization Rate Among Adults with COVID-19 - United States, April-September 2022. MMWR Morb Mortal Wkly Rep. 2022 Dec 2;71(48):1531\u20131537.","key":"8115_CR3","DOI":"10.15585\/mmwr.mm7148e2"},{"key":"8115_CR4","doi-asserted-by":"publisher","first-page":"220099","DOI":"10.1183\/16000617.0099-2022","volume":"31","author":"M Bafadhel","year":"2022","unstructured":"Bafadhel M, Faner R, Taill\u00e9 C, Russell REK, Welte T, Barnes PJ, Agust\u00ed A. Inhaled corticosteroids for the treatment of COVID-19. Eur Respir Rev. 2022;31:220099.","journal-title":"Eur Respir Rev"},{"key":"8115_CR5","doi-asserted-by":"publisher","first-page":"e247461","DOI":"10.1371\/journal.pone.0247461","volume":"16","author":"A Booth","year":"2021","unstructured":"Booth A, Reed AB, Ponzo S, Yassaee A, Aral M, Plans D, Labrique A, Mohan D. Population risk factors for severe disease and mortality in COVID-19: a global systematic review and meta-analysis. PLoS ONE. 2021;16:e247461.","journal-title":"PLoS ONE"},{"key":"8115_CR6","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1038\/s41586-020-2521-4","volume":"584","author":"EJ Williamson","year":"2020","unstructured":"Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, Curtis HJ, Mehrkar A, Evans D, Inglesby P, Cockburn J, McDonald HI, MacKenna B, Tomlinson L, Douglas IJ, Rentsch CT, Mathur R, Wong AYS, Grieve R, Harrison D, Forbes H, Schultze A, Croker R, Parry J, Hester F, Harper S, Perera R, Evans SJW, Smeeth L, Goldacre B. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584:430\u20136.","journal-title":"Nature"},{"key":"8115_CR7","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s13722-022-00349-8","volume":"17","author":"AH Behnoush","year":"2022","unstructured":"Behnoush AH, Bazmi E, Forouzesh M, Behnoush B. Risk of COVID-19 infection and the associated hospitalization, ICU admission and mortality in opioid use disorder: a systematic review and meta-analysis. Addict Sci Clin Pract. 2022;17:68.","journal-title":"Addict Sci Clin Pract"},{"key":"8115_CR8","doi-asserted-by":"publisher","first-page":"5706","DOI":"10.3390\/cancers14225706","volume":"14","author":"S Oldani","year":"2022","unstructured":"Oldani S, Petrelli F, Dognini G, Borgonovo K, Parati MC, Ghilardi M, Dottorini L, Cabiddu M, Luciani A. COVID-19 and lung cancer survival: an updated systematic review and meta-analysis. Cancers (Basel). 2022;14:5706.","journal-title":"Cancers (Basel)"},{"key":"8115_CR9","doi-asserted-by":"publisher","first-page":"m3731","DOI":"10.1136\/bmj.m3731","volume":"371","author":"AK Clift","year":"2020","unstructured":"Clift AK, Coupland CAC, Keogh RH, Diaz-Ordaz K, Williamson E, Harrison EM, Hayward A, Hemingway H, Horby P, Mehta N, Benger J, Khunti K, Spiegelhalter D, Sheikh A, Valabhji J, Lyons RA, Robson J, Semple MG, Kee F, Johnson P, Jebb S, Williams T, Hippisley-Cox J. Living risk prediction algorithm (QCOVID) for risk of hospital admission and mortality from coronavirus 19 in adults: national derivation and validation cohort study. BMJ. 2020;371:m3731.","journal-title":"BMJ"},{"doi-asserted-by":"crossref","unstructured":"Knight SR, Ho A, Pius R, Buchan I, Carson G, Drake TM, Dunning J, Fairfield CJ, Gamble C, Green CA, Gupta R, Halpin S, Hardwick HE, Holden KA, Horby PW, Jackson C, Mclean KA, Merson L, Nguyen-Van-Tam JS, Norman L, Noursadeghi M, Olliaro PL, Pritchard MG, Russell CD, Shaw CA, Sheikh A, Solomon T, Sudlow C, Swann OV, Turtle LC, Openshaw PJ, Baillie JK, Semple MG, Docherty AB, Harrison EM. ; ISARIC4C investigators. Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO Clinical Characterization Protocol: development and validation of the 4\u00a0C Mortality Score. BMJ 2020; 370: m3339.","key":"8115_CR10","DOI":"10.1136\/bmj.m3339"},{"key":"8115_CR11","doi-asserted-by":"publisher","first-page":"e100235","DOI":"10.1136\/bmjhci-2020-100235","volume":"28","author":"A Stachel","year":"2021","unstructured":"Stachel A, Daniel K, Ding D, Francois F, Phillips M, Lighter J. Development and validation of a machine learning model to predict mortality risk in patients with COVID-19. BMJ Health Care Inform. 2021;28:e100235.","journal-title":"BMJ Health Care Inform"},{"unstructured":"R Core Team. : The R project for statistical computing. The R Foundation, Vienna, Austria. URL: https:\/\/www.R-project.org\/).","key":"8115_CR12"},{"doi-asserted-by":"publisher","unstructured":"Nilsson L, Andersson C, Kastbom L, Sj\u00f6dahl R. Association between vaccination and preventive routines on COVID-19-related mortality in nursing home facilities: a population-based systematic retrospective chart review. Prim Health Care Res Dev. 2022 Nov 18;23:e75. https:\/\/doi.org\/10.1017\/S1463423622000640","key":"8115_CR13","DOI":"10.1017\/S1463423622000640"},{"key":"8115_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ecl.2013.09.009","volume":"43","author":"SL Samson","year":"2014","unstructured":"Samson SL, Garber AJ. Metabolic syndrome. Endocrinol Metab Clin North Am. 2014;43:1\u201323.","journal-title":"Endocrinol Metab Clin North Am"},{"key":"8115_CR15","first-page":"204","volume":"4","author":"A Gupta","year":"2010","unstructured":"Gupta A, Gupta V. Metabolic syndrome: what are the risks for humans? Biosci Trends. 2010;4:204\u201312.","journal-title":"Biosci Trends"},{"key":"8115_CR16","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/1741-7015-9-48","volume":"9","author":"E Kassi","year":"2011","unstructured":"Kassi E, Pervanidou P, Kaltsas G, Chrousos G. Metabolic syndrome: definitions and controversies. BMC Med. 2011;9:48.","journal-title":"BMC Med"},{"doi-asserted-by":"crossref","unstructured":"Westreich D, Edwards JK, van Smeden M et al. Comment on Williamson. (OpenSAFELY): The Table\u00a02 Fallacy in a Study of COVID-19 Mortality Risk Factors. Epidemiology. 2021 Jan;32(1):e1-e2.","key":"8115_CR17","DOI":"10.1097\/EDE.0000000000001259"},{"doi-asserted-by":"publisher","unstructured":"Nordberg P, Jonsson M, Hollenberg J, Ringh M, Kiiski Berggren R, Hofmann R, Svensson P. Immigrant background and socioeconomic status are associated with severe COVID-19 requiring intensive care. Sci Rep. 2022 Jul 15;12(1):12133. https:\/\/doi.org\/10.1038\/s41598-022-15884-2","key":"8115_CR18","DOI":"10.1038\/s41598-022-15884-2"},{"key":"8115_CR19","doi-asserted-by":"publisher","first-page":"e2","DOI":"10.1097\/EDE.0000000000001258","volume":"32","author":"PWG Tennant","year":"2021","unstructured":"Tennant PWG, Murray EJ. The Quest for timely insights into COVID-19 should not come at the cost of scientific rigor. Epidemiology. 2021;32:e2.","journal-title":"Epidemiology"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-023-08115-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-023-08115-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-023-08115-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T20:32:34Z","timestamp":1679862754000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-023-08115-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,14]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["8115"],"URL":"https:\/\/doi.org\/10.1186\/s12879-023-08115-0","relation":{},"ISSN":["1471-2334"],"issn-type":[{"type":"electronic","value":"1471-2334"}],"subject":[],"published":{"date-parts":[[2023,3,14]]},"assertion":[{"value":"5 March 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 March 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Swedish Ethical Review Authority on February 24, 2021 (Dnr. 2020\u201306951). Patient consent was waived by the Swedish Ethical Review Authority on the same day. Subsequent collection of data was carried out in accordance with current regulations and guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"156"}}