{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T20:57:02Z","timestamp":1776200222682,"version":"3.50.1"},"reference-count":68,"publisher":"JMIR Publications Inc.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>COVID-19, a viral respiratory disease first reported in December 2019, quickly became a threat to global public health. Further understanding of the epidemiology of the SARS-CoV-2 virus and the risk perception of the community may better inform targeted interventions to reduce the impact and spread of COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In this study, we aimed to examine the association between chronic diseases and serious outcomes following COVID-19 infection, and to explore its influence on people\u2019s self-perception of risk for worse COVID-19 outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study draws data from two databases: (1) the nationwide database of all confirmed COVID-19 cases in Portugal, extracted on April 28, 2020 (n=20,293); and (2) the community-based COVID-19 Barometer survey, which contains data on health status, perceptions, and behaviors during the first wave of COVID-19 (n=171,087). We assessed the association between relevant chronic diseases (ie, respiratory, cardiovascular, and renal diseases; diabetes; and cancer) and death and intensive care unit (ICU) admission following COVID-19 infection. We identified determinants of self-perception of risk for severe COVID-19 outcomes using logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Respiratory, cardiovascular, and renal diseases were associated with mortality and ICU admission among patients hospitalized due to COVID-19 infection (odds ratio [OR] 1.48, 95% CI 1.11-1.98; OR 3.39, 95% CI 1.80-6.40; and OR 2.25, 95% CI 1.66-3.06, respectively). Diabetes and cancer were associated with serious outcomes only when considering the full sample of COVID-19\u2013infected cases in the country (OR 1.30, 95% CI 1.03-1.64; and OR 1.40, 95% CI 1.03-1.89, respectively). Older age and male sex were both associated with mortality and ICU admission. The perception of risk for severe COVID-19 disease in the study population was 23.9% (n=40,890). This was markedly higher for older adults (n=5235, 46.4%), those with at least one chronic disease (n=17,647, 51.6%), or those in both of these categories (n=3212, 67.7%). All included diseases were associated with self-perceptions of high risk in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results demonstrate the association between some prevalent chronic diseases and increased risk of worse COVID-19 outcomes. It also brings forth a greater understanding of the community\u2019s risk perceptions of serious COVID-19 disease. Hence, this study may aid health authorities to better adapt measures to the real needs of the population and to identify vulnerable individuals requiring further education and awareness of preventive measures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/22794","type":"journal-article","created":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T22:46:46Z","timestamp":1607986006000},"page":"e22794","source":"Crossref","is-referenced-by-count":85,"title":["The Association Between Chronic Disease and Serious COVID-19 Outcomes and Its Influence on Risk Perception: Survey Study and Database Analysis"],"prefix":"10.2196","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1930-7913","authenticated-orcid":false,"given":"Pedro Almeida","family":"Laires","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5085-0685","authenticated-orcid":false,"given":"S\u00f3nia","family":"Dias","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6958-6159","authenticated-orcid":false,"given":"Ana","family":"Gama","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5902-9113","authenticated-orcid":false,"given":"Marta","family":"Moniz","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9197-7129","authenticated-orcid":false,"given":"Ana R","family":"Pedro","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5033-9115","authenticated-orcid":false,"given":"Patricia","family":"Soares","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-7732","authenticated-orcid":false,"given":"Pedro","family":"Aguiar","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4562-1057","authenticated-orcid":false,"given":"Carla","family":"Nunes","sequence":"additional","affiliation":[]}],"member":"1010","published-online":{"date-parts":[[2021,1,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30183-5"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.01.009"},{"key":"ref3","unstructured":"World Health OrganizationCOVID-19 Dashboard20202020-12-10https:\/\/covid19.who.int\/"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30211-7"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1585"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(20)30086-4"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m792"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1056\/nejmp2002125"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1348\/135910710X485826"},{"key":"ref11","first-page":"3","author":"Fischhoff, B","year":"2012","journal-title":"Risk Analysis and Human Behavior"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1177\/109019817400200405"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1080\/00223980.1975.9915803"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2020.05.001"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.31234\/osf.io\/dz428"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.45221"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.2196\/19782"},{"key":"ref18","unstructured":"Centers for Disease Control and Prevention20202020-12-10https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/prevent-getting-sick\/prevention.html"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.2196\/19904"},{"key":"ref20","unstructured":"Inqu\u00e9rito Nacional de Sa\u00fade 2014 (National Health Survey - 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