Age-dependence of healthcare interventions for COVID-19 in Ontario, Canada
Date
2021-04-12
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: Patient age is one of the most salient clinical indicators of risk from COVID-19. Age-specific distributions
of known SARS-CoV-2 infections and COVID-19-related deaths are available for many regions. Less attention has been
given to the age distributions of serious medical interventions administered to COVID-19 patients, which could reveal
sources of potential pressure on the healthcare system should SARS-CoV-2 prevalence increase, and could inform
mass vaccination strategies. The aim of this study is to quantify the relationship between COVID-19 patient age and
serious outcomes of the disease, beyond fatalities alone.
Methods: We analysed 277,555 known SARS-CoV-2 infection records for Ontario, Canada, from 23 January 2020 to 16
February 2021 and estimated the age distributions of hospitalizations, Intensive Care Unit admissions, intubations, and
ventilations. We quantified the probability of hospitalization given known SARS-CoV-2 infection, and of survival given
COVID-19-related hospitalization.
Results: The distribution of hospitalizations peaks with a wide plateau covering ages 60–90, whereas deaths are
concentrated in ages 80+. The estimated probability of hospitalization given known infection reaches a maximum of
27.8% at age 80 (95% CI 26.0%–29.7%). The probability of survival given hospitalization is nearly 100% for adults
younger than 40, but declines substantially after this age; for example, a hospitalized 54-year-old patient has a 91.7%
chance of surviving COVID-19 (95% CI 88.3%–94.4%).
Conclusions: Our study demonstrates a significant need for hospitalization in middle-aged individuals and young
seniors. This need is not captured by the distribution of deaths, which is heavily concentrated in very old ages. The
probability of survival given hospitalization for COVID-19 is lower than is generally perceived for patients over 40. If
acute care capacity is exceeded due to an increase in COVID-19 prevalence, the distribution of deaths could expand
toward younger ages. These results suggest that vaccine programs should aim to prevent infection not only in old
seniors, but also in young seniors and middle-aged individuals, to protect them from serious illness and to limit stress
on the healthcare system.
Description
CITATION: Papst, I., et al. 2021. Age-dependence of healthcare interventions for COVID-19 in Ontario, Canada. BMC Public Health, 21:706, doi:10.1186/s12889-021-10611-4.
The original publication is available at https://bmcpublichealth.biomedcentral.com
The original publication is available at https://bmcpublichealth.biomedcentral.com
Keywords
Communicable diseases – Ontario, COVID-19 (Disease) -- Age factors -- Ontario, Age factors in disease -- Ontario, Public health administration -- Ontario
Citation
Papst, I., et al. 2021. Age-dependence of healthcare interventions for COVID-19 in Ontario, Canada. BMC Public Health, 21:706, doi:10.1186/s12889-021-10611-4