Age-dependence of healthcare interventions for COVID-19 in Ontario, Canada

dc.contributor.authorPapst, Irenaen_ZA
dc.contributor.authorLi, Michaelen_ZA
dc.contributor.authorChampredon, Daviden_ZA
dc.contributor.authorBolker, Benjamin M.en_ZA
dc.contributor.authorDushoff, Jonathanen_ZA
dc.contributor.authorEarn, David JDen_ZA
dc.date.issued2021-04-12en_ZA
dc.descriptionCITATION: 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.en_ZA
dc.descriptionThe original publication is available at https://bmcpublichealth.biomedcentral.comen_ZA
dc.description.abstractBackground: 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.en_ZA
dc.description.urihttps://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10611-4en_ZA
dc.description.versionPublisher's versionen_ZA
dc.format.extent9 pagesen_ZA
dc.identifier.citationPapst, I., et al. 2021. Age-dependence of healthcare interventions for COVID-19 in Ontario, Canada. BMC Public Health, 21:706, doi:10.1186/s12889-021-10611-4en_ZA
dc.identifier.issn1471-2458 (online)en_ZA
dc.identifier.otherdoi:10.1186/s12889-021-10611-4en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/110400en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)en_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectCommunicable diseases – Ontarioen_ZA
dc.subjectCOVID-19 (Disease) -- Age factors -- Ontarioen_ZA
dc.subjectAge factors in disease -- Ontarioen_ZA
dc.subjectPublic health administration -- Ontarioen_ZA
dc.titleAge-dependence of healthcare interventions for COVID-19 in Ontario, Canadaen_ZA
dc.typeArticleen_ZA
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