%0 Journal Article
%@ 2369-2960
%I JMIR Publications
%V 7
%N 1
%P e22794
%T The Association Between Chronic Disease and Serious COVID-19 Outcomes and Its Influence on Risk Perception: Survey Study and Database Analysis
%A Laires,Pedro Almeida
%A Dias,Sónia
%A Gama,Ana
%A Moniz,Marta
%A Pedro,Ana R
%A Soares,Patricia
%A Aguiar,Pedro
%A Nunes,Carla
%+ Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Av Padre Cruz, Lisbon, Portugal, 351 919783234, pedro.laires@ensp.unl.pt
%K COVID-19
%K risk factors
%K morbidity
%K chronic disease
%K risk
%K perception
%K outcome
%K association
%D 2021
%7 12.1.2021
%9 Original Paper
%J JMIR Public Health Surveill
%G English
%X Background: 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. Objective: 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’s self-perception of risk for worse COVID-19 outcomes. Methods: 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. Results: 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–infected 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. Conclusions: 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’s 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. 
%M 33433397
%R 10.2196/22794
%U http://publichealth.jmir.org/2021/1/e22794/
%U https://doi.org/10.2196/22794
%U http://www.ncbi.nlm.nih.gov/pubmed/33433397