Manara - Qatar Research Repository
Browse
Influenza Resp Viruses - 2023 - Mahmoud - SARS‐CoV‐2 infection and effects of age sex comorbidity and vaccination among.pdf (1.35 MB)

SARS‐CoV‐2 infection and effects of age, sex, comorbidity, and vaccination among older individuals: A national cohort study

Download (1.35 MB)
journal contribution
submitted on 2024-02-20, 11:18 and posted on 2024-02-20, 11:19 authored by Mai A. Mahmoud, Houssein H. Ayoub, Peter Coyle, Patrick Tang, Mohammad R. Hasan, Hadi M. Yassine, Asmaa A. Al Thani, Zaina Al‐Kanaani, Einas Al‐Kuwari, Andrew Jeremijenko, Anvar Hassan Kaleeckal, Ali Nizar Latif, Riyazuddin Mohammad Shaik, Hanan F. Abdul‐Rahim, Gheyath K. Nasrallah, Mohamed Ghaith Al‐Kuwari, Adeel A. Butt, Hamad Eid Al‐Romaihi, Mohamed H. Al‐Thani, Abdullatif Al‐Khal, Roberto Bertollini, Laith J. Abu‐Raddad, Hiam Chemaitelly

Background

We investigated the contribution of age, coexisting medical conditions, sex, and vaccination to incidence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and of severe, critical, or fatal COVID‐19 in older adults since pandemic onset.

Methods

A national retrospective cohort study was conducted in the population of Qatar aged ≥50 years between February 5, 2020 and June 15, 2023. Adjusted hazard ratios (AHRs) for infection and for severe coronavirus disease 2019 (COVID‐19) outcomes were estimated through Cox regression models.

Results

Cumulative incidence was 25.01% (95% confidence interval [CI]: 24.86–25.15%) for infection and 1.59% (95% CI: 1.55–1.64%) for severe, critical, or fatal COVID‐19 after a follow‐up duration of 40.9 months. Risk of infection varied minimally by age and sex but increased significantly with coexisting conditions. Risk of infection was reduced with primary‐series vaccination (AHR: 0.91, 95% CI: 0.90–0.93) and further with first booster vaccination (AHR: 0.75, 95% CI: 0.74–0.77). Risk of severe, critical, or fatal COVID‐19 increased exponentially with age and linearly with coexisting conditions. AHRs for severe, critical, or fatal COVID‐19 were 0.86 (95% CI: 0.7–0.97) for one dose, 0.15 (95% CI: 0.13–0.17) for primary‐series vaccination, and 0.11 (95% CI: 0.08–0.14) for first booster vaccination. Sensitivity analysis restricted to only Qataris yielded similar results.

Conclusion

Incidence of severe COVID‐19 in older adults followed a dynamic pattern shaped by infection incidence, variant severity, and population immunity. Age, sex, and coexisting conditions were strong determinants of infection severity. Vaccine protection against severe outcomes showed a dose–response relationship, highlighting the importance of booster vaccination for older adults.

Other Information

Published in: Influenza and Other Respiratory Viruses
License: http://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://dx.doi.org/10.1111/irv.13224

Additional institutions affiliated with: Hamad Bin Khalifa University, College of health and life science

Funding

Open Access funding provided by the Qatar National Library.

History

Language

  • English

Publisher

Wiley

Publication Year

  • 2023

License statement

This Item is licensed under the Creative Commons Attribution 4.0 International License.

Institution affiliated with

  • Weill Cornell Medicine - Qatar
  • Qatar University
  • Qatar University Health - QU
  • College of Health Sciences - QU HEALTH
  • College of Arts and Sciences - QU
  • Biomedical Research Center - QU
  • Hamad Medical Corporation
  • Sidra Medicine
  • Primary Health Care Corporation
  • Ministry of Public Health - State of Qatar

Methodology

A national retrospective cohort study was conducted in the population of Qatar aged ≥50 years between February 5, 2020 and June 15, 2023. Adjusted hazard ratios (AHRs) for infection and for severe coronavirus disease 2019 (COVID‐19) outcomes were estimated through Cox regression models.

Usage metrics

    Manara - Qatar Research Repository

    Licence

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC