Aims The risks associated with diabetes, obesity and hypertension for severe COVID-19 may be confounded and differ by sociodemographic background. We assessed the risks associated with cardiometabolic factors for severe COVID-19 when accounting for socioeconomic factors and in subgroups by age, sex and region of birth. Methods and results In this nationwide case–control study, 1.086 patients admitted to intensive care with COVID-19 requiring mechanical ventilation (cases), and 10.860 population-based controls matched for age, sex and district of residency were included from mandatory national registries. ORs with 95% CIs for associations between severe COVID-19 and exposures with adjustment for confounders were estimated using logistic regression. The median age was 62 years (IQR 52–70), and 3003 (24.9%) were women. Type 2 diabetes (OR, 2.3 (95% CI 1.9 to 2.7)), hypertension (OR, 1.7 (95% CI 1.5 to 2.0)), obesity (OR, 3.1 (95% CI 2.4 to 4.0)) and chronic kidney disease (OR, 2.5 (95% CI 1.7 to 3.7)) were all associated with severe COVID-19. In the younger subgroup (below 57 years), ORs were significantly higher for all cardiometabolic risk factors. The risk associated with type 2 diabetes was higher in women (p=0.001) and in patients with a region of birth outside European Union(EU) (p=0.004). Conclusion Diabetes, obesity and hypertension were all independently associated with severe COVID-19 with stronger associations in the younger population. Type 2 diabetes implied a greater risk among women and in non-EU immigrants. These findings, originating from high-quality Swedish registries, may be important to direct preventive measures such as vaccination to susceptible patient groups. Trial registration number Clinicaltrial.gov ( NCT04426084 ).
【저자키워드】 COVID-19, intensive & critical care, hypertension, diabetes & endocrinology, 【초록키워드】 vaccination, intensive care, severe COVID-19, mechanical ventilation, obesity, Sex, risk, Chronic kidney disease, diabetes, Patient, Control, Logistic regression, age, women, Cardiometabolic risk factors, association, cardiometabolic, preventive measure, subgroup, Socioeconomic factor, Factor, 95% CI, median age, patient groups, National, Sociodemographic, susceptible, European, confounder, greater, significantly higher, Swedish, Type, diabete, IQR, mandatory, type 2 diabete, with COVID-19, 【제목키워드】 Patient, Invasive mechanical ventilation, cardiometabolic disease,