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Epidemiol Health > Volume 43; 2021 > Article |
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Characteristics |
Recipients of COVID-19 diagnostic tests (n=232,390) |
Confirmed cases of COVID-19 (n=8,515) |
||||
---|---|---|---|---|---|---|
NHI (n=218,070) | Medicaid (n=14,320) | NHI (n=7,777) | Medicaid (n=738) | p-value1 | ||
Age (yr)2 | ||||||
Mean±SD | 50.2±20.0 | 63.8±17.7 | <0.001 | 47.8±19.1 | 57.5±16.8 | <0.001 |
19-29 | 41,802 (19.2) | 840 (5.9) | <0.001 | 2,039 (26.2) | 79 (10.7) | <0.001 |
30-39 | 39,995 (18.3) | 541 (3.8) | 903 (11.6) | 17 (2.3) | ||
40-49 | 33,040 (15.2) | 1,355 (9.5) | 1,047 (13.5) | 87 (11.8) | ||
50-59 | 30,600 (14.0) | 2,638 (18.4) | 1,536 (19.8) | 195 (26.4) | ||
60-69 | 26,631 (12.2) | 3,156 (22.0) | 1,139 (14.6) | 195 (26.4) | ||
70-79 | 22,949 (10.5) | 2,721 (19.0) | 650 (8.4) | 104 (14.1) | ||
80-89 | 19,257 (8.8) | 2,389 (16.7) | 391 (5.0) | 48 (6.5) | ||
>89 | 3,796 (1.7) | 680 (4.7) | 72 (0.9) | 13 (1.8) | ||
Sex2 | <0.001 | <0.001 | ||||
Male | 102,964 (47.2) | 7,379 (51.5) | 3,127 (40.2) | 348 (47.2) | ||
Female | 115,106 (52.8) | 6,941 (48.5) | 4,650 (59.8) | 390 (52.8) | ||
Charlson comorbidity index score3 | ||||||
Mean±SD | 2.2±1.7 | 2.4±1.6 | <0.001 | 1.7±1.0 | 2.0±1.1 | <0.001 |
1 | 37,850 (17.4) | 3,227 (22.5) | <0.001 | 1,229 (15.8) | 91 (12.3) | <0.001 |
2 | 29,667 (13.6) | 3,305 (23.1) | 862 (11.1) | 165 (22.4) | ||
≥3 | 24,905 (11.4) | 3,802 (26.6) | 387 (5.0) | 65 (8.8) | ||
Comorbidities3 | ||||||
Hypertension | 48,930 (22.4) | 5,999 (41.9) | <0.001 | 1,372 (17.6) | 208 (28.2) | <0.001 |
Hyperlipidemia | 38,384 (17.6) | 3,852 (26.9) | <0.001 | 1,224 (15.7) | 183 (24.8) | <0.001 |
Diabetes mellitus | 29,495 (13.5) | 4,470 (31.2) | <0.001 | 777 (10.0) | 145 (19.6) | <0.001 |
Asthma | 15,375 (7.1) | 1,761 (12.3) | <0.001 | 383 (4.9) | 33 (4.5) | 0.585 |
COPD | 37,010 (17.0) | 3,694 (25.8) | <0.001 | 1,021 (13.1) | 84 (11.4) | 0.177 |
Atherosclerosis | 2,161 (1.0) | 331 (2.3) | <0.001 | 31 (0.4) | 11 (1.5) | <0.001 |
Heart failure | 5,282 (2.4) | 942 (6.6) | <0.001 | 84 (1.1) | 17 (2.3) | 0.003 |
Stroke | 9,384 (4.3) | 1,741 (12.2) | <0.001 | 198 (2.5) | 61 (8.3) | <0.001 |
Myocardial infarction | 1,565 (0.7) | 262 (1.8) | <0.001 | 32 (0.4) | 6 (0.8) | 0.118 |
Renal failure | 8,091 (3.7) | 1,792 (12.5) | <0.001 | 56 (0.7) | 17 (2.3) | <0.001 |
Chronic liver disease | 16,894 (7.7) | 2,175 (15.2) | <0.001 | 457 (5.9) | 83 (11.2) | <0.001 |
Fracture | 14,394 (6.6) | 2,080 (14.5) | <0.001 | 344 (4.4) | 62 (8.4) | <0.001 |
Osteoarthritis | 33,865 (15.5) | 4,131 (28.8) | <0.001 | 1,063 (13.7) | 159 (21.5) | <0.001 |
Rheumatoid arthritis | 3,152 (1.4) | 315 (2.2) | <0.001 | 105 (1.4) | 9 (1.2) | 0.768 |
Psychiatric disorders | 33,143 (15.2) | 6,133 (42.8) | <0.001 | 857 (11.0) | 386 (52.3) | <0.001 |
Thyroid disorders | 11,993 (5.5) | 1,067 (7.5) | <0.001 | 389 (5.0) | 52 (7.0) | 0.017 |
Osteoporosis | 11,052 (5.1) | 1,533 (10.7) | <0.001 | 413 (5.3) | 54 (7.3) | 0.022 |
Dementia | 11,885 (5.5) | 2,253 (15.7) | <0.001 | 315 (4.1) | 77 (10.4) | <0.001 |
Cancer | 21,039 (9.6) | 1,834 (12.8) | <0.001 | 253 (3.3) | 31 (4.2) | 0.171 |
Severe incurable disease4 | 37,628 (17.3) | 4,429 (30.9) | <0.001 | 495 (6.4) | 60 (8.1) | 0.063 |
Concomitant medications3 | ||||||
ACE inhibitors | 2,427 (1.1) | 396 (2.8) | <0.001 | 68 (0.9) | 12 (1.6) | 0.043 |
ARBs | 40,853 (18.7) | 5,341 (37.3) | <0.001 | 1,096 (14.1) | 172 (23.3) | <0.001 |
β-blockers | 28,367 (13.0) | 4,272 (29.8) | <0.001 | 667 (8.6) | 171 (23.2) | <0.001 |
Calcium channel blockers | 40,060 (18.4) | 5,652 (39.5) | <0.001 | 943 (12.1) | 173 (23.4) | <0.001 |
Diuretics | 14,107 (6.5) | 1,734 (12.1) | <0.001 | 429 (5.5) | 49 (6.6) | 0.205 |
Nitrates | 8,932 (4.1) | 1,469 (10.3) | <0.001 | 103 (1.3) | 20 (2.7) | 0.003 |
Antidiabetic drugs | 28,926 (13.3) | 4,401 (30.7) | <0.001 | 729 (9.4) | 149 (20.2) | <0.001 |
Anxiolytics | 127,676 (58.5) | 12,052 (84.2) | <0.001 | 3,186 (41.0) | 544 (73.7) | <0.001 |
Antipsychotics | 16,336 (7.5) | 4,494 (31.4) | <0.001 | 316 (4.1) | 292 (39.6) | <0.001 |
Antidepressants | 30,304 (13.9) | 5,289 (36.9) | <0.001 | 721 (9.3) | 231 (31.3) | <0.001 |
NSAIDs | 177,366 (81.3) | 11,814 (82.5) | <0.001 | 6,101 (78.4) | 527 (71.4) | <0.001 |
Anticoagulants | 53,794 (24.7) | 7,739 (54.0) | <0.001 | 1,149 (14.8) | 231 (31.3) | <0.001 |
Values are presented as number (%).
COVID-19, coronavirus disease 2019; NHI, National Health Insurance; SD, standard deviation; COPD, chronic obstructive pulmonary disease; ACE, angiotensin converting enzyme; ARB, angiotensin-receptor II blocker; NSAID, non-steroidal anti-inflammatory drug.
1 The chi-square test for categorical variables and the t-test for continuous variables were used to determine statistically significant differences between health insurance types.
Characteristics | No. of subjects | No. of events | No. of events per 100 patients, % (95% CI) | Unadjusted model | Age- and sex-adjusted model | IPT weighted model1,2 | Age-, sex-, CCI- adjusted model |
---|---|---|---|---|---|---|---|
Risk of SARS-CoV-2 infection | |||||||
NHI | 218,070 | 7,777 | 3.57 (3.49, 3.64) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Medicaid | 14,320 | 738 | 5.15 (4.79, 5.52) | 1.47 (1.36, 1.59) | 1.54 (1.42, 1.67) | 1.17 (1.05, 1.30) | 1.22 (1.09 1.38) |
Primary composite outcome | |||||||
NHI | 7,777 | 403 | 5.18 (4.69, 5.67) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Medicaid | 738 | 69 | 9.35 (7.25, 11.45) | 1.89 (1.45, 2.47) | 1.26 (0.95, 1.67) | 1.20 (0.90, 1.60) | 1.10 (0.77, 1.57) |
All-cause death | |||||||
NHI | 7,777 | 238 | 3.06 (2.68, 3.44) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Medicaid | 738 | 51 | 6.91 (5.08, 8.74) | 2.35 (1.72, 3.21) | 1.68 (1.19, 2.36) | 1.31 (0.95, 1.80) | 1.35 (0.90, 2.02) |
Intensive care unit admission | |||||||
NHI | 7,777 | 171 | 2.20 (1.87, 2.52) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Medicaid | 738 | 18 | 2.44 (1.33, 3.55) | 1.11 (0.68, 1.82) | 0.74 (0.45, 1.21) | 1.35 (0.84, 2.16) | 0.98 (0.53, 1.79) |
Mechanical ventilation use | |||||||
NHI | 7,777 | 166 | 2.13 (1.81, 2.46) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
Medicaid | 738 | 22 | 2.98 (1.75, 4.21) | 1.41 (0.90, 2.21) | 0.86 (0.55, 1.37) | 0.96 (0.58, 1.57) | 0.77 (0.41, 1.42) |
Values are presented as odds ratio (95% confidence interval).
SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; COVID-19, coronavirus disease 2019; IPT, inverse probability of treatment; CCI, Charlson comorbidity index score; NHI, National Health Insurance.
1 IPT-weighted multivariable logistic regression model (considered our sensitivity analysis) for the risk of SARS-CoV-2 infection, in which the propensity score was estimated by including age, sex, CCI, hypertension, hyperlipidemia, diabetes mellitus, asthma, chronic obstructive pulmonary disease, atherosclerosis, heart failure, myocardial infarction, stroke, renal failure, chronic liver disease, fractures, osteoarthritis, psychiatric disorders, thyroid disorders, dementia, malignancy, severe incurable diseases, angiotensin converting enzyme inhibitors, angiotensin-receptor II blockers, β-blockers, calcium channel blockers, diuretics, nitrates, antidiabetic medications including insulin, anxiolytics, antipsychotics, antidepressants, non-steroidal anti-inflammatory drugs, and anticoagulants in the multivariable logistic regression model (c-statistic, 0.719).
2 IPT-weighted multivariable logistic regression model (considered our sensitivity analysis) for the risk of worsened clinical outcomes, in which the propensity score was estimated by including age, CCI, hypertension, hyperlipidemia, diabetes mellitus, asthma, chronic obstructive pulmonary disease, atherosclerosis, heart failure, myocardial infarction, renal failure, chronic liver disease, fractures, osteoarthritis, psychiatric disorders, osteoporosis, dementia, malignancy, severe incurable diseases, and use of angiotensin converting enzyme inhibitors, angiotensin-receptor II blockers, β-blockers, calcium channel blockers, diuretics, nitrates, antidiabetic medications including insulin, anxiolytics, antipsychotics, antidepressants, and anticoagulants in the multivariable logistic regression model (c-statistic, 0.779).
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