Chronic Diseases, COVID-19 Impact Population Health

Mayo Clinic researchers have discovered new risk factors impacting the population health of those under 45 when it comes to severe COVID-19 infection. 

Using data from 9,859 COVID-19 infections, researchers found that younger populations had a greater than threefold increased risk of severe infection if they had chronic diseases such as cancer, heart disease, or blood, neurologic, or endocrine disorders.

The team of researchers studied individuals living in a 27-county region of Southeast Minnesota and West Central Wisconsin who were diagnosed with COVID-19 between March and September 2020. The study used the Rochester Epidemiology Project, a linkage of 1.7 million medical records from multiple health care systems that provided significant insight into the risks for the whole geographical region.

"Medical care is really fragmented in our country, so someone diagnosed with COVID-19 at one health care provider might end up at a totally different hospital for their severe case. If those records are not linked together, there's really not a good way for us to understand that that is even the same patient," Jennifer St. Sauver, PhD, a Mayo Clinic epidemiologist and the study's first author, said in a press release.

"By contrast, the Rochester Epidemiology Project allowed us to follow patients from the time they were diagnosed through their use of health care after that diagnosis, even if they were taken care of at different places. In addition, we could look back in their medical records to better understand all of the chronic diseases this population had even before getting diagnosed with COVID-19 and how those diseases might have contributed to more severe infections," Sauver continued.

Researchers identified cancer to be the biggest difference in risk when comparing study participants younger than 45 to those older. For those under 45, cancer was a strong risk factor. However, it was not as significant for the older age group.

Additionally, patients with developmental disorders, personality disorders, schizophrenia, and other psychoses have the highest adjusted risk for severe COVID-19 compared to all chronic conditions.

Researchers also discovered risk factors among races and ethnicities. According to the study, Asian Americans had the highest risk of developing severe COVID-19, followed by Black Americans and Latino populations.

"The Rochester Epidemiology Project allows us to study diseases, such as COVID-19, in a defined population, which provides the ability to translate our results to all people with COVID-19, not just those with the most severe disease requiring medical care," senior author Celine Vachon, PhD, Chair of the Mayo Clinic Division of Epidemiology said.

"This type of infrastructure will allow us to follow patients who had COVID-19 in the 27-county region over time to better understand any future links to disease."