Comparison of All-Cause Mortality Between Individuals With COVID-19 and Propensity Score–Matched Individuals Without COVID-19 in South Korea
Open Access
- 1 February 2021
- journal article
- research article
- Published by Oxford University Press (OUP) in Open Forum Infectious Diseases
- Vol. 8 (4), ofab057
- https://doi.org/10.1093/ofid/ofab057
Abstract
Background We compared all-cause mortality between individuals in South Korea with and without coronavirus disease 2019 (COVID-19) using propensity score (PS) matching. Methods This population-based cohort study used data from the National Health Insurance Service COVID-19 cohort database. In the database, we included individuals (COVID-19 patients, control population, and test-negative individuals) aged 20 years or older, regardless of hospitalization. The primary end point was all-cause mortality between January 1, 2020, and August 27, 2020. Results A total of 328 374 adults were included in the study: 7713 and 320 660 in the COVID-19 group and the control group. After PS matching, a total of 15 426 individuals (7713 per group) were included in the analysis. All-cause mortality was 3.2% (248/7713) and 1.6% (126/7713) in the COVID-19 group and the control group, respectively. In Cox regression analysis after PS matching, the risk of death in the COVID-19 group was twice as high (hazard ratio, 2.00; 95% CI, 1.61–2.48; P < .001) as that in the control group. Among patients aged ≥60 years, the COVID-19 group had a 2.32-fold higher all-cause mortality compared with the control group, while statistically significant differences were not observed in the age groups 20–39 years (P = .339) and 40–59 years (P = .562). Conclusions In South Korea, all-cause mortality was twice as high among individuals with COVID-19 as among those with similar underlying risks, primarily because of the elevated COVID-19-associated mortality in those aged ≥60 years. Our results highlight the need for prevention of COVID-19 with respect to mortality as a public health outcome.This publication has 22 references indexed in Scilit:
- Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing studyJournal of Infection, 2020
- Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysisJournal of Infection, 2020
- Anesthesia Procedure of Emergency Operation for Patients with Suspected or Confirmed COVID-19Surgical Infections, 2020
- Unknown unknowns - COVID-19 and potential global mortalityEarly Human Development, 2020
- Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in ItalyJama-Journal Of The American Medical Association, 2020
- COVID-19 pandemic: perspectives on an unfolding crisisBritish Journal of Surgery, 2020
- Real estimates of mortality following COVID-19 infectionThe Lancet Infectious Diseases, 2020
- The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studiesJournal of Clinical Epidemiology, 2008
- The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational StudiesAnnals of Internal Medicine, 2007
- Reducing Bias in Observational Studies Using Subclassification on the Propensity ScoreJournal of the American Statistical Association, 1984