Estonian corona-positive patients are hospitalized due to pneumonia

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Anneli Uusküla Source: Aavo Kaine

Researchers at the University of Tartu have analyzed the data from the first eight months of 2020 on nearly 32,000 people, including those who had been tested positive for coronavirus during that period and those who had not. The initial results of the analysis showed that a coronavirus patient was mostly likely hospitalized due to pneumonia or acute bronchitis. Those who did not have COVID-19 went to the hospital mostly to give birth or for a medical repeat procedure.

Few studies in the world have analyzed the data of all people who have been tested positive for COVID‑19 among the population of one country. To assess the different factors related to COVID-19 morbidity, medical researchers of the University of Tartu decided to analyze the data of these Estonian residents who had been tested positive for coronavirus.

Anneli Uusküla, Professor of Epidemiology at the University of Tartu, led the analysis of the data of the Estonian Health Insurance Fund and Health Board about these 3,598 people who tested positive for SARS‑CoV-2 from 25 February to 6 October 2020. The control group of 28,399 people consisted of people who did not have COVID-19 in the same period.

Professor Anneli Uusküla emphasized that the results of the analysis are initial but allow her to confirm that coronavirus is very democratic – it affects men and women equally and can strike people of any age. According to the analysis, about half of the people infected with coronavirus were men (47 percent) and the average person suffering from the disease was age 45.

Hospitalized coronavirus-positive patients

After being informed of their positive test result, 93 percent of the subjects contacted a medical institution for medical advice or help, including the family doctor in 85 percent of cases. 7 percent of people who tested positive did not reach the radar screen of our medical system. 19 percent of all coronavirus-positives needed to be hospitalized, including 5.5 percent in intensive care, spending nine days in the intensive care unit on average.

According to Uusküla, patients older than 70 needed the attention of the medical system the most. Eighty percent of hospitalized corona patients were admitted to the hospital within about two weeks from the positive test result. "The need for hospital care significantly differs by age but is mostly related to an older age. Nearly 60 percent of patients older than 80 needed to be hospitalized," said Uusküla.

The main causes for the hospitalization of a corona patient were viral pneumonia (53 percent), acute bronchitis (6 percent), urinary tract infection (2 percent) and ischemic heart disease (2 percent).

During the period concerned, 107 corona-positive patients (3 percent) died. "About a quarter of COVID‑19-patients who died were older than 70," described Uusküla. More than half of those who died passed away at the hospital, though some deaths occurred also after discharge from the hospital. For instance, 9 percent of deaths occurred within 30 days after being discharged from the hospital. In the case of almost one-third of deaths (29 percent), patients had not been hospitalized during the period concerned.

Causes of hospitalization among people not suffering from COVID-19

The analysis of the control group showed that it also included people who went to the hospital or the family doctor's appointment during the period for various reasons. More than half of the control group (56 percent) contacted a medical institution with a health problem, including the family doctor in 43 percent of the cases.

In the control group, the most common cause of hospitalization was childbirth (6 percent of cases). 3 percent of hospitalized people needed medical procedures, mostly related to cancer treatment, 3 percent of cases were due to an ischemic stroke and atrial fibrillation. 2 percent of hospitalized patients needed help due to non-insulin-dependent diabetes.

Three percent of the people not suffering from COVID-19 needed to be hospitalized, 0.8 percent of them in intensive care. The average period of intensive care was half of that of corona patients – four days. "Such use of hospital care is rather customary for Estonia," said Uusküla.

The control group also includied deaths – 106 people (0.4 percent) from the control group died over the period considered (the total number of deaths among people who had contracted COVID-19 in Estonia stands at 141 at present - ed.).

Cohort study

Researchers are soon to start the individual monitoring of people who were infected with the coronavirus to assess its potential long-term impact on the people who have recovered from the disease. "By this, we mean health problems that remain in some patients after recovering from the disease. According to specialist literature, there are many causes for that: Post-intensive care syndrome or post-viral syndrome, but also specific disorders that occur after recovering from COVID-19. It is worth further study, as knowing the causes will help us to find better treatment," Uusküla said.

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Editor: Roberta Vaino

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