Estonian corona-positive patients are hospitalised due to pneumonia, other patients due to childbirth

Researchers of the University of Tartu analysed the data from the eight months of 2020 about 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 corona patient was mostly likely hospitalised due to pneumonia or acute bronchitis. Those who did not have corona went to the hospital mostly to give birth or for a medical repeat procedure.

Few studies in the world have analysed 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 analyse the data of these Estonian residents who had been tested positive for coronavirus.

Anneli Uusküla, Professor of Epidemiology of 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 emphasised 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%) and an average person suffering from the disease was 45 years old.

Hospitalised corona-positive patients

After being informed of their positive test result, 93% of the subjects contacted a medical institution for medical advice or help, including the family doctor in 85% of cases. 7% of people who tested positive did not reach the radar screen of our medical system. 19% of all corona-positives needed to be hospitalised, incl. 5.5% 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. 80% of hospitalised 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% of patients older than 80 needed to be hospitalised,” said Uusküla.

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

During the period concerned, 107 corona-positive patients (3%) 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% of deaths occurred within 30 days after being discharged from the hospital. In the case of almost one third of deaths (29%), patients had not been hospitalised during the period concerned.

Causes of hospitalisation 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%) contacted a medical institution with a health problem, including the family doctor in 43% of the cases.

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

3% of the people not suffering from COVID-19 needed to be hospitalised, 0.8% 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 included deaths – 106 people (0.4%) from the control group died during the period considered.

Cohort study

Researchers will soon 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,” said Uusküla.

Further information:
Anneli Uusküla
Professor of Epidemiology, University of Tartu
+372 518 3552