A population-based cohort study of socio-demographic risk factors for COVID-19 deaths in Sweden

Abstract

As global deaths from COVID-19 continue to rise, the world's governments, institutions, and agencies are still working toward an understanding of who is most at risk of death. In this study, data on all recorded COVID-19 deaths in Sweden up to May 7, 2020 are linked to high-quality and accurate individual-level background data from administrative registers of the total population. By means of individual-level survival analysis we demonstrate that being male, having less individual income, lower education, not being married all independently predict a higher risk of death from COVID-19 and from all other causes of death. Being an immigrant from a low- or middle-income country predicts higher risk of death from COVID-19 but not for all other causes of death. The main message of this work is that the interaction of the virus causing COVID-19 and its social environment exerts an unequal burden on the most disadvantaged members of society.

Fig. 1. Hazard ratios of dying from COVID-19 and all other causes of death for men and women in Sweden.

a Men aged 20 years and older, error bars representing 95% confidence intervals of hazard ratios, n = 3,876,881 men. b Women aged 20 years and older, error bars representing 95% confidence intervals of hazard ratios, n = 3,898,173 women. Blue squares indicating COVID-19 mortality. Orange circles indicating mortality from all other causes of death.

Fig. 2. Hazard ratios of dying from COVID-19 and all other causes of death for working ages and retirement ages.

a Working ages (20–65 years), error bars representing 95% confidence intervals of hazard ratios, n = 5,813,359 individuals. b Retirement ages (66 years and older), error bars representing 95% confidence intervals of hazard ratios, n = 1,979,710 individuals. Blue squares indicating COVID-19 mortality. Orange circles indicating mortality from all other causes of death.