As of the beginning of 2020, there were reports of strange cases of pneumonia, which were accumulating in China, for the first time. Then at the end of January – the new type of coronavirus SARS-CoV-2 had long been seen in several countries – doctors here in Germany saw the first cases. Then everything went very fast. Within just under six months, by mid-June, more than 190,000 people in this country had been proven to be infected with Covid-19. Only then did the infection slow down temporarily. The first wave was over.
The Robert Koch Institute has now evaluated the cases from these six months in detail, with a particular focus on the severity of the disease. Who only got mildly ill, who had to go to the intensive care unit? What are the risk factors for a severe course? Julia Schilling’s research team hopes to provide help in the event of another massive increase in numbers, as we are currently experiencing. When medical professionals know who is particularly susceptible and at risk for a severe course, they can react faster and more efficiently.
Men aged 60 and over with at least one risk factor were particularly affected
In the first six months of the pandemic, therefore, in two thirds of all registered cases, those affected were younger than 60 years. According to the authors, the first wave was “mainly characterized by a high proportion of cases between the ages of 20 and 59.” Two thirds of all Covid 19 patients fell into these age groups.
The majority of those affected, across all age groups, only fell mildly at 80 percent, but 20 percent suffered a severe course. The epidemiologists wrote that these included men over the age of 60 with at least one risk factor such as cardiovascular disease, diabetes, a lung disease or a neurological disorder.
You can see the effect when you compare severe and mild cases in the different age groups. In the 60 to 79-year-olds, the disease was mild in 62 percent and severe in 38 percent; in those over 80, it was exactly the other way around. Almost every second case among those aged 80 and over had to be treated in hospital, the researchers report – and in every third case the patient died.
The 40 to 59 year olds were in the intensive care unit the longest
A total of 18 percent of the patients came to the hospital: for women it was 15 percent, for men it was 21 percent. Of all those who were treated in a clinic, 23 percent died in the first wave – more than one in five. Mainly people who had a known risk factor were admitted; this was the case in 70 percent of the patients. However, this also means that a third ended up in hospital without having a risk factor. This was especially the case with those up to 39 years of age.
14 percent had to be transferred to the intensive care unit, 70 percent of them were men. It became very critical for these patients: Almost half of them, 47 percent, died.
The researchers also looked at how long it took for someone to come to the clinic after the illness started. This happened the fastest with toddlers up to four years of age and over 80-year-olds: They usually came to the hospital on the first day, while 50 percent of all patients were admitted to the hospital after four days. It took the longest to hospital admission for patients aged 40 to 59 years. They usually came after six days. If they had to go to the intensive care unit, then they stayed there longer than other age groups, around eleven days.
In their conclusion, the scientists write that the high proportion of severe cases in patients aged 60 and over confirms the initial assessments that there is a connection between the severity of the disease and increasing age. However, the researchers seem to have been surprised at the exact age at which the risk increases. You write: “The role of 40 to 59-year-olds, especially among the critical cases, could indicate that the risk of a severe course of the disease increases earlier than previously assumed and should be further investigated.”