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

TLDR

Global COVID‑19 deaths continue to rise, and governments seek to identify who is most at risk. The study linked all recorded COVID‑19 deaths in Sweden up to May 7 2020 with high‑quality individual‑level administrative register data for the entire population. Survival analysis shows that male sex, lower income, lower education, unmarried status, and being an immigrant from a low‑ or middle‑income country independently predict higher COVID‑19 mortality, while the latter does not increase all‑cause mortality, underscoring that the virus and social environment together impose an unequal burden on disadvantaged groups.

Abstract

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.