| الوصف: |
Background: A wide range of response strategies have been implemented by different countries to slow the spread of the COVID-19 outbreak. While the effects of these strategies in the general population have been investigated, less is known about the effects of these strategies on those with pre-existing comorbid conditions including rheumatic and musculoskeletal diseases (RMDs). We aimed to quantify the impact of stringent lockdown restrictions in Norway compared to Sweden on COVID-19 hospitalization/death and all-cause mortality in persons with and without RMDs. Methods: Using ICD codes from register data, individuals aged ≥35 years residing in Norway and Skåne region (Sweden) on 31st December 2019 were divided into the RMD cohort (those with any diagnosis of RMDs during January 1, 2017–January 31, 2020), and the non-RMDs cohort. We obtained daily data on the outcomes for February–May, 2020 and applied difference-in-difference and event study to estimate the causal effect of lockdown. Results: Compared with Skåne, strict lockdown in Norway was, on average, associated with 18.0 (95% CI 8.6, 27.3), 2.7 (1.5, 3.9), and 2.9 (–4.0, 9.7) fewer daily COVID-19 hospitalizations, COVID-19 death, and all-cause mortality per million persons, respectively, among individuals with RMD. Corresponding reductions were 9.1 (95% CI 4.5, 13.7), 0.9 (0.4, 1.5), and 2.9 (–3.8, 9.7) among those without RMD. Event study showed that the effects on COVID-19 hospitalization and death were evident from 1-2 weeks after lockdown implementation and onward with generally greater effects in the RMDs than the non-RMDs cohort and in older than younger individuals. Conclusion: Strict lockdown was associated with reductions in COVID-19 hospitalizations and (to a lesser extent) COVID-19 death with no essential effect on all-cause mortality. Our findings confirm effect of strict lockdown in particular among those at higher risk of COVID-19 adverse outcomes such as older persons with RMDs. |
