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Disease Epidemiology/Clinical Course

Category: Safety End Points

Poster Gallery-Disease Epidemiology/Clinical Course

(P-371) Swedish covid-19 Investigation for Future Insights – a Population Epidemiology Approach Using Register Linkage (SCIFI- PEARL)

Location: Poster Gallery-Disease Epidemiology/Clinical Course

    Presenting Author(s)

  • FN

    Fredrik Nyberg, MPH, MD, PhD, FISPE

    Professor of Register Epidemiology
    University of Gothenburg
    Mölndal, Västra Götalands län, Sweden

    • Co-Author(s)

  • SF

    Stefan Franzén

    School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; National Diabetes Register, Centre of Registers Västra Götaland, Gothenburg, Sweden, Sweden

  • AS

    Ailiana Santosa

    School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden

  • LV

    Lowie E.G.W. Vanfleteren

    COPD Center, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Sweden

  • NH

    Niklas Hammar

    Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden, Sweden

  • JS

    Johan Sundström

    Clinical Epidemiology Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; The George Institute for Global Health, University of New South Wales, Sydney, Australia, Sweden

  • ML

    Magnus Lindh

    Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Sweden, Sweden

  • SB

    Staffan Björck

    Centre of Registers Västra Götaland, Gothenburg, Sweden, Sweden

  • MG

    Magnus Gisslén

    Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden, Sweden

  • BW

    Björn Wettermark

    professor
    Pharmacoepidemiology & Social Pharmacy, Department of Pharmacy, Uppsala University, Uppsala, Sweden
    Uppsala, Uppsala Lan, Sweden

Background: In response to the Covid-19 pandemic, we designed and initiated a nationwide linked multi-register, regularly updated, observational study for timely response to urgent public health and scientific questions.

Objectives: To present the SCIFI-PEARL (Swedish Covid-19 Investigation for Future Insights – a Population Epidemiology Approach using Register Linkage) linked database encompassing essentially all known diagnosed Swedish COVID-19 patients plus a large general population comparison cohort, describe its study population, and outline its utility in the current and future phases of the pandemic.

Methods: Individuals with COVID-19 from the entire country are identified on a regularly updated basis, from different sources: all individuals from SmiNet, the national database of notifiable diseases, with positive SARS-CoV-2 polymerase chain reaction (PCR) test results; patients identified in the healthcare system by condition (ICD-10) or procedure codes in the National Patient Register or Cause-of-Death Register; patients identified through several disease-specific national quality registers (NQRs); and for one large region additionally from visits in primary care. A comparison population was obtained by stratified random sampling from Swedish national population registers (case cohort approach).
Data from all of these registers plus the National Prescribed Drug Register, the Cancer Register, national sociodemographic registers, some additional NQRs, the National Vaccination Register, and some more data sources, are linked to all study subjects (COVID-19 cases and population cohort).
New cases in the study population and all data for all subjects are updated every 1-2 months, as required.

Results: The SCIFI-PEARL study cohort captures essentially all Swedish residents diagnosed with COVID-19 on an ongoing basis, includes a representative general population comparison cohort, and links to a broad range of national and regional healthcare data for a comprehensive longitudinal view of the COVID-19 pandemic. In the initial database until Aug 2020, 126953 COVID-19 patients with healthcare contact were identified, of whom 86798 test-positive and 17026 hospitalized, and 972723 population controls. Women and ages 20-59 years dominate among cases with healthcare contact or positive test, while men and ages over 60 dominate among hospitalized COVID-19 patients.

Conclusions: By combining high quality national registers with short time delay and continuous repeated linkage updates, the project will bring timely and internationally unique data on the SARS-CoV-2 pandemic.