OBJECTIVES: SARS-CoV-2 infection tends to progress more rapidly and more frequently to severe COVID-19 among individuals with specific comorbidities (e.g., congestive heart failure, cerebrovascular disease, dementia, diabetes, renal disease, chronic pulmonary disease, paralysis comorbidities, and malignancies). This study aimed to describe the comorbidities among individuals at risk to develop severe form of COVID-19 in case of SARS-CoV-2 infection.

METHODS: We used the Echantillon Généraliste de Bénéficiaires (EGB), a random, anonymous, nationally representative 1/97^th sample of the French health insurance beneficiaries to select individuals at risk for progression toward a severe form of COVID-19 according to the Haute Autorité de Santé list of risk factors. Participants’ socio-demographic characteristics were assessed at the time of index date which has been set for January 1, 2019. A five-year period before the index date was used to assess participants’ comorbidities, therefore the study period went from January 1, 2014, to December 31, 2019.

RESULTS: Among the 782,200 individuals registered in the EGB database during the study period, 334,935 (42.8%) were identified (males: 65.3%; median (Q1-Q3) age: 56 (40-70) y). Of these, 68.0% were included only because of their sociodemographic characteristics (men, age ≥ 60, or socially deprived), while 32.0% were included because having at least one comorbidity. Overall, 13.6% of individuals had two or more comorbidities. The most common situations at risk of progression to severe COVID-19 were cardiovascular diseases (12.1%), type 2 diabetes (8.7%) and solid cancer (7.8%).

CONCLUSIONS: Using a representative database of the French population, we found that 42.8% of adults were at risk for severe COVID-19 if infected with SARS-CoV-2. By extrapolation, this would represent 23 million French adults. Among them, 32.0%, or 7 million, would have at least one comorbidity. Although the use of the EGB database prevented us from studying more recent years, we can expect similar figures for subsequent years.