SBE study dataset.

Background
Globally, as of December 2023, over 700 million cases of COVID-19 were confirmed since the initial outbreak late in 2019, claiming around 7 million lives and fuelling widespread fear and anxiety. However, prospective patient-data are unavailable to assess individuals’ perceptions of risk of severe COVID-19 illness, which may imply actual disease severity and inform risk perception for future epidemics.
Methods
We surveyed 1701 adults about their concern for severe COVID-19 disease using a population-based survey of rural South Africans. The initial telephonic survey was conducted between August-October 2020 with a follow-up survey conducted between August-October 2021. Multinomial logistic regression was used to investigate predictors of perceived COVID-19 illness severity (low, medium, or high) controlling for measured confounders.
Results
The prevalence of concern for COVID-19 illness severity in 2020 was 28.7% low, 26.8% moderate and 44.5% severe, with corresponding levels in 2021 of 42%, 31.8% and 29.2%, respectively. Although older age was associated with a lower odds of COVID-19 concern [50–59 years (aOR=0.54, 95% CI: 0.38–0.75)], [≥60 years (aOR=0.41,95% CI: 0.41–0.57)], adults having ≥1 chronic conditions (aOR=1.38,1.00–1.89) or residing outside of the study community (aOR=1.29,1.01–1.65) were more likely to experience moderate and high concern for illness severity, respectively.
Conclusions
Understanding presumptive COVID-19 disease severity may help disentangle various underlying mechanisms behind personal risk assessment. This may inform current thinking and practice of public health emergency medicine in managing emerging and re-emerging respiratory diseases with pandemic potential such as hPMV.

研究背景
截至2023年12月，全球自2019年末新型冠状病毒肺炎（COVID-19）首次暴发以来，累计确诊病例已超7亿例，造成约700万人死亡，并引发了广泛的恐慌与焦虑。然而，目前尚无前瞻性患者数据可用于评估个体对重症COVID-19感染风险的认知，而此类认知或可反映实际疾病严重程度，同时也能为未来流行病的风险认知研究提供参考。

研究方法
本研究针对南非农村地区人群开展基于人群的调查，共纳入1701名成年人，调研其对重症COVID-19的担忧程度。首次电话调查于2020年8月至10月开展，后续追踪调查于2021年8月至10月完成。本研究采用多项逻辑回归分析，在控制已测量混杂因素的前提下，探究影响个体对COVID-19感染严重程度认知（低、中、高）的预测因子。

研究结果
2020年，受访者中对COVID-19重症担忧程度为低、中、高的占比分别为28.7%、26.8%和44.5%；2021年对应占比则分别为42%、31.8%和29.2%。尽管年龄较大与COVID-19担忧程度降低存在关联[50~59岁组：调整后优势比（adjusted Odds Ratio, aOR）=0.54，95%置信区间（Confidence Interval, CI）：0.38~0.75]；≥60岁组：aOR=0.41，95% CI：0.41~0.57]，但患有至少1种慢性疾病的成年人（aOR=1.38，95% CI：1.00~1.89）或居住在研究社区以外的成年人（aOR=1.29，95% CI：1.01~1.65）分别更易出现中等和高度的重症担忧。

研究结论
明晰个体对COVID-19重症的认知情况，有助于厘清个人风险评估背后的多种潜在机制。这可为当前公共卫生急诊医学在管理具有大流行潜力的新发和再发呼吸道疾病（如hPMV）时的思路与实践提供参考。