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Association between multimorbidity and mortality in a cohort of patients admitted to hospital with COVID-19 in Scotland

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Agrawal_2021_RSM_Association_multimorbidity_mortality_COVID19_CC.pdf (577.1Kb)
Date
01/2022
Author
Agrawal, Utkarsh
Azcoaga-Lorenzo, Amaya
Fagbamigbe, Adeniyi
Vasileiou, Eleftheria
Henery, Paul
Simpson, Colin
Stock, Sarah
Shah, Syed
Robertson, Chris
Woolhouse, Mark
Ritchie, Lewis
Sheikh, Aziz
Harrison, Ewen
Docherty, Annemarie
McCowan, Colin
Keywords
COVID-19
SARS-CoV2
Hospital admissions
Multimorbidity
Shielding
RA0421 Public health. Hygiene. Preventive Medicine
DAS
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Abstract
Objectives We investigated the association between multimorbidity among patients hospitalised with COVID-19 and their subsequent risk of mortality. We also explored the interaction between the presence of multimorbidity and the requirement for an individual to shield due to the presence of specific conditions and its association with mortality. Design We created a cohort of patients hospitalised in Scotland due to COVID-19 during the first wave (between 28 February 2020 and 22 September 2020) of the pandemic. We identified the level of multimorbidity for the patient on admission and used logistic regression to analyse the association between multimorbidity and risk of mortality among patients hospitalised with COVID-19. Setting Scotland, UK. Participants Patients hospitalised due to COVID-19. Main outcome measures Mortality as recorded on National Records of Scotland death certificate and being coded for COVID-19 on the death certificate or death within 28 days of a positive COVID-19 test. Results Almost 58% of patients admitted to the hospital due to COVID-19 had multimorbidity. Adjusting for confounding factors of age, sex, social class and presence in the shielding group, multimorbidity was significantly associated with mortality (adjusted odds ratio 1.48, 95%CI 1.26–1.75). The presence of multimorbidity and presence in the shielding patients list were independently associated with mortality but there was no multiplicative effect of having both (adjusted odds ratio 0.91, 95%CI 0.64–1.29). Conclusions Multimorbidity is an independent risk factor of mortality among individuals who were hospitalised due to COVID-19. Individuals with multimorbidity could be prioritised when making preventive policies, for example, by expanding shielding advice to this group and prioritising them for vaccination.
Citation
Agrawal , U , Azcoaga-Lorenzo , A , Fagbamigbe , A , Vasileiou , E , Henery , P , Simpson , C , Stock , S , Shah , S , Robertson , C , Woolhouse , M , Ritchie , L , Sheikh , A , Harrison , E , Docherty , A & McCowan , C 2022 , ' Association between multimorbidity and mortality in a cohort of patients admitted to hospital with COVID-19 in Scotland ' , Journal of the Royal Society of Medicine , vol. 115 , no. 1 , pp. 22-30 . https://doi.org/10.1177/01410768211051715
Publication
Journal of the Royal Society of Medicine
Status
Peer reviewed
DOI
https://doi.org/10.1177/01410768211051715
ISSN
0141-0768
Type
Journal article
Rights
Copyright © The Royal Society of Medicine 2021. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Description
Funding: BREATHE - The Health Data Research Hub for Respiratory Health, which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK (MC_PC_19004); CSO Rapid Research in Covid-19 Programme (COV/SAN/20/06); HDR UK Measuring and Understanding Multi-morbidity using Routine Data in the UK (MurMuRUK) (HDR-9006-9006; CFC0110); Medical Research Council (MR/R008345/1).
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  • University of St Andrews Research
URI
http://hdl.handle.net/10023/24190

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