Abu Z M Dayem Ullah 1,2 , Lavanya Sivapalan 3 , Hemant M Kocher 2,4 , Claude Chelala 3 Show Affiliations »
Abstract
OBJECTIVE: To explore risk factors associated with COVID-19 susceptibility and survival in patients with pre-existing hepato-pancreato-biliary (HPB) conditions. DESIGN: Cross-sectional study. SETTING: East London Pancreatic Cancer Epidemiology (EL-PaC-Epidem) Study at Barts Health National Health Service Trust, UK. Linked electronic health records were interrogated on a cohort of participants (age ≥18 years), reported with HPB conditions between 1 April 2008 and 6 March 2020. PARTICIPANTS: EL-PaC-Epidem Study participants, alive on 12 February 2020, and living in East London within the previous 6 months (n=15 440). The cohort represents a multi-ethnic population with 51.7% belonging to the non-White background. MAIN OUTCOME MEASURE: COVID-19 incidence and mortality. RESULTS: Some 226 (1.5%) participants had confirmed COVID-19 diagnosis between 12 February and 12 June 2020, with increased odds for men (OR 1.56; 95% CI 1.2 to 2.04) and Black ethnicity (2.04; 1.39 to 2.95) as well as patients with moderate to severe liver disease (2.2; 1.35 to 3.59). Each additional comorbidity increased the odds of infection by 62%. Substance misusers were at more risk of infection, so were patients on vitamin D treatment. The higher ORs in patients with chronic pancreatic or mild liver conditions, age >70, and a history of smoking or obesity were due to coexisting comorbidities. Increased odds of death were observed for men (3.54; 1.68 to 7.85) and Black ethnicity (3.77; 1.38 to 10.7). Patients having respiratory complications from COVID-19 without a history of chronic respiratory disease also had higher odds of death (5.77; 1.75 to 19). CONCLUSIONS: In this large population-based study of patients with HPB conditions, men, Black ethnicity, pre-existing moderate to severe liver conditions, six common medical multimorbidities, substance misuse and a history of vitamin D treatment independently posed higher odds of acquiring COVID-19 compared with their respective counterparts. The odds of death were significantly high for men and Black people. © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
OBJECTIVE: To explore risk factors associated with COVID-19 susceptibility and survival in patients with pre-existing hepato-pancreato-biliary (HPB) conditions. DESIGN: Cross-sectional study. SETTING: East London Pancreatic Cancer Epidemiology (EL-PaC -Epidem) Study at Barts Health National Health Service Trust, UK. Linked electronic health records were interrogated on a cohort of participants (age ≥18 years), reported with HPB conditions between 1 April 2008 and 6 March 2020. PARTICIPANTS : EL-PaC -Epidem Study participants , alive on 12 February 2020, and living in East London within the previous 6 months (n=15 440). The cohort represents a multi-ethnic population with 51.7% belonging to the non-White background. MAIN OUTCOME MEASURE: COVID-19 incidence and mortality . RESULTS: Some 226 (1.5%) participants had confirmed COVID-19 diagnosis between 12 February and 12 June 2020, with increased odds for men (OR 1.56; 95% CI 1.2 to 2.04) and Black ethnicity (2.04; 1.39 to 2.95) as well as patients with moderate to severe liver disease (2.2; 1.35 to 3.59). Each additional comorbidity increased the odds of infection by 62%. Substance misusers were at more risk of infection , so were patients on vitamin D treatment. The higher ORs in patients with chronic pancreatic or mild liver conditions , age >70, and a history of smoking or obesity were due to coexisting comorbidities. Increased odds of death were observed for men (3.54; 1.68 to 7.85) and Black ethnicity (3.77; 1.38 to 10.7). Patients having respiratory complications from COVID-19 without a history of chronic respiratory disease also had higher odds of death (5.77; 1.75 to 19). CONCLUSIONS: In this large population-based study of patients with HPB conditions, men , Black ethnicity, pre-existing moderate to severe liver conditions , six common medical multimorbidities, substance misuse and a history of vitamin D treatment independently posed higher odds of acquiring COVID-19 compared with their respective counterparts. The odds of death were significantly high for men and Black people . © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
Entities: Chemical
Disease
Gene
Species
Keywords:
COVID-19; hepatobiliary disease; pancreatic disease
Year: 2021
PMID： 33875444 DOI： 10.1136/bmjopen-2020-045077
Source DB: PubMed Journal: BMJ Open ISSN： 2044-6055 Impact factor: 2.692