Author: Wingfield, David; Taghavi Azar Sharabiani, Mansour; Majeed, Azeem; Molokhia, Mariam
Title: Risk of Covid-19 in shielded and nursing care home patients: cohort study in general practice. Cord-id: 23vua1qg Document date: 2021_8_26
ID: 23vua1qg
Snippet: BACKGROUND Covid-19 cases were first detected in the UK in January 2020 and vulnerable patients were asked to shield from March to reduce their risk of Covid-19 infection. AIM To determine the risk and determinants of Covid-19 diagnosis in shielded vs. non-shielded groups adjusted for key comorbidities not explained by shielding. DESIGN & SETTING Retrospective cohort study of adults with COVID-19 infection between 1/2/20-15/5/20 in West London. METHOD Individuals diagnosed with Covid-19 were ide
Document: BACKGROUND Covid-19 cases were first detected in the UK in January 2020 and vulnerable patients were asked to shield from March to reduce their risk of Covid-19 infection. AIM To determine the risk and determinants of Covid-19 diagnosis in shielded vs. non-shielded groups adjusted for key comorbidities not explained by shielding. DESIGN & SETTING Retrospective cohort study of adults with COVID-19 infection between 1/2/20-15/5/20 in West London. METHOD Individuals diagnosed with Covid-19 were identified in SystmOne records using clinical codes. Infection risks were adjusted for socio-demographic factors, nursing home status and comorbidities. RESULTS Of 57,713 adults, 573 (1%) individuals were identified as shielded and 1,074 adults had documented Covid-19 infections (1.9%). Covid-19 infection rate in the shielded group individuals compared with non-shielded adult individuals was 6.5% (37/573) vs 1.8% (1,037/57, 140), P<0.0001. A multivariable fully adjusted Cox proportional hazards regression identified that Covid-19 infection was increased with aHR (95% CI): shielding status 1.52 (1.00-2.30), P=0.048. Other determinants of Covid-19 infection included nursing home residency 7.05 (4.22-11.77) p<0.001, Black African, 2.52 (1.99-3.18) p<0.001, Other 1.74 (1.42-2.13) p<0.001, Non-stated 1.70 (1.02-2.84) P=0.04, or South Asian ethnicity 1.46 (1.10-1.93) P=0.01, history of respiratory disease 1.51 (1.06-2.16), P=0.02, deprivation (third vs. least deprived IMD quintile) 1.25 (1.01-1.56) P=0.045, obesity (BMI >30 kg/m2) 1.39 (1.18-1.63) p<0.001, and age 1.02 (1.01-1.02) p<0.001. Male gender was associated with lower risk of Covid-19 infection: 0.71 (0.62-0.82) p<0.001. CONCLUSION Shielded individuals had a higher Covid-19 infection rate compared with non-shielded individuals, after adjusting for socio-demographic factors, nursing home status, and comorbidities.
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