UK prevalence of underlying conditions which increase the risk of severe COVID-19 disease: a point prevalence study using electronic health records

Walker, J. L.; Grint, D. J.; Strongman, H.; Eggo, R. M.; Peppa, M.; Minassian, C.; Mansfield, K. E.; Rentsch, C. T.; Douglas, I. J.; Mathur, R.; Wong, A.; Quint, J. K.; Andrews, N.; Lopez Bernal, J.; Scott, J. A.; Ramsay, M.; Smeeth, L.; McDonald, H. I.

Background This study aimed to describe the population at risk of severe COVID-19 due to underlying health conditions across the United Kingdom in 2019. Methods We used anonymised electronic health records from the Clinical Practice Research Datalink GOLD to describe the point prevalence on 5 March 2019 of the at-risk population following national guidance. Prevalence for any risk condition and for each individual condition is given overall and stratified by age and region. We repeated the analysis on 5 March 2014 for full regional representation and to describe prevalence of underlying health conditions in pregnancy. We additionally described the population of cancer survivors, and assessed the value of linked secondary care records for ascertaining COVID-19 at-risk status. Findings On 5 March 2019, 24.4% of the UK population were at risk due to a record of at least one underlying health condition, including 8.3% of school-aged children, 19.6% of working-aged adults, and 66.2% of individuals aged 70 years or more. 7.1% of the population had multimorbidity. The size of the at-risk population was stable over time comparing 2014 to 2019, despite increases in chronic liver disease and diabetes and decreases in chronic kidney disease and current asthma. Separately, 1.6% of the population had a new diagnosis of cancer in the past five years. Interpretation The population at risk of severe COVID-19 (aged [≥]70 years, or with an underlying health condition) comprises 18.5 million individuals in the UK, including a considerable proportion of school-aged and working-aged individuals.