Risk of Covid-19 in shielded and nursing care home patients: cohort study in general practice
File(s)
Published version
Author(s)
Majeed, Farrukh
Wingfield, David
Taghavi Azar Sharabiani, Mansour
Molokhia, Mariam
Type
Journal Article
Abstract
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: 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 (3rd vs. least deprived IMD quintile) 1.25 (1.01-1.56) p=0.045, obesity (BMI>30kg/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.
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: 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 (3rd vs. least deprived IMD quintile) 1.25 (1.01-1.56) p=0.045, obesity (BMI>30kg/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.
Date Issued
2021-12-14
Date Acceptance
2021-08-18
Citation
British Journal of General Practice Open, 2021, 5 (6), pp.1-14
ISSN
2398-3795
Publisher
Royal College of General Practitioners
Start Page
1
End Page
14
Journal / Book Title
British Journal of General Practice Open
Volume
5
Issue
6
Copyright Statement
© 2021, The Authors. This article is Open Access: CC
BY license (https://creativecommons.org/licenses/by/4.0/)
BY license (https://creativecommons.org/licenses/by/4.0/)
License URL
Identifier
https://bjgpopen.org/content/5/6/BJGPO.2021.0081
Subjects
COVID-19
ethnic groups
general practice
nursing homes
primary healthcare
shielding
Publication Status
Published
Date Publish Online
2021-12-14