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Tytuł:
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UK prevalence of underlying conditions which increase the risk of severe COVID-19 disease: a point prevalence study using electronic health records.
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Autorzy:
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Walker JL; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.; Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK.
Grint DJ; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Strongman H; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Eggo RM; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Peppa M; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Minassian C; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Mansfield KE; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Rentsch CT; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Douglas IJ; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Mathur R; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Wong AYS; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Quint JK; Imperial College London, South Kensington, London, SW7 2BU, UK.
Andrews N; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.; Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK.
Bernal JL; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.; Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK.
Scott JA; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Ramsay M; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.; Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK.
Smeeth L; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
McDonald HI; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK. .; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. .
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Źródło:
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BMC public health [BMC Public Health] 2021 Mar 11; Vol. 21 (1), pp. 484. Date of Electronic Publication: 2021 Mar 11.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: London : BioMed Central, [2001-
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MeSH Terms:
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Health Status*
COVID-19/*epidemiology
Adolescent ; Adult ; Age Factors ; Aged ; Child ; Chronic Disease/epidemiology ; Electronic Health Records ; Female ; Humans ; Male ; Middle Aged ; Multimorbidity ; Pregnancy ; Prevalence ; Public Health ; Risk Factors ; United Kingdom/epidemiology
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References:
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Grant Information:
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MC_PC_19065 United Kingdom MRC_ Medical Research Council; MR/R010161/1 United Kingdom MRC_ Medical Research Council; MR/S003975/1 United Kingdom MRC_ Medical Research Council; MR/S019669/1 United Kingdom MRC_ Medical Research Council
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Contributed Indexing:
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Keywords: COVID-19; Electronic health records; Prevalence; Risk factors; United Kingdom
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Entry Date(s):
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Date Created: 20210312 Date Completed: 20210405 Latest Revision: 20240214
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Update Code:
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20240214
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PubMed Central ID:
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PMC7948667
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DOI:
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10.1186/s12889-021-10427-2
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PMID:
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33706738
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Background: Characterising the size and distribution of the population at risk of severe COVID-19 is vital for effective policy and planning. Older age, and underlying health conditions, are associated with higher risk of death from COVID-19. This study aimed to describe the population at risk of severe COVID-19 due to underlying health conditions across the United Kingdom.
Methods: We used anonymised electronic health records from the Clinical Practice Research Datalink GOLD to estimate 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 with binomial exact confidence intervals. 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.
Results: 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 5 y.
Conclusions: The population at risk of severe COVID-19 (defined as either aged ≥70 years, or younger with an underlying health condition) comprises 18.5 million individuals in the UK, including a considerable proportion of school-aged and working-aged individuals. Our national estimates broadly support the use of Global Burden of Disease modelled estimates in other countries. We provide age- and region- stratified prevalence for each condition to support effective modelling of public health interventions and planning of vaccine resource allocation. The high prevalence of health conditions among older age groups suggests that age-targeted vaccination strategies may efficiently target individuals at higher risk of severe COVID-19.
