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Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort
Janice L Atkins1, Jane A H Masoli1,2, Joao Delgado1
1Epidemiology and Public Health Group, University of Exeter Medical School, UK.
Insights
Specific preexisting conditions like dementia and type 2 diabetes increase COVID-19 hospitalization and death risk in older adults. These findings highlight the need for targeted interventions beyond just age-based strategies.
Area of Science:
- Gerontology
- Epidemiology
- Infectious Diseases
Background:
- Older adults are disproportionately affected by COVID-19.
- Preexisting conditions are common in hospitalized COVID-19 patients, but their role as independent risk factors is unclear.
Purpose of the Study:
- To investigate the association between preexisting diagnoses and COVID-19 hospitalization and mortality in an older community cohort.
Main Methods:
- Utilized UK Biobank data from 2006-2020, including hospital discharge and death records.
- Analyzed associations between preexisting diagnoses and laboratory-confirmed COVID-19 hospitalization and mortality using logistic models.
Main Results:
- Dementia, type 2 diabetes, COPD, pneumonia, depression, atrial fibrillation, and hypertension were independent risk factors for COVID-19 hospitalization.
- Dementia, type 2 diabetes, COPD, pneumonia, and depression remained significant risk factors for COVID-19 related mortality.
- Chronic kidney disease and asthma posed risks for hospitalization in women but not men.
Conclusions:
- Identified specific high-risk comorbidities for severe COVID-19 outcomes in older adults.
- Results suggest that age-based targeting alone is insufficient for preventing severe COVID-19.
Background:
Hospitalized COVID-19 patients tend to be older and frequently have hypertension, diabetes, or coronary heart disease, but whether these comorbidities are true risk factors (ie, more common than in the general older population) is unclear. We estimated associations between preexisting diagnoses and hospitalized COVID-19 alone or with mortality, in a large community cohort.
Methods:
UK Biobank (England) participants with baseline assessment 2006-2010, followed in hospital discharge records to 2017 and death records to 2020. Demographic and preexisting common diagnoses association tested with hospitalized laboratory-confirmed COVID-19 (March 16 to April 26, 2020), alone or with mortality, in logistic models.
Results:
Of 269 070 participants aged older than 65, 507 (0.2%) became COVID-19 hospital inpatients, of which 141 (27.8%) died. Common comorbidities in hospitalized inpatients were hypertension (59.6%), history of fall or fragility fractures (29.4%), coronary heart disease (21.5%), type 2 diabetes (type 2, 19. 9%), and asthma (17.6%). However, in models adjusted for comorbidities, age group, sex, ethnicity, and education, preexisting diagnoses of dementia, type 2 diabetes, chronic obstructive pulmonary disease, pneumonia, depression, atrial fibrillation, and hypertension emerged as independent risk factors for COVID-19 hospitalization, the first 5 remaining statistically significant for related mortality. Chronic kidney disease and asthma were risk factors for COVID-19 hospitalization in women but not men.
Conclusions:
There are specific high-risk preexisting comorbidities for COVID-19 hospitalization and related deaths in community-based older men and women. These results do not support simple age-based targeting of the older population to prevent severe COVID-19 infections.