scholarly journals Is older age associated with COVID-19 mortality in the absence of other risk factors? General population cohort study of 470,034 participants

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241824 ◽  
Author(s):  
Frederick K. Ho ◽  
Fanny Petermann-Rocha ◽  
Stuart R. Gray ◽  
Bhautesh D. Jani ◽  
S. Vittal Katikireddi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cohort Study ◽  
Mortality Risk ◽  
Handgrip Strength ◽  
Older Age ◽  
High Systolic Blood Pressure ◽  
Long Term Conditions ◽  
Population Cohort ◽  
Population Cohort Study

Introduction Older people have been reported to be at higher risk of COVID-19 mortality. This study explored the factors mediating this association and whether older age was associated with increased mortality risk in the absence of other risk factors. Methods In UK Biobank, a population cohort study, baseline data were linked to COVID-19 deaths. Poisson regression was used to study the association between current age and COVID-19 mortality. Results Among eligible participants, 438 (0.09%) died of COVID-19. Current age was associated exponentially with COVID-19 mortality. Overall, participants aged ≥75 years were at 13-fold (95% CI 9.13–17.85) mortality risk compared with those <65 years. Low forced expiratory volume in 1 second, high systolic blood pressure, low handgrip strength, and multiple long-term conditions were significant mediators, and collectively explained 39.3% of their excess risk. The associations between these risk factors and COVID-19 mortality were stronger among older participants. Participants aged ≥75 without additional risk factors were at 4-fold risk (95% CI 1.57–9.96, P = 0.004) compared with all participants aged <65 years. Conclusions Higher COVID-19 mortality among older adults was partially explained by other risk factors. ‘Healthy’ older adults were at much lower risk. Nonetheless, older age was an independent risk factor for COVID-19 mortality.

scholarly journals HIV and risk of COVID-19 death: a population cohort study from the Western Cape Province, South Africa

2020 ◽  
Author(s):  
Mary-Ann Davies
Keyword(s):  
South Africa ◽  
Cohort Study ◽  
Public Sector ◽  
Mortality Risk ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Western Cape ◽  
Population Cohort ◽  
Increased Risk ◽  
Population Cohort Study

AbstractBackgroundThe effect of HIV co-infection on COVID-19 outcomes in sub-Saharan Africa is unknown.MethodsWe conducted a population cohort study using linked data from adults attending public sector health facilities in the Western Cape, South Africa. We used Cox-proportional hazards models adjusted for age, sex, location and comorbidities to examine the association between HIV and COVID-19 death among (i) public sector “active patients” (≥1 health visit in the 3 years before March 2020), (ii) laboratory-diagnosed COVID-19 cases and (iii) hospitalized COVID-19 cases. COVID-19 was diagnosed with SARS-CoV-2 PCR tests. We calculated the standardized mortality ratio (SMR) for COVID-19 comparing HIV positive vs. negative adults using modelled population estimates.ResultsAmong 3,460,932 public sector patients (16% HIV positive), 22,308 were diagnosed with COVID-19, of whom 625 died. In adjusted analysis, HIV increased risk of COVID-19 mortality (adjusted hazard ratio [aHR]:2.14; 95% confidence interval [CI]:1.70; 2.70), with similar risks across strata of viral load and immunosuppression. increased HIV-associated risk of COVID-19 death remained when restricting to COVID-19 cases (aHR:1.70; 95%CI:132; 2.18) or hospitalized cases (aHR:1.45; 95%CI:1.14; 1.84). Current and previous tuberculosis also increased COVID-19 mortality risk (aHR [95%CI]:2.70 [1.81; 4.04] and 1.51 [1.18; 1.93] respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI:1.96; 2.86); population attributable fraction 8.5% (95%CI:6.1; 11.1).ConclusionHIV was associated with a doubling of COVID-19 mortality risk. While our findings may over-estimate the HIV-associated risk COVID-19 death due to residual confounding, people with HIV should be considered a high-risk group for COVID-19 management.

scholarly journals Prenatal and perinatal risk factors for eating disorders in women: A population cohort study

2019 ◽  
Author(s):  
Hunna J. Watson ◽  
Elizabeth W. Diemer ◽  
Stephanie Zerwas ◽  
Kristin Gustavson ◽  
Gun Peggy Knudsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Eating Disorders ◽  
Cohort Study ◽  
Perinatal Risk Factors ◽  
Perinatal Risk ◽  
Population Cohort ◽  
Population Cohort Study

scholarly journals Risk factors for COVID-19 death in a population cohort study from the Western Cape Province, South Africa

2020 ◽  
Author(s):  
Andrew Boulle ◽  
Mary-Ann Davies ◽  
Hannah Hussey ◽  
Muzzammil Ismail ◽  
Erna Morden ◽  
...  
Keyword(s):  
Risk Factors ◽  
South Africa ◽  
Cohort Study ◽  
Public Sector ◽  
Population Attributable Fraction ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Western Cape ◽  
Population Cohort ◽  
Population Cohort Study

Abstract Background Risk factors for COVID-19 death in sub-Saharan Africa and the effects of HIV and tuberculosis on COVID-19 outcomes are unknown. Methods We conducted a population cohort study using linked data from adults attending public sector health facilities in the Western Cape, South Africa. We used Cox-proportional hazards models adjusted for age, sex, location and comorbidities to examine the association between HIV, tuberculosis and COVID-19 death from 1 March-9 June 2020 among (i) public sector “active patients” (≥1 visit in the 3 years before March 2020), (ii) laboratory-diagnosed COVID-19 cases and (iii) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19 comparing HIV positive vs. negative adults using modelled population estimates. Results Among 3,460,932 patients (16% HIV positive), 22,308 were diagnosed with COVID-19, of whom 625 died. COVID-19 death was associated with male sex, increasing age, diabetes, hypertension and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR] 2.14; 95% confidence interval [CI] 1.70-2.70), with similar risks across strata of viral load and immunosuppression. Current and previous tuberculosis were associated with COVID-19 death (aHR [95%CI] 2.70 [1.81-4.04] and 1.51 [1.18-1.93] respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95%CI 1.96-2.86); population attributable fraction 8.5% (95%CI 6.1-11.1). Conclusion While our findings may over-estimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both HIV and current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex and other comorbidities and COVID-19 mortality were similar to other settings.

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