Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform.
Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform.
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DOI：
10.1016/j.lanepe.2021.100109
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Goldacre B
中科院分区：
文献类型：
--
作者：
Bhaskaran K;Bacon S;Evans SJ;Bates CJ;Rentsch CT;MacKenna B;Tomlinson L;Walker AJ;Schultze A;Morton CE;Grint D;Mehrkar A;Eggo RM;Inglesby P;Douglas IJ;McDonald HI;Cockburn J;Williamson EJ;Evans D;Curtis HJ;Hulme WJ;Parry J;Hester F;Harper S;Spiegelhalter D;Smeeth L;Goldacre B
COVID-19的死亡率与年龄和先前存在的医疗状况密切相关，其他原因的死亡率也是如此。我们的目的是研究与COVID-19以外原因的死亡率相比，特定因素与COVID-19死亡率的差异性相关性。我们代表英国NHS在OpenSAFELY平台上进行了一项队列研究。英国的初级保健数据与国家死亡登记有关。我们在2020年2月1日将所有成年人（年龄≥18岁）纳入数据库，并且连续登记超过1年;死亡的截止日期为2020年11月9日。个体水平特征与COVID-19和非COVID死亡（根据死亡证明上是否存在COVID-19代码作为潜在死亡原因进行分类）之间的关联，通过为这两种结果拟合年龄和性别调整的logistic模型进行估计。其中包括17，456，515人。17，063人死于新冠肺炎，134，316人死于其他原因。与COVID-19死亡相关的大多数因素与非COVID死亡相似，但关联程度不同。与非COVID死亡相比，年龄较大与COVID-19死亡的相关性更强（例如，≥80岁与50-59岁的OR分别为40.7 [95% CI 37.7-43.8]和29.6 [28.9-30.3]），男性、贫困、肥胖和一些合并症也是如此。与COVID-19死亡相比，吸烟、癌症史和慢性肝病与非COVID死亡的关联更强。所有非白色种族群体的COVID-19死亡几率均高于白色（黑人：2.20 [1.96-2.47]，南亚人：2.33 [2.16-2.52]），但非COVID死亡几率低于白色（黑人：0.88 [0.83-0.94]，南亚人：0.78 [0.75-0.81]）。大多数个人层面的因素与COVID-19和非COVID死亡之间的类似关联表明，COVID-19在很大程度上增加了患者面临的现有风险，但也有一些值得注意的例外。识别导致非白人群体COVID-19死亡风险过高的独特因素是减少COVID-19死亡的优先事项。惠康，皇家学会，国家健康研究所，国家健康研究所牛津生物医学研究中心，英国医学研究理事会，英国健康数据研究。
Mortality from COVID-19 shows a strong relationship with age and pre-existing medical conditions, as does mortality from other causes. We aimed to investigate how specific factors are differentially associated with COVID-19 mortality as compared to mortality from causes other than COVID-19. Working on behalf of NHS England, we carried out a cohort study within the OpenSAFELY platform. Primary care data from England were linked to national death registrations. We included all adults (aged ≥18 years) in the database on 1st February 2020 and with >1 year of continuous prior registration; the cut-off date for deaths was 9th November 2020. Associations between individual-level characteristics and COVID-19 and non-COVID deaths, classified according to the presence of a COVID-19 code as the underlying cause of death on the death certificate, were estimated by fitting age- and sex-adjusted logistic models for these two outcomes. 17,456,515 individuals were included. 17,063 died from COVID-19 and 134,316 from other causes. Most factors associated with COVID-19 death were similarly associated with non-COVID death, but the magnitudes of association differed. Older age was more strongly associated with COVID-19 death than non-COVID death (e.g. ORs 40.7 [95% CI 37.7-43.8] and 29.6 [28.9-30.3] respectively for ≥80 vs 50-59 years), as was male sex, deprivation, obesity, and some comorbidities. Smoking, history of cancer and chronic liver disease had stronger associations with non-COVID than COVID-19 death. All non-white ethnic groups had higher odds than white of COVID-19 death (OR for Black: 2.20 [1.96-2.47], South Asian: 2.33 [2.16-2.52]), but lower odds than white of non-COVID death (Black: 0.88 [0.83-0.94], South Asian: 0.78 [0.75-0.81]). Similar associations of most individual-level factors with COVID-19 and non-COVID death suggest that COVID-19 largely multiplies existing risks faced by patients, with some notable exceptions. Identifying the unique factors contributing to the excess COVID-19 mortality risk among non-white groups is a priority to inform efforts to reduce deaths from COVID-19. Wellcome, Royal Society, National Institute for Health Research, National Institute for Health Research Oxford Biomedical Research Centre, UK Medical Research Council, Health Data Research UK.
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影响因子：
5
作者：
Fry A;Littlejohns TJ;Sudlow C;Doherty N;Adamska L;Sprosen T;Collins R;Allen NE
通讯作者：
Allen NE
影响因子：
3.4
作者：
Herrett, Emily;Thomas, Sara L.;Hall, Andrew J.
通讯作者：
Hall, Andrew J.
影响因子：
16.6
作者：
Griffith GJ;Morris TT;Tudball MJ;Herbert A;Mancano G;Pike L;Sharp GC;Sterne J;Palmer TM;Davey Smith G;Tilling K;Zuccolo L;Davies NM;Hemani G
通讯作者：
Hemani G
影响因子：
15.8
作者：
Bhopal RS;Gruer L;Cezard G;Douglas A;Steiner MFC;Millard A;Buchanan D;Katikireddi SV;Sheikh A
通讯作者：
Sheikh A
DOI：
10.1093/pubmed/fdt116
发表时间：
2014-12
期刊：
Journal of public health (Oxford, England)
影响因子：
--
作者：
Mathur R;Bhaskaran K;Chaturvedi N;Leon DA;vanStaa T;Grundy E;Smeeth L
通讯作者：
Smeeth L