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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.
Walker, Jemma L; Grint, Daniel J; Strongman, Helen; Eggo, Rosalind M; Peppa, Maria; Minassian, Caroline; Mansfield, Kathryn E; Rentsch, Christopher T; Douglas, Ian J; Mathur, Rohini; Wong, Angel Y S; Quint, Jennifer K; Andrews, Nick; Bernal, Jamie Lopez; Scott, J Anthony; Ramsay, Mary; Smeeth, Liam; McDonald, Helen I.
  • Walker JL; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.
  • Grint DJ; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
  • Strongman H; Public Health England, 61 Colindale Ave, London, NW9 5EQ, UK.
  • Eggo RM; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.
  • Peppa M; 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; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, 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; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
  • Andrews N; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
  • Bernal JL; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
  • Scott JA; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
  • Ramsay M; Imperial College London, South Kensington, London, SW7 2BU, UK.
  • Smeeth L; NIHR Health Protection Research Unit (HPRU) in Immunisation, London, UK.
  • McDonald HI; London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
BMC Public Health ; 21(1): 484, 2021 03 11.
Article in English | MEDLINE | ID: covidwho-1133589
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
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Semantic information from SemMedBD (by NLM)
1. Disease PROCESS_OF Persons
Subject
Disease
Predicate
PROCESS_OF
Object
Persons
2. Diabetes AFFECTS Asthma
Subject
Diabetes
Predicate
AFFECTS
Object
Asthma
3. Diabetes AFFECTS Chronic Kidney Diseases
Subject
Diabetes
Predicate
AFFECTS
Object
Chronic Kidney Diseases
4. Chronic liver disease AFFECTS Chronic Kidney Diseases
Subject
Chronic liver disease
Predicate
AFFECTS
Object
Chronic Kidney Diseases
5. Chronic liver disease AFFECTS Asthma
Subject
Chronic liver disease
Predicate
AFFECTS
Object
Asthma
6. Vaccination TREATS Persons
Subject
Vaccination
Predicate
TREATS
Object
Persons
7. Disease PROCESS_OF Persons
Subject
Disease
Predicate
PROCESS_OF
Object
Persons
8. Diabetes AFFECTS Asthma
Subject
Diabetes
Predicate
AFFECTS
Object
Asthma
9. Diabetes AFFECTS Chronic Kidney Diseases
Subject
Diabetes
Predicate
AFFECTS
Object
Chronic Kidney Diseases
10. Chronic liver disease AFFECTS Chronic Kidney Diseases
Subject
Chronic liver disease
Predicate
AFFECTS
Object
Chronic Kidney Diseases
11. Chronic liver disease AFFECTS Asthma
Subject
Chronic liver disease
Predicate
AFFECTS
Object
Asthma
12. Vaccination TREATS Persons
Subject
Vaccination
Predicate
TREATS
Object
Persons
ABSTRACT

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.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Health Status / COVID-19 Type of study: Etiology study / Clinical Practice Guide / Prevalence study / Prognostic study / Randomized controlled trials / Risk factors Topics: Vaccines Limits: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged / Pregnancy Country/Region as subject: Europa Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-10427-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Health Status / COVID-19 Type of study: Etiology study / Clinical Practice Guide / Prevalence study / Prognostic study / Randomized controlled trials / Risk factors Topics: Vaccines Limits: Adolescent / Adult / Aged / Child / Female / Humans / Male / Middle aged / Pregnancy Country/Region as subject: Europa Language: English Journal: BMC Public Health Journal subject: Public Health Year: 2021 Document Type: Article Affiliation country: S12889-021-10427-2