QRISK3® stratification during the Coronavirus pandemic and the evolution of a health promotion opportunity in NHS hospital employees

ABSTRACT

Introduction: Healthcare workers (HCWs) from black and minority ethnic origin (BAME) worldwide paid a higher price in terms of mortality and morbidity during the pandemic. An association between cardiovascular (CVD) risk and COVID-19 complications was suspected as a cause for this disparity. A large NHS Trust developed its own COVID-19 risk stratification incorporating CVD risk of staff assessed by QRISK3® algorithm alongside other risk factors such as asthma/COPD, low immunity and cancer, long before UK wide guidance was published. High and increased-risk staff were offered additional COVID-19 protection. Material and Methods: All staff aged ≥45 years (8047 among total 18025 employees) were eligible to participate. Clinical information alongside blood pressure, BMI, renal and lipid profile and HbA1c was entered into the QRISK3 calculator. Staff with “increased” (Score >10;10% risk of a CVD event over 10 years) and “high” (>20) CVD risk were restricted at work. Results: A total of 1075 employees participated (75% white, 25% BAME). 5% and 7% were identified as increased and high-risk requiring restriction. Advice was provided to participants who were obese (36%);overweight (36%);hypertensive (25%);diabetic/ pre-diabetic (11%) and with unexpected results (BP≥140 systolic 17%, CKD 2%, HbA1c >48 1%). Hypertension was commoner among whites and Diabetes among BAME staff. Conclusions: The trust’s initiative of risk stratification by using QRISK3® may have provided an additional protection to staff with high CVD risk from COVID-19 complications. Its potentiality as a wellbeing tool for health promotion needs to be explored.