Scientists confirm 4 big risk factors that predict severe COVID-19

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In a new study, researchers found that age, male sex, obesity, and underlying illness have emerged as risk factors for severe Covid-19 or death.

They found the risk of death increases in the over 50s, as does being male, obese, or having underlying heart, lung, liver, and kidney disease.

The research was conducted by a team of UK scientists.

As the largest prospective observational study reported worldwide to date, the study provides a comprehensive picture of the characteristics of patients hospitalized in the UK with Covid-19 and their outcomes.

Because the study is ongoing, it has now recruited over 43,000 patients.

The findings will help health professionals learn more about how the illness progresses and enable us to compare the UK with other countries.

Studies in China have reported risk factors associated with severe Covid-19, but studies describing the features and outcomes of patients with severe Covid-19 who have been admitted to hospital in Europe are lacking.

To address this knowledge gap, the team analyzed data from 20,133 patients with Covid-19 admitted to 208 acute care hospitals in England, Wales, and Scotland between 6 February and 19 April 2020.

This represents around a third of all patients admitted to the hospital with Covid-19 in the UK.

The average age of patients in the study was 73 years, and more men (12,068; 60%) were admitted to hospital than women (8,065; 40%).

Besides increasing age, and underlying heart, lung, liver, and kidney disease—factors already known to cause poor outcomes—the researchers found that obesity and gender were key factors associated with the need for higher levels of care and a higher risk of death in hospital.

At the time of publication, just over a quarter (26%) of all Covid-19 patients in hospital had died, 54% were discharged alive, and a third (34%) remained in hospital.

Outcomes were poorer for those requiring mechanical ventilation: 37% had died, 17% had been discharged alive, and 46% remained in hospital.

The pattern of disease we describe broadly reflects the pattern reported globally, say the researchers.

However, obesity is a major additional risk factor that was not highlighted in data from China. They suspect that reduced lung function or inflammation associated with obesity may play a role.

This is the largest study of its kind outside of China and clearly shows that severe Covid-19 leads to a prolonged hospital stay and a high mortality rate.

These results have already been shared with the UK Government and World Health Organisation, and are being compared with data from other countries around the world.

The lead author of the study is Annemarie B Docherty, a senior clinical lecturer and honorary consultant in critical care.

The study is published in The BMJ.

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