In a new study, researchers found risk factors linked to COVID-19 death, based on analyses of health records of 17 million adults in England.
The study provides detailed information on the size of the risk linked to various pre-existing medical conditions, such as diabetes and obesity.
Consistent with previous work, it also indicates a higher risk of death from COVID-19 for men, older people, and people with greater deprivation.
Black and Asian people were also found to be at a higher risk of death; however, this increased risk was only partially attributable to pre-existing clinical risk factors and deprivation.
The research was conducted by a team at the University of Oxford and elsewhere.
In the study, the team developed OpenSAFELY, a secure analytics platform that incorporates data for 40% of all National Health Service (NHS) patients in England.
Among the electronic health records of 17,278,392 adults, there were 10,926 deaths in and out of the hospital that was linked to COVID-19.
In line with previous studies, the team found men had a greater risk of COVID-19-related death than women, and age was also found to be a risk factor—people aged 80 or above had a 20-fold-increased risk compared to 50–59-year-old people, for example.
Black and South Asian people, and those of mixed background, were 1.62–1.88 times more likely to die with COVID-19 than white people, after taking into account their prior medical conditions.
The most deprived people in the cohort were 1.8 times more likely than the least deprived to die with COVID-19; clinical factors made only a small contribution to this risk, suggesting that social factors have a role.
Pre-existing medical conditions—including obesity (especially a BMI of over 40), diabetes, severe asthma, and respiratory, chronic heart, liver, neurological, and autoimmune diseases—were all found to be linked to an increased risk of COVID-19-related death.
Smoking and hypertension both had a slight negative association with risk, for example, but the authors suggest that this could be a result of interactions with other clinical factors, and they note that further studies are needed to better understand these relationships.
The researchers caution that as clinically suspected but unconfirmed cases of COVID-19 were included, some patients might have been incorrectly identified as having COVID-19 and, conversely, some deaths—particularly at earlier stages—might have been misclassified as non-COVID-19.
One author of the study is Elizabeth J. Williamson.
The study is published in Nature.
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