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COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London
OBJECTIVE: To explore risk factors associated with COVID-19 susceptibility and survival in patients with pre-existing hepato–pancreato–biliary (HPB) conditions. DESIGN: Cross-sectional study. SETTING: East London Pancreatic Cancer Epidemiology (EL-PaC-Epidem) Study at Barts Health National Health Se...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057071/ https://www.ncbi.nlm.nih.gov/pubmed/33875444 http://dx.doi.org/10.1136/bmjopen-2020-045077 |
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author | Dayem Ullah, Abu Z M Sivapalan, Lavanya Kocher, Hemant M Chelala, Claude |
author_facet | Dayem Ullah, Abu Z M Sivapalan, Lavanya Kocher, Hemant M Chelala, Claude |
author_sort | Dayem Ullah, Abu Z M |
collection | PubMed |
description | OBJECTIVE: To explore risk factors associated with COVID-19 susceptibility and survival in patients with pre-existing hepato–pancreato–biliary (HPB) conditions. DESIGN: Cross-sectional study. SETTING: East London Pancreatic Cancer Epidemiology (EL-PaC-Epidem) Study at Barts Health National Health Service Trust, UK. Linked electronic health records were interrogated on a cohort of participants (age ≥18 years), reported with HPB conditions between 1 April 2008 and 6 March 2020. PARTICIPANTS: EL-PaC-Epidem Study participants, alive on 12 February 2020, and living in East London within the previous 6 months (n=15 440). The cohort represents a multi-ethnic population with 51.7% belonging to the non-White background. MAIN OUTCOME MEASURE: COVID-19 incidence and mortality. RESULTS: Some 226 (1.5%) participants had confirmed COVID-19 diagnosis between 12 February and 12 June 2020, with increased odds for men (OR 1.56; 95% CI 1.2 to 2.04) and Black ethnicity (2.04; 1.39 to 2.95) as well as patients with moderate to severe liver disease (2.2; 1.35 to 3.59). Each additional comorbidity increased the odds of infection by 62%. Substance misusers were at more risk of infection, so were patients on vitamin D treatment. The higher ORs in patients with chronic pancreatic or mild liver conditions, age >70, and a history of smoking or obesity were due to coexisting comorbidities. Increased odds of death were observed for men (3.54; 1.68 to 7.85) and Black ethnicity (3.77; 1.38 to 10.7). Patients having respiratory complications from COVID-19 without a history of chronic respiratory disease also had higher odds of death (5.77; 1.75 to 19). CONCLUSIONS: In this large population-based study of patients with HPB conditions, men, Black ethnicity, pre-existing moderate to severe liver conditions, six common medical multimorbidities, substance misuse and a history of vitamin D treatment independently posed higher odds of acquiring COVID-19 compared with their respective counterparts. The odds of death were significantly high for men and Black people. |
format | Online Article Text |
id | pubmed-8057071 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-80570712021-04-20 COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London Dayem Ullah, Abu Z M Sivapalan, Lavanya Kocher, Hemant M Chelala, Claude BMJ Open Gastroenterology and Hepatology OBJECTIVE: To explore risk factors associated with COVID-19 susceptibility and survival in patients with pre-existing hepato–pancreato–biliary (HPB) conditions. DESIGN: Cross-sectional study. SETTING: East London Pancreatic Cancer Epidemiology (EL-PaC-Epidem) Study at Barts Health National Health Service Trust, UK. Linked electronic health records were interrogated on a cohort of participants (age ≥18 years), reported with HPB conditions between 1 April 2008 and 6 March 2020. PARTICIPANTS: EL-PaC-Epidem Study participants, alive on 12 February 2020, and living in East London within the previous 6 months (n=15 440). The cohort represents a multi-ethnic population with 51.7% belonging to the non-White background. MAIN OUTCOME MEASURE: COVID-19 incidence and mortality. RESULTS: Some 226 (1.5%) participants had confirmed COVID-19 diagnosis between 12 February and 12 June 2020, with increased odds for men (OR 1.56; 95% CI 1.2 to 2.04) and Black ethnicity (2.04; 1.39 to 2.95) as well as patients with moderate to severe liver disease (2.2; 1.35 to 3.59). Each additional comorbidity increased the odds of infection by 62%. Substance misusers were at more risk of infection, so were patients on vitamin D treatment. The higher ORs in patients with chronic pancreatic or mild liver conditions, age >70, and a history of smoking or obesity were due to coexisting comorbidities. Increased odds of death were observed for men (3.54; 1.68 to 7.85) and Black ethnicity (3.77; 1.38 to 10.7). Patients having respiratory complications from COVID-19 without a history of chronic respiratory disease also had higher odds of death (5.77; 1.75 to 19). CONCLUSIONS: In this large population-based study of patients with HPB conditions, men, Black ethnicity, pre-existing moderate to severe liver conditions, six common medical multimorbidities, substance misuse and a history of vitamin D treatment independently posed higher odds of acquiring COVID-19 compared with their respective counterparts. The odds of death were significantly high for men and Black people. BMJ Publishing Group 2021-04-19 /pmc/articles/PMC8057071/ /pubmed/33875444 http://dx.doi.org/10.1136/bmjopen-2020-045077 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Gastroenterology and Hepatology Dayem Ullah, Abu Z M Sivapalan, Lavanya Kocher, Hemant M Chelala, Claude COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London |
title | COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London |
title_full | COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London |
title_fullStr | COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London |
title_full_unstemmed | COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London |
title_short | COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London |
title_sort | covid-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in east london |
topic | Gastroenterology and Hepatology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057071/ https://www.ncbi.nlm.nih.gov/pubmed/33875444 http://dx.doi.org/10.1136/bmjopen-2020-045077 |
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