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52. Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform

Author

Rentsch, Christopher T, DeVito, Nicholas J, MacKenna, Brian, Morton, Caroline E, Bhaskaran, Krishnan, Brown, Jeremy P, Schultze, Anna, Hulme, William J, Croker, Richard, Walker, Alex J, Williamson, Elizabeth J, Bates, Chris, Bacon, Seb, Mehrkar, Amir, Curtis, Helen J, Evans, David, Wing, Kevin, Inglesby, Peter, Mathur, Rohini, Drysdale, Henry, Wong, Angel Y S, McDonald, Helen I, Cockburn, Jonathan, Forbes, Harriet, Parry, John, Hester, Frank, Harper, Sam, Smeeth, Liam, Douglas, Ian J, Dixon, William G, Evans, Stephen J W, Tomlinson, Laurie, and Goldacre, Ben

Published
2021
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53. HIV infection and COVID-19 death: a population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

Author

Bhaskaran, Krishnan, Rentsch, Christopher T, MacKenna, Brian, Schultze, Anna, Mehrkar, Amir, Bates, Chris J, Eggo, Rosalind M, Morton, Caroline E, Bacon, Sebastian C J, Inglesby, Peter, Douglas, Ian J, Walker, Alex J, McDonald, Helen I, Cockburn, Jonathan, Williamson, Elizabeth J, Evans, David, Forbes, Harriet J, Curtis, Helen J, Hulme, William J, Parry, John, Hester, Frank, Harper, Sam, Evans, Stephen J W, Smeeth, Liam, and Goldacre, Ben

Published
2021
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55. Causes of death in children with congenital Zika syndrome in Brazil, 2015 to 2018: A nationwide record linkage study

Author

Costa, Maria da Conceição N., Cardim, Luciana Lobato, Moore, Cynthia A., de Jesus, Eliene dos Santos, Carvalho-Sauer, Rita, Barreto, Mauricio L., Rodrigues, Laura C., Smeeth, Liam, Schuler-Faccini, Lavínia, Brickley, Elizabeth B., Oliveira, Wanderson K., Carmo, Eduardo Hage, Pescarini, Julia Moreira, Andrade, Roberto F. S., Rodrigues, Moreno M. S., Veiga, Rafael V., Costa, Larissa C., França, Giovanny V. A., Teixeira, Maria Gloria, and Paixão, Enny S.

Subjects
Perinatal infection -- Statistics -- Patient outcomes -- Complications and side effects, Communicable diseases in children -- Statistics -- Complications and side effects -- Patient outcomes, Pediatric research, Biological sciences
Abstract

Background Children with congenital Zika syndrome (CZS) have severe damage to the peripheral and central nervous system (CNS), greatly increasing the risk of death. However, there is no information on the sequence of the underlying, intermediate, immediate, and contributing causes of deaths among these children. The aims of this study are describe the sequence of events leading to death of children with CZS up to 36 months of age and their probability of dying from a given cause, 2015 to 2018. Methods and findings In a population-based study, we linked administrative data on live births, deaths, and cases of children with CZS from the SINASC (Live Birth Information System), the SIM (Mortality Information System), and the RESP (Public Health Event Records), respectively. Confirmed and probable cases of CZS were those that met the criteria established by the Brazilian Ministry of Health. The information on causes of death was collected from death certificates (DCs) using the World Health Organization (WHO) DC template. We estimated proportional mortality (PM%) among children with CZS and among children with non-Zika CNS congenital anomalies (CA) by 36 months of age and proportional mortality ratio by cause (PMRc). A total of 403 children with confirmed and probable CZS who died up to 36 months of age were included in the study; 81.9% were younger than 12 months of age. Multiple congenital malformations not classified elsewhere, and septicemia unspecified, with 18 (PM = 4.5%) and 17 (PM = 4.2%) deaths, respectively, were the most attested underlying causes of death. Unspecified septicemia (29 deaths and PM = 11.2%) and newborn respiratory failure (40 deaths and PM = 12.1%) were, respectively, the predominant intermediate and immediate causes of death. Fetuses and newborns affected by the mother's infectious and parasitic diseases, unspecified cerebral palsy, and unspecified severe protein-caloric malnutrition were the underlying causes with the greatest probability of death in children with CZS (PMRc from 10.0 to 17.0) when compared to the group born with non-Zika CNS anomalies. Among the intermediate and immediate causes of death, pneumonitis due to food or vomiting and unspecified seizures (PMRc = 9.5, each) and unspecified bronchopneumonia (PMRc = 5.0) were notable. As contributing causes, fetus and newborn affected by the mother's infectious and parasitic diseases (PMRc = 7.3), unspecified cerebral palsy, and newborn seizures (PMRc = 4.5, each) were more likely to lead to death in children with CZS than in the comparison group. The main limitations of this study were the use of a secondary database without additional clinical information and potential misclassification of cases and controls. Conclusion The sequence of causes and circumstances involved in the deaths of the children with CZS highlights the greater vulnerability of these children to infectious and respiratory conditions compared to children with abnormalities of the CNS not related to Zika., Author(s): Maria da Conceição N. Costa 1,2, Luciana Lobato Cardim 1, Cynthia A. Moore 3, Eliene dos Santos de Jesus 2,4, Rita Carvalho-Sauer 2,5, Mauricio L. Barreto 1,2, Laura C. [...]

Published
2023
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59. Risk of COVID-19-related death among patients with chronic obstructive pulmonary disease or asthma prescribed inhaled corticosteroids: an observational cohort study using the OpenSAFELY platform

Author

Schultze, Anna, Walker, Alex J, MacKenna, Brian, Morton, Caroline E, Bhaskaran, Krishnan, Brown, Jeremy P, Rentsch, Christopher T, Williamson, Elizabeth, Drysdale, Henry, Croker, Richard, Bacon, Seb, Hulme, William, Bates, Chris, Curtis, Helen J, Mehrkar, Amir, Evans, David, Inglesby, Peter, Cockburn, Jonathan, McDonald, Helen I, Tomlinson, Laurie, Mathur, Rohini, Wing, Kevin, Wong, Angel Y S, Forbes, Harriet, Parry, John, Hester, Frank, Harper, Sam, Evans, Stephen J W, Quint, Jennifer, Smeeth, Liam, Douglas, Ian J, and Goldacre, Ben

Published
2020
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64. Ethnic differences in the manifestation of early-onset type 2 diabetes

Author

Kibirige, Davis, primary, Hill, Anita V, additional, Katte, Jean Claude, additional, Sekitoleko, Isaac, additional, Lumu, William, additional, Knupp, Julieanne, additional, Squires, Steven, additional, Hattersley, Andrew, additional, Smeeth, Liam, additional, Jones, Angus G, additional, and Nyirenda, Moffat J, additional

Published
2024
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65. Roteiro para redação de estudos em farmacoepidemiologia conduzidos a partir de dados de saúde observacionais coletados rotineiramente (RECORD-PE), tradução para o Português

Author

Langan, Sinead, primary, Schmidt, Sigrún AJ, additional, Wing, Kevin, additional, Ehrenstein, Vera, additional, Nicholls, Stuart, additional, Filion, Kristian, additional, Klungel, Olaf, additional, Petersen, Irene, additional, Sørensen, Henrik Toft, additional, Dixon, William G, additional, Guttmann, Astrid, additional, Harron, Katie, additional, Hemkens, Lars G., additional, Moher, David, additional, Schneeweiss, Sebastian, additional, Smeeth, Liam, additional, Sturkenboom, Miriam, additional, von Elm, Erik, additional, Wang, Shirley, additional, and Benchimol, Eric I, additional

Published
2024
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68. Prospective study design and data analysis in UK Biobank

Author

Allen, Naomi E., primary, Lacey, Ben, additional, Lawlor, Deborah A., additional, Pell, Jill P., additional, Gallacher, John, additional, Smeeth, Liam, additional, Elliott, Paul, additional, Matthews, Paul M., additional, Lyons, Ronan A., additional, Whetton, Anthony D., additional, Lucassen, Anneke, additional, Hurles, Matthew E., additional, Chapman, Michael, additional, Roddam, Andrew W., additional, Fitzpatrick, Natalie K., additional, Hansell, Anna L., additional, Hardy, Rebecca, additional, Marioni, Riccardo E., additional, O’Donnell, Valerie B., additional, Williams, Julie, additional, Lindgren, Cecilia M., additional, Effingham, Mark, additional, Sellors, Jonathan, additional, Danesh, John, additional, and Collins, Rory, additional

Published
2024
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70. Incident dementia risk among patients with type 2 diabetes receiving metformin versus alternative oral glucose-lowering therapy: an observational cohort study using UK primary healthcare records

Author

Doran, William, primary, Tunnicliffe, Louis, additional, Muzambi, Rutendo, additional, Rentsch, Christopher T, additional, Bhaskaran, Krishnan, additional, Smeeth, Liam, additional, Brayne, Carol, additional, Williams, Dylan M, additional, Chaturvedi, Nish, additional, Eastwood, Sophie V, additional, Dunachie, Susanna J, additional, Mathur, Rohini, additional, and Warren-Gash, Charlotte, additional

Published
2024
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74. UK prevalence of underlying conditions which increase the risk of severe COVID-19 disease: a point prevalence study using electronic health records

Author

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, and McDonald, Helen I.

Published
2021
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77. Factors associated with COVID-19-related death using OpenSAFELY

Author

Williamson, Elizabeth J., Walker, Alex J., Bhaskaran, Krishnan, Bacon, Seb, Bates, Chris, Morton, Caroline E., Curtis, Helen J., Mehrkar, Amir, Evans, David, Inglesby, Peter, Cockburn, Jonathan, McDonald, Helen I., MacKenna, Brian, Tomlinson, Laurie, Douglas, Ian J., Rentsch, Christopher T., Mathur, Rohini, Wong, Angel Y. S., Grieve, Richard, Harrison, David, Forbes, Harriet, Schultze, Anna, Croker, Richard, Parry, John, Hester, Frank, Harper, Sam, Perera, Rafael, Evans, Stephen J. W., Smeeth, Liam, and Goldacre, Ben

Published
2020
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78. Differential associations between psychosocial stress and obesity among Ghanaians in Europe and in Ghana: findings from the RODAM study

Author

Baratin, Clarissa, Beune, Erik, van Schalkwijk, Daan, Meeks, Karlijn, Smeeth, Liam, Addo, Juliet, de-Graft Aikins, Ama, Owusu-Dabo, Ellis, Bahendeka, Silver, Mockenhaupt, Frank P., Danquah, Ina, Schulze, Matthias B., Spranger, Joachim, Boateng, Daniel, Klipstein-Grobusch, Kerstin, Stronks, Karien, and Agyemang, Charles

Published
2020
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81. Incidence of diabetes after SARS-CoV-2 infection in England and the implications of COVID-19 vaccination: a retrospective cohort study of 16 million people

Author

Taylor, Kurt, Eastwood, Sophie, Walker, Venexia, Cezard, Genevieve, Knight, Rochelle, Al Arab, Marwa, Wei, Yinghui, Horne, Elsie M F, Teece, Lucy, Forbes, Harriet, Walker, Alex, Fisher, Louis, Massey, Jon, Hopcroft, Lisa E M, Palmer, Tom, Cuitun Coronado, Jose, Ip, Samantha, Davy, Simon, Dillingham, Iain, Morton, Caroline, Greaves, Felix, Macleod, John, Goldacre, Ben, Wood, Angela, Chaturvedi, Nishi, Sterne, Jonathan A C, Denholm, Rachel, Al Arab, Marwa, Almaghrabi, Fatima, Andrews, Colm, Badrick, Ellena, Baz, Sarah, Beckford, Chelsea, Berman, Samantha, Bolton, Tom, Booth, Charlotte, Bowyer, Ruth, Boyd, Andy, Bridger-Staatz, Charis, Brophy, Sinead, Campbell, Archie, Campbell, Kirsteen C, Carnemolla, Alisia, Carpentieri, Jd, Cezard, Genevieve, Chaturvedi, Nishi, Cheetham, Nathan, Costello, Ruth, Cowling, Thomas, Crane, Matthew, Cuitun Coronado, Jose Ignacio, Curtis, Helen, Denaxas, Spiros, Denholm, Rachel, Di Gessa, Giorgio, Dobson, Richard, Douglas, Ian, Evans, Katharine M, Fang, Chao, Ferreira, Vanessa, Finnigan, Lucy, Fisher, Louis, Flaig, Robin, Folarin, Amos, Forbes, Harriet, Foster, Diane, Fox, Laura, Freydin, Maxim, Garcia, Paz, Gibson, Andy, Glen, Fiona, Goldacre, Ben, Goncalves Soares, Ana, Greaves, Felix, Green, Amelia, Green, Mark, Green, Michael, Griffith, Gareth, Hamill Howes, Lee, Hamilton, Olivia, Herbet, Annie, Herrett, Emily, Hopcroft, Lisa, Horne, Elsie, Hou, Bo, Hughes, Alun, Hulme, William, Huntley, Lizzie, Ip, Samantha, Jacques, Wels, Jezzard, Peter, Jones, Louise, Kanagaratnam, Arun, Karthikeyan Suseeladevi, Arun, Katikireddi, Vittal, Kellas, John, Kennedy, Jonathan I, Kibble, Milla, Knight, Rochelle, Knueppel, Anika, Kopasker, Daniel, Kromydas, Theocharis, Kwong, Alex, Langan, Sinead, Lemanska, Agnieszka, Lukaschuk, Elena, Mackenna, Brain, Macleod, John, Maddock, Jane, Mahalingasivam, Viyaasan, Mansfield, Kathryn, McArdle, Fintan, McCartney, Daniel, McEachan, Rosie, McElroy, Eoin, McLachlan, Stela, Mitchell, Ruth, Moltrecht, Bettina, Morley, Jess, Nab, Linda, Neubauer, Stefan, Nigrelli, Lidia, North, Teri, Northstone, Kate, Oakley, Jacqui, Palmer, Tom, Park, Chloe, Parker, Michael, Parsons, Sam, Patalay, Praveetha, Patel, Kishan, Perez-Reche, Francisco, Piechnik, Stefan, Piehlmaier, Dominik, Ploubidis, George, Rafeti, Elena, Raman, Betty, Ranjan, Yatharth, Rapala, Alicja, Rhead, Rebecca, Roberts, Amy, Sampri, Alexia, Sanders, Zeena-Britt, Santorelli, Gillian, Saunders, Laura C, Shah, Anoop, Shah, Syed Ahmar, Sharp, Steve, Shaw, Richard, Sheard, Laura, Sheikh, Aziz, Silverwood, Richard, Smeeth, Liam, Smith, Stephen, Stafford, Jean, Steptoe, Andrew, Sterne, Jonathan, Steves, Claire, Stewart, Callum, Taylor, Kurt, Tazare, John, Teece, Lucy, Thomas, Richard, Thompson, Ellen, Tilling, Kate, Timpson, Nicholas, Tomlinson, Laurie, Toms, Renin, Tunnicliffe, Elizabeth, Turner, Emma L, Walker, Alex, Walker, Venexia, Walter, Scott, Wang, Kevin, Wei, Yinghui, Whitehorn, Rebecca, Wielgoszewska, Bozena, Wild, James M, Willan, Kathryn, Willans, Robert, Williams, Dylan, Wong, Andrew, Wood, Angela, Woodward, Hannah, Wright, John, Yang, Tiffany, Zaninotto, Paola, Zheng, Bang, and Zhu, Jingmin

Abstract

Some studies have shown that the incidence of type 2 diabetes increases after a diagnosis of COVID-19, although the evidence is not conclusive. However, the effects of the COVID-19 vaccine on this association, or the effect on other diabetes subtypes, are not clear. We aimed to investigate the association between COVID-19 and incidence of type 2, type 1, gestational and non-specific diabetes, and the effect of COVID- 19 vaccination, up to 52 weeks after diagnosis.

Published
2024
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85. Perinatal health outcomes of international migrant women in Brazil: A nationwide data linkage study of the CIDACS birth cohort (2011–2018)

Author

Pescarini, Julia M., primary, Falcao, Ila R., additional, Reboucas, Poliana, additional, Paixao, Enny S., additional, Sanchez-Clemente, Nuria, additional, Goes, Emanuelle F., additional, Abubakar, Ibrahim, additional, Rodrigues, Laura C., additional, Brickley, Elizabeth B., additional, Smeeth, Liam, additional, and Barreto, Mauricio L., additional

Published
2023
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89. Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa: a systematic review and meta-analysis.

Author

Gurdasani, Deepti, Riha, Johanna, Ekoru, Kenneth, Asiki, Gershim, Mayanja, Billy, Levitt, Naomi, Crowther, Nigel, Nyirenda, Moffat, Njelekela, Marina, Ramaiya, Kaushik, Nyan, Ousman, Adewole, Olanisun, Anastos, Kathryn, Azzoni, Livio, Boom, W, Compostella, Caterina, Dave, Joel, Dawood, Halima, Erikstrup, Christian, Fourie, Carla, Friis, Henrik, Kruger, Annamarie, Idoko, John, Longenecker, Chris, Mbondi, Suzanne, Mukaya, Japheth, Mutimura, Eugene, Ndhlovu, Chiratidzo, Praygod, George, Pefura Yone, Eric, Pujades-Rodriguez, Mar, Range, Nyagosya, Sani, Mahmoud, Schutte, Aletta, Sliwa, Karen, Vorster, Este, Walsh, Corinna, Zinyama, Rutendo, Mashili, Fredirick, Sobngwi, Eugene, Adebamowo, Clement, Kamali, Anatoli, Seeley, Janet, Young, Elizabeth, Smeeth, Liam, Motala, Ayesha, Kaleebu, Pontiano, Sandhu, Manjinder, Tien, Phyllis, and Dillon, David

Subjects
ART, HIV, cardiometabolic disease, sub-Saharan Africa, Africa South of the Sahara, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Body Mass Index, Diabetes Mellitus, Dyslipidemias, HIV Infections, Humans, Hypertension
Abstract

BACKGROUND: Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations. METHODS: We conducted a systematic review and meta-analysis through MEDLINE and EMBASE (up to January 2012), as well as direct author contact. Eligible studies provided summary or individual-level data on one or more of the following traits in HIV+ and HIV-, or ART+ and ART- subgroups in SSA: body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TGs) and fasting blood glucose (FBG) or glycated hemoglobin (HbA1c). Information was synthesized under a random-effects model and the primary outcomes were the standardized mean differences (SMD) of the specified traits between subgroups of participants. RESULTS: Data were obtained from 49 published and 3 unpublished studies which reported on 29 755 individuals. HIV infection was associated with higher TGs [SMD, 0.26; 95% confidence interval (CI), 0.08 to 0.44] and lower HDL (SMD, -0.59; 95% CI, -0.86 to -0.31), BMI (SMD, -0.32; 95% CI, -0.45 to -0.18), SBP (SMD, -0.40; 95% CI, -0.55 to -0.25) and DBP (SMD, -0.34; 95% CI, -0.51 to -0.17). Among HIV+ individuals, ART use was associated with higher LDL (SMD, 0.43; 95% CI, 0.14 to 0.72) and HDL (SMD, 0.39; 95% CI, 0.11 to 0.66), and lower HbA1c (SMD, -0.34; 95% CI, -0.62 to -0.06). Fully adjusted estimates from analyses of individual participant data were consistent with meta-analysis of summary estimates for most traits. CONCLUSIONS: Broadly consistent with results from populations of European descent, these results suggest differences in cardiometabolic traits between HIV-infected and uninfected individuals in SSA, which might be modified by ART use. In a region with the highest burden of HIV, it will be important to clarify these findings to reliably assess the need for monitoring and managing cardiometabolic risk in HIV-infected populations in SSA.

Published
2013

91. Prevalence of obesity, hypertension, and diabetes, and cascade of care in sub-Saharan Africa: a cross-sectional, population-based study in rural and urban Malawi

Author

Price, Alison J, Crampin, Amelia C, Amberbir, Alemayehu, Kayuni-Chihana, Ndoliwe, Musicha, Crispin, Tafatatha, Terence, Branson, Keith, Lawlor, Debbie A, Mwaiyeghele, Elenaus, Nkhwazi, Lawrence, Smeeth, Liam, Pearce, Neil, Munthali, Elizabeth, Mwagomba, Beatrice M, Mwansambo, Charles, Glynn, Judith R, Jaffar, Shabbar, and Nyirenda, Moffat

Published
2018
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92. Cardiovascular disease risk prediction in sub-Saharan African populations — Comparative analysis of risk algorithms in the RODAM study

Author

Boateng, Daniel, Agyemang, Charles, Beune, Erik, Meeks, Karlijn, Smeeth, Liam, Schulze, Matthias B., Addo, Juliet, de-Graft Aikins, Ama, Galbete, Cecilia, Bahendeka, Silver, Danquah, Ina, Agyei-Baffour, Peter, Owusu-Dabo, Ellis, Mockenhaupt, Frank P., Spranger, Joachim, Kengne, Andre P., Grobbee, Diederick E., and Klipstein-Grobusch, Kerstin

Published
2018
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93. Type 2 diabetes mellitus management among Ghanaian migrants resident in three European countries and their compatriots in rural and urban Ghana – The RODAM study

Author

Bijlholt, Margriet, Meeks, Karlijn A.C., Beune, Erik, Addo, Juliet, Smeeth, Liam, Schulze, Matthias B., Danquah, Ina, Galbete, Cecilia, de-Graft Aikins, Ama, Klipstein-Grobusch, Kerstin, Owusu-Dabo, Ellis, Spranger, Joachim, Mockenhaupt, Frank P., Amoah, Stephen K., Bahendeka, Silver, Stronks, Karien, and Agyemang, Charles

Published
2018
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99. Food variety, dietary diversity, and type 2 diabetes in a multi-center cross-sectional study among Ghanaian migrants in Europe and their compatriots in Ghana: the RODAM study

Author

Danquah, Ina, Galbete, Cecilia, Meeks, Karlijn, Nicolaou, Mary, Klipstein-Grobusch, Kerstin, Addo, Juliet, Aikins, Ama de-Graft, Amoah, Stephen K., Agyei-Baffour, Peter, Boateng, Daniel, Bedu-Addo, George, Spranger, Joachim, Smeeth, Liam, Owusu-Dabo, Ellis, Agyemang, Charles, Mockenhaupt, Frank P., Beune, Erik, and Schulze, Matthias B.

Published
2018
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100. Overall and cause-specific hospitalisation and death after COVID-19 hospitalisation in England: A cohort study using linked primary care, secondary care, and death registration data in the OpenSAFELY platform

Author

Bhaskaran, Krishnan, Rentsch, Christopher T., Hickman, George, Hulme, William J., Schultze, Anna, Curtis, Helen J., Wing, Kevin, Warren-Gash, Charlotte, Tomlinson, Laurie, Bates, Chris J., Mathur, Rohini, MacKenna, Brian, Mahalingasivam, Viyaasan, Wong, Angel, Walker, Alex J., Morton, Caroline E., Grint, Daniel, Mehrkar, Amir, Eggo, Rosalind M., Inglesby, Peter, Douglas, Ian J., McDonald, Helen I., Cockburn, Jonathan, Williamson, Elizabeth J., Evans, David, Parry, John, Hester, Frank, Harper, Sam, Evans, Stephen JW, Bacon, Sebastian, Smeeth, Liam, and Goldacre, Ben

Subjects
Hospital care -- Patient outcomes -- Risk factors, Biological sciences
Abstract

Background There is concern about medium to long-term adverse outcomes following acute Coronavirus Disease 2019 (COVID-19), but little relevant evidence exists. We aimed to investigate whether risks of hospital admission and death, overall and by specific cause, are raised following discharge from a COVID-19 hospitalisation. Methods and findings With the approval of NHS-England, we conducted a cohort study, using linked primary care and hospital data in OpenSAFELY to compare risks of hospital admission and death, overall and by specific cause, between people discharged from COVID-19 hospitalisation (February to December 2020) and surviving at least 1 week, and (i) demographically matched controls from the 2019 general population; and (ii) people discharged from influenza hospitalisation in 2017 to 2019. We used Cox regression adjusted for age, sex, ethnicity, obesity, smoking status, deprivation, and comorbidities considered potential risk factors for severe COVID-19 outcomes. We included 24,673 postdischarge COVID-19 patients, 123,362 general population controls, and 16,058 influenza controls, followed for [less than or equal to]315 days. COVID-19 patients had median age of 66 years, 13,733 (56%) were male, and 19,061 (77%) were of white ethnicity. Overall risk of hospitalisation or death (30,968 events) was higher in the COVID-19 group than general population controls (fully adjusted hazard ratio [aHR] 2.22, 2.14 to 2.30, p < 0.001) but slightly lower than the influenza group (aHR 0.95, 0.91 to 0.98, p = 0.004). All-cause mortality (7,439 events) was highest in the COVID-19 group (aHR 4.82, 4.48 to 5.19 versus general population controls [p < 0.001] and 1.74, 1.61 to 1.88 versus influenza controls [p < 0.001]). Risks for cause-specific outcomes were higher in COVID-19 survivors than in general population controls and largely similar or lower in COVID-19 compared with influenza patients. However, COVID-19 patients were more likely than influenza patients to be readmitted or die due to their initial infection or other lower respiratory tract infection (aHR 1.37, 1.22 to 1.54, p < 0.001) and to experience mental health or cognitive-related admission or death (aHR 1.37, 1.02 to 1.84, p = 0.039); in particular, COVID-19 survivors with preexisting dementia had higher risk of dementia hospitalisation or death (age- and sex-adjusted HR 2.47, 1.37 to 4.44, p = 0.002). Limitations of our study were that reasons for hospitalisation or death may have been misclassified in some cases due to inconsistent use of codes, and we did not have data to distinguish COVID-19 variants. Conclusions In this study, we observed that people discharged from a COVID-19 hospital admission had markedly higher risks for rehospitalisation and death than the general population, suggesting a substantial extra burden on healthcare. Most risks were similar to those observed after influenza hospitalisations, but COVID-19 patients had higher risks of all-cause mortality, readmission or death due to the initial infection, and dementia death, highlighting the importance of postdischarge monitoring., Author(s): Krishnan Bhaskaran 1,*, Christopher T. Rentsch 1, George Hickman 2, William J. Hulme 2, Anna Schultze 1, Helen J. Curtis 2, Kevin Wing 1, Charlotte Warren-Gash 1, Laurie Tomlinson [...]

Published
2022
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