Preexisting Comorbidities Predicting COVID-19 and Mortality in the UK Biobank Community Cohort

Author:

Atkins Janice L1ORCID,Masoli Jane A H12ORCID,Delgado Joao1ORCID,Pilling Luke C13ORCID,Kuo Chia-Ling3ORCID,Kuchel George A3,Melzer David13

Affiliation:

1. Epidemiology and Public Health Group, University of Exeter Medical School, UK

2. Department of Healthcare for Older People, Royal Devon and Exeter Hospital, UK

3. Center on Aging, University of Connecticut Health Center, Farmington

Abstract

AbstractBackgroundHospitalized COVID-19 patients tend to be older and frequently have hypertension, diabetes, or coronary heart disease, but whether these comorbidities are true risk factors (ie, more common than in the general older population) is unclear. We estimated associations between preexisting diagnoses and hospitalized COVID-19 alone or with mortality, in a large community cohort.MethodsUK Biobank (England) participants with baseline assessment 2006–2010, followed in hospital discharge records to 2017 and death records to 2020. Demographic and preexisting common diagnoses association tested with hospitalized laboratory-confirmed COVID-19 (March 16 to April 26, 2020), alone or with mortality, in logistic models.ResultsOf 269 070 participants aged older than 65, 507 (0.2%) became COVID-19 hospital inpatients, of which 141 (27.8%) died. Common comorbidities in hospitalized inpatients were hypertension (59.6%), history of fall or fragility fractures (29.4%), coronary heart disease (21.5%), type 2 diabetes (type 2, 19. 9%), and asthma (17.6%). However, in models adjusted for comorbidities, age group, sex, ethnicity, and education, preexisting diagnoses of dementia, type 2 diabetes, chronic obstructive pulmonary disease, pneumonia, depression, atrial fibrillation, and hypertension emerged as independent risk factors for COVID-19 hospitalization, the first 5 remaining statistically significant for related mortality. Chronic kidney disease and asthma were risk factors for COVID-19 hospitalization in women but not men.ConclusionsThere are specific high-risk preexisting comorbidities for COVID-19 hospitalization and related deaths in community-based older men and women. These results do not support simple age-based targeting of the older population to prevent severe COVID-19 infections.

Funder

UK Medical Research Council

University of Exeter Medical School

University of Connecticut School of Medicine

NIHR Doctoral Research Fellowship

University of Connecticut

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Aging

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