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 Service...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-04-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/4/e045077.full |
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| author | Abu Z M Dayem Ullah Lavanya Sivapalan Hemant M Kocher Claude Chelala |
| author_facet | Abu Z M Dayem Ullah Lavanya Sivapalan Hemant M Kocher Claude Chelala |
| author_sort | Abu Z M Dayem Ullah |
| collection | DOAJ |
| 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 | Article |
| id | doaj-art-c622184ede5b48a197fbf871d72e4690 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-c622184ede5b48a197fbf871d72e46902024-11-21T12:15:08ZengBMJ Publishing GroupBMJ Open2044-60552021-04-0111410.1136/bmjopen-2020-045077COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East LondonAbu Z M Dayem Ullah0Lavanya Sivapalan1Hemant M Kocher2Claude Chelala3Centre for Cancer Biomarker and Biotherapeutics, Barts Cancer Institute, London, UKThe Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA1 Barts and the London HPB Centre, Barts Health NHS Trust, London, London, UKCentre for Cancer Biomarkers and Biotherapeutics, Queen Mary University of London, London, UKObjective 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.https://bmjopen.bmj.com/content/11/4/e045077.full |
| spellingShingle | Abu Z M Dayem Ullah Lavanya Sivapalan Hemant M Kocher Claude Chelala COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London BMJ Open |
| 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 |
| url | https://bmjopen.bmj.com/content/11/4/e045077.full |
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