Association between multimorbidity and mortality in a cohort of patients admitted to hospital with COVID-19 in Scotland

Utkarsh Agrawal*, Amaya Azcoaga-Lorenzo, Adeniyi Fagbamigbe, Eleftheria Vasileiou, Paul Henery, Colin Simpson, Sarah Stock, Syed Shah, Chris Robertson, Mark Woolhouse, Lewis Ritchie, Aziz Sheikh, Ewen Harrison, Annemarie Docherty, Colin McCowan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)
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Abstract

Objectives
We investigated the association between multimorbidity among patients hospitalised with COVID-19 and their subsequent risk of mortality. We also explored the interaction between the presence of multimorbidity and the requirement for an individual to shield due to the presence of specific conditions and its association with mortality.

Design
We created a cohort of patients hospitalised in Scotland due to COVID-19 during the first wave (between 28 February 2020 and 22 September 2020) of the pandemic. We identified the level of multimorbidity for the patient on admission and used logistic regression to analyse the association between multimorbidity and risk of mortality among patients hospitalised with COVID-19.

Setting
Scotland, UK.

Participants
Patients hospitalised due to COVID-19.

Main outcome measures
Mortality as recorded on National Records of Scotland death certificate and being coded for COVID-19 on the death certificate or death within 28 days of a positive COVID-19 test.

Results
Almost 58% of patients admitted to the hospital due to COVID-19 had multimorbidity. Adjusting for confounding factors of age, sex, social class and presence in the shielding group, multimorbidity was significantly associated with mortality (adjusted odds ratio 1.48, 95%CI 1.26–1.75). The presence of multimorbidity and presence in the shielding patients list were independently associated with mortality but there was no multiplicative effect of having both (adjusted odds ratio 0.91, 95%CI 0.64–1.29).

Conclusions
Multimorbidity is an independent risk factor of mortality among individuals who were hospitalised due to COVID-19. Individuals with multimorbidity could be prioritised when making preventive policies, for example, by expanding shielding advice to this group and prioritising them for vaccination.
Original languageEnglish
Pages (from-to)22-30
Number of pages9
JournalJournal of the Royal Society of Medicine
Volume115
Issue number1
Early online date21 Oct 2021
DOIs
Publication statusPublished - Jan 2022

Keywords

  • COVID-19
  • SARS-CoV2
  • Hospital admissions
  • Multimorbidity
  • Shielding

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