| Title: | Multimorbidity, polypharmacy, and COVID-19 infection within the UK Biobank cohort |
| Journal: | PLOS ONE |
| Published: | 20 Aug 2020 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/32817712/ |
| DOI: | https://doi.org/10.1371/journal.pone.0238091 |
| URL: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0238091&type=printable |
Publication 5431
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
BACKGROUND: It is now well recognised that the risk of severe COVID-19 increases with some long-term conditions (LTCs). However, prior research primarily focuses on individual LTCs and there is a lack of data on the influence of multimorbidity (≥2 LTCs) on the risk of COVID-19. Given the high prevalence of multimorbidity, more detailed understanding of the associations with multimorbidity and COVID-19 would improve risk stratification and help protect those most vulnerable to severe COVID-19. Here we examine the relationships between multimorbidity, polypharmacy (a proxy of multimorbidity), and COVID-19; and how these differ by sociodemographic, lifestyle, and physiological prognostic factors.</p>
METHODS AND FINDINGS: We studied data from UK Biobank (428,199 participants; aged 37-73; recruited 2006-2010) on self-reported LTCs, medications, sociodemographic, lifestyle, and physiological measures which were linked to COVID-19 test data. Poisson regression models examined risk of COVID-19 by multimorbidity/polypharmacy and effect modification by COVID-19 prognostic factors (age/sex/ethnicity/socioeconomic status/smoking/physical activity/BMI/systolic blood pressure/renal function). 4,498 (1.05%) participants were tested; 1,324 (0.31%) tested positive for COVID-19. Compared with no LTCs, relative risk (RR) of COVID-19 in those with 1 LTC was no higher (RR 1.12 (CI 0.96-1.30)), whereas those with ≥2 LTCs had 48% higher risk; RR 1.48 (1.28-1.71). Compared with no cardiometabolic LTCs, having 1 and ≥2 cardiometabolic LTCs had a higher risk of COVID-19; RR 1.28 (1.12-1.46) and 1.77 (1.46-2.15), respectively. Polypharmacy was associated with a dose response higher risk of COVID-19. All prognostic factors were associated with a higher risk of COVID-19 infection in multimorbidity; being non-white, most socioeconomically deprived, BMI ≥40 kg/m2, and reduced renal function were associated with the highest risk of COVID-19 infection: RR 2.81 (2.09-3.78); 2.79 (2.00-3.90); 2.66 (1.88-3.76); 2.13 (1.46-3.12), respectively. No multiplicative interaction between multimorbidity and prognostic factors was identified. Important limitations include the low proportion of UK Biobank participants with COVID-19 test data (1.05%) and UK Biobank participants being more affluent, healthier and less ethnically diverse than the general population.</p>
CONCLUSIONS: Increasing multimorbidity, especially cardiometabolic multimorbidity, and polypharmacy are associated with a higher risk of developing COVID-19. Those with multimorbidity and additional factors, such as non-white ethnicity, are at heightened risk of COVID-19.</p>
25 Keywords
- Adult
- Aged
- Aged, 80 and over
- Betacoronavirus
- Biological Specimen Banks
- COVID-19
- Coronavirus Infections
- Ethnicity
- Female
- Health Status
- Humans
- Longitudinal Studies
- Male
- Middle Aged
- Multimorbidity
- Pandemics
- Pneumonia, Viral
- Polypharmacy
- Prevalence
- Prognosis
- Prospective Studies
- Risk Factors
- SARS-CoV-2
- Self Report
- United Kingdom
15 Authors
- Ross McQueenie
- Hamish M. E. Foster
- Bhautesh D. Jani
- Srinivasa Vittal Katikireddi
- Naveed Sattar
- Jill P. Pell
- Frederick K. Ho
- Claire L. Niedzwiedz
- Claire E. Hastie
- Jana Anderson
- Patrick B. Mark
- Michael Sullivan
- Catherine A. O'Donnell
- Frances S. Mair
- Barbara I. Nicholl
1 Application
| Application ID | Title |
|---|---|
| 14151 | Exploring multimorbidity in UK Biobank ? patterns of illness reporting and effects of comorbidity and multimorbidity on health outcomes |
Enabling scientific discoveries that improve human health