What factors increase risk of severe COVID-19 or death?

A UK study has revealed that age, male sex, obesity and underlying illness emerge as risk factors for severe COVID-19 or death.

Findings from an ongoing study published by The BMJ have revealed that being over 50, male, obese or having underlying heart, lung, liver and kidney disease increases a person’s chance of dying from COVID-19

Reported to be the largest prospective observational study reported worldwide to date — with more than 43,000 patients currently recruited — the findings provide a comprehensive picture of the characteristics of patients hospitalised in the UK with COVID-19 and their outcomes.

The researchers hope that the findings will help health professionals learn more about how the illness progresses and enable data from the UK to be compared with that of other countries.

Studies in China have reported risk factors associated with severe COVID-19, but studies from Europe are lacking. To address this knowledge gap, the team of UK researchers analysed data from 20,133 patients with COVID-19 admitted to 208 acute-care hospitals in England, Wales and Scotland between 6 February and 19 April 2020. This represents around a third of all patients admitted to hospital with COVID-19 in the UK.

The average age of patients in the study was 73 years, and more men (12,068; 60%) were admitted to hospital than women (8065; 40%).

Besides increasing age and underlying heart, lung, liver and kidney disease — factors already known to cause poor outcomes — the researchers found that obesity and sex were key factors associated with the need for higher levels of care and higher risk of death in hospital.

At the time of publication, just over one-quarter (26%) of all COVID-19 patients in hospital had died; 54% were discharged alive; and a third (34%) remained in hospital. Outcomes were poorer for those requiring mechanical ventilation: 37% had died, 17% had been discharged alive and 46% remained in hospital.

The researchers noted that the observed pattern of disease broadly reflects the pattern reported globally; however, obesity is a major additional risk factor that was not highlighted in data from China. They suspect that reduced lung function or inflammation associated with obesity may play a role.

The study found that severe COVID-19 leads to prolonged hospital stays and a high mortality rate.

“Our study identifies sectors of the population that are at greatest risk of a poor outcome, and shows the importance of forward planning and investment in preparedness studies,” the researchers wrote.

Image credit: ©stock.adobe.com/au/Georgiy