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.
【저자키워드】 COVID-19, hepatobiliary disease, pancreatic disease, 【초록키워드】 Treatment, Mortality, susceptibility, obesity, Comorbidities, Comorbidity, smoking, risk factor, Electronic health record, Cohort, cross-sectional study, survival, Patient, COVID-19 diagnosis, death, Mild, age, Trust, London, liver, moderate, risk of infection, National Health Service, black people, COVID-19 incidence, black, Participants, outcome measure, participant, severe liver disease, substance, chronic respiratory disease, East, men, objective, setting, Result, significantly, reported, condition, conditions, Increased, odds of infection, higher odd, pancreatic, patients with moderate, respiratory complication, with COVID-19, 【제목키워드】 cross-sectional, London, East, COVID-19 in patient, pancreatic,