COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London. Issue 4 (19th April 2021)

• Record Type: Journal Article
• Authors: Dayem Ullah, Abu Z M; Sivapalan, Lavanya; Kocher, Hemant M; Chelala, Claude
• Is Part Of: BMJ open. Volume 11:Issue 4(2021)
• Publication Date: 2021-04-19
• Subjects: hepatobiliary disease -- pancreatic disease -- COVID-19; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-045077
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : 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.