Takeaway
- Most COVID-19-related deaths among nonwhite populations are not attributable to existing comorbidities.
- In COVID-19, the association of hypertension with mortality attenuates with age.
Why this matters
- Education about prevention should target vulnerable at-risk populations about factors exacerbating poor COVID-19 outcomes, including smoking and obesity.
Key results
- 17,278,392 adults.
- COVID-19 deaths: 0.06% (10,926).
- Mortality risk factors (adjusted HRs; 95% CIs):
- Age ≥80 vs 50-59 years: 20.61 (18.72-22.70).
- Male sex: 1.59 (1.53-1.65).
- Black African ancestry: 1.48 (1.30-1.69).
- South Asian ancestry: 1.44 (1.32-1.58).
- Most deprived quintile on index of multiple deprivation: 1.80 (1.69-1.91).
- Obesity (BMI >40 kg/m2): 1.92 (1.72-2.13).
- Smoking (adjusted for age, sex, deprivation, ethnicity): 1.07 (0.98-1.18).
- Increased risk (adjusted HRs; 95% CIs) with hypertension persisted to age
- 18 to
- 40 to
- 50 to
- 60 to
- 70 to
- ≥80 years: 0.73 (0.69-0.78).
Study design
- Retrospective analysis of pseudonymously linked National Health Service electronic health records of factors linked to COVID-19-related deaths.
- Funding: None.
Limitations
- Case, mortality misclassifications.
- Limited generalizability.
- Missing ethnicity, obesity, smoking confounders.
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