Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.09.07.20189621; this version posted March 4, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission. COVID-19 in patients with hepatobiliary and pancreatic diseases: A single-centre cross-sectional study in East London Abu Z M Dayem Ullah, UKRI/Rutherford research fellow1 2, Lavanya Sivapalan, PhD student1, Hemant M Kocher, professor of liver and pancreas surgery1 3, Claude Chelala, professor of bioinformatics1 Author affiliations 1 Centre for Cancer Biomarkers and Therapeutics, Barts Cancer Institute, Queen Mary University of London, London, UK 2 Barts and the London HPB Centre, The Royal London Hospital, Barts Health NHS Trust, London, UK 3 Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, London, UK Correspondence to: Abu Z M Dayem Ullah Centre for Cancer Biomarkers and Therapeutics, Barts Cancer Institute, Queen Mary University of London, London EC1M 6BQ, UK Email: d.ullah@qmul.ac.uk 1 NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2020.09.07.20189621; this version posted March 4, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission. 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 NHS 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 six 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 an 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 mis-users were at more risk of infection, so were patients on Vitamin D treatment. The higher odds ratios in patients with chronic pancreatic or mild liver conditions, age>70, and history of smoking or obesity were due to co-existing 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 HPB patients, men, Black ethnicity, pre-existing moderate to severe liver conditions, six common medical multimorbidities, substance mis-use, and a history..