COVID-19 in patients with hepatobiliary and pancreatic diseases in East London: a single-centre cohort study
Ullah et al.,
COVID-19 in patients with hepatobiliary and pancreatic diseases in East London: a single-centre cohort study,
Pancreatology, doi:10.1016/j.pan.2020.10.005
Retrospective 15,440 patients with hepatobiliary and pancreatic diseases in the United Kingdom, 226 with confirmed COVID-19, showing higher risk with vitamin D supplementation. Results are likely confounded by impaired vitamin D processing and propensity to prescribe supplementation based on specifics of each patient's disease and vitamin D levels. Adjustments used broad age ranges, likely adding to residual confounding.
This study is excluded in the after exclusion results of meta
analysis:
significant unadjusted confounding possible.
risk of death, 42.1% higher, RR 1.42, p = 0.34, treatment 21 of 64 (32.8%), control 26 of 135 (19.3%), adjusted per study, odds ratio converted to relative risk.
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risk of case, 146.0% higher, RR 2.46, p < 0.001, treatment 69 of 2,168 (3.2%), control 139 of 12,681 (1.1%), adjusted per study, odds ratio converted to relative risk.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Ullah et al., 4 Mar 2021, retrospective, United Kingdom, peer-reviewed, 3 authors, dosage not specified.
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(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.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..
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