Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, SW7 2AZ, UK.
Department of Primary Care and Public Health, Imperial College London, London, W6 8RP, UK.
Nat Commun. 2022 Apr 29;13(1):2356. doi: 10.1038/s41467-022-29880-7.
The Covid-19 mortality rate varies between countries and over time but the extent to which this is explained by the underlying risk in those infected is unclear. Using data on all adults in England with a positive Covid-19 test between 1st October 2020 and 30th April 2021 linked to clinical records, we examined trends and risk factors for hospital admission and mortality. Of 2,311,282 people included in the study, 164,046 (7.1%) were admitted and 53,156 (2.3%) died within 28 days of a positive Covid-19 test. We found significant variation in the case hospitalisation and mortality risk over time, which remained after accounting for the underlying risk of those infected. Older age groups, males, those resident in areas of greater socioeconomic deprivation, and those with obesity had higher odds of admission and death. People with severe mental illness and learning disability had the highest odds of admission and death. Our findings highlight both the role of external factors in Covid-19 admission and mortality risk and the need for more proactive care in the most vulnerable groups.
新冠死亡率在不同国家和不同时期有所差异，但感染人群的潜在风险在多大程度上对此有所解释尚不清楚。利用 2020 年 10 月 1 日至 2021 年 4 月 30 日期间英格兰所有新冠检测呈阳性并与临床记录相关联的成年人数据，我们研究了住院和死亡的趋势及风险因素。在纳入研究的 2311282 人中，164046 人（7.1%）在新冠检测呈阳性后 28 天内住院，53156 人（2.3%）死亡。我们发现，随着时间的推移，病例住院和死亡风险存在显著差异，在考虑了感染人群的潜在风险后，这种差异仍然存在。年龄较大的人群、男性、社会经济剥夺程度较高地区的居民以及肥胖人群住院和死亡的几率更高。患有严重精神疾病和学习障碍的人群住院和死亡的几率最高。我们的研究结果既强调了外部因素在新冠住院和死亡风险中的作用，也凸显了在最脆弱群体中需要更积极主动的护理。
