Excess mortality in the first COVID pandemic peak: cross-sectional analyses of the impact of age, sex, ethnicity, household size, and long-term conditions in people of known SARS-CoV-2 status in England
Open Access
- 19 October 2020
- journal article
- research article
- Published by Royal College of General Practitioners in British Journal of General Practice
- Vol. 70 (701), e890-e898
- https://doi.org/10.3399/bjgp20x713393
Abstract
Background The SARS-CoV-2 pandemic has passed its first peak in Europe. Aim To describe the mortality in England and its association with SARS-CoV-2 status and other demographic and risk factors. Design and setting Cross-sectional analyses of people with known SARS-CoV-2 status in the Oxford RCGP Research and Surveillance Centre (RSC) sentinel network. Method Pseudonymised, coded clinical data were uploaded from volunteer general practice members of this nationally representative network ( n = 4 413 734). All-cause mortality was compared with national rates for 2019, using a relative survival model, reporting relative hazard ratios (RHR), and 95% confidence intervals (CI). A multivariable adjusted odds ratios (OR) analysis was conducted for those with known SARS-CoV-2 status ( n = 56 628, 1.3%) including multiple imputation and inverse probability analysis, and a complete cases sensitivity analysis. Results Mortality peaked in week 16. People living in households of ≥9 had a fivefold increase in relative mortality (RHR = 5.1, 95% CI = 4.87 to 5.31, PPPP = 0.0056) had higher odds of mortality. Conclusion The first SARS-CoV-2 peak in England has been associated with excess mortality. Planning for subsequent peaks needs to better manage risk in males, those of black ethnicity, older people, people with learning disabilities, and people who live in multi-occupancy dwellings.This publication has 29 references indexed in Scilit:
- Significant spike in excess mortality in England in winter 2014/15 – influenza the likely culpritEpidemiology and Infection, 2018
- An ontological approach to identifying cases of chronic kidney disease from routine primary care data: a cross-sectional studyBMC Nephrology, 2018
- RCGP Research and Surveillance Centre: 50 years’ surveillance of influenza, infections, and respiratory conditionsBritish Journal of General Practice, 2017
- Ethnicity Recording in Primary Care Computerised Medical Record Systems: An Ontological ApproachJournal of Innovation in Health Informatics, 2017
- Royal College of General Practitioners Research and Surveillance Centre (RCGP RSC) sentinel network: a cohort profileBMJ Open, 2016
- REALCOM-IMPUTESoftware for Multilevel Multiple Imputation with Mixed Response TypesJournal of Statistical Software, 2011
- Complex SurveysPublished by Wiley ,2010
- The index of multiple deprivation 2000 access domain: a useful indicator for public health?Social Science & Medicine (1982), 2005
- An Individual Measure of Relative SurvivalJournal of the Royal Statistical Society Series C: Applied Statistics, 2004
- Non-parametric comparison of relative versus cause-specific survival in Surveillance, Epidemiology and End Results (SEER) programme breast cancer patientsStatistical Methods in Medical Research, 2001