Background: Hospitalized COVID-19 patients tend to be older and frequently have
hypertension, diabetes or coronary heart disease (CHD), but whether these co-morbidities are
true risk factors (i.e. more common than in the general older population) is unclear. We
estimated associations between pre-existing diagnoses and hospitalized ...
Background: Hospitalized COVID-19 patients tend to be older and frequently have
hypertension, diabetes or coronary heart disease (CHD), but whether these co-morbidities are
true risk factors (i.e. more common than in the general older population) is unclear. We
estimated associations between pre-existing diagnoses and hospitalized COVID-19 alone or
with mortality, in a large community cohort.
Methods: UK Biobank (England) participants with baseline assessment 2006 to 2010,
followed in hospital discharge records to 2017 and death records to 2020. Demographic and
pre-existing common diagnoses association tested with hospitalized laboratory confirmed
COVID-19 (16th March to 26th April 2020), alone or with mortality, in logistic models.
Results: Of 269,070 participants aged 65+, 507 (0.2%) became COVID-19 hospital inpatients,
of which 141 (27.8%) died. Common co-morbidities in hospitalized inpatients were
hypertension (59.6%), history of fall or fragility fractures (29.4%), coronary heart disease
(CHD, 21.5%), type 2 diabetes (type 2, 19. 9%) and asthma (17.6%). However, in models
adjusted for comorbidities, age-group, sex, ethnicity and education, pre-existing diagnoses of
dementia, type 2 diabetes, COPD, pneumonia, depression, atrial fibrillation and hypertension
emerged as independent risk factors for COVID-19 hospitalization, the first five remaining
statistically significant for related mortality. Chronic Kidney Disease and asthma were risk
factors for COVID-19 hospitalization in women but not men.
Conclusion: There are specific high risk pre-existing co-morbidities for COVID-19
hospitalization and related deaths in community based older men and women. These results do
not support simple age-based targeting of the older population to prevent severe COVID-19
infections.
