Factors associated with COVID-19-related death using OpenSAFELY

Elizabeth J. Williamson, Alex J. Walker, Krishnan Bhaskaran, Seb Bacon, Chris Bates, Caroline E. Morton, Helen J. Curtis, Amir Mehrkar, David Evans, Peter Inglesby, Jonathan Cockburn, Helen I. McDonald, Brian MacKenna, Laurie Tomlinson, Ian J. Douglas, Christopher T. Rentsch, Rohini Mathur, Angel Y. S. Wong, Richard Grieve, David Harrison, Harriet Forbes, Anna Schultze, Richard Croker, John Parry, Frank Hester, Sam Harper, Rafael Perera, Stephen J. W. Evans, Liam Smeeth and Ben Goldacre ()
Additional contact information
Elizabeth J. Williamson: Faculty of Epidemiology and Population Health
Alex J. Walker: University of Oxford
Krishnan Bhaskaran: Faculty of Epidemiology and Population Health
Seb Bacon: University of Oxford
Chris Bates: TPP
Caroline E. Morton: University of Oxford
Helen J. Curtis: University of Oxford
Amir Mehrkar: University of Oxford
David Evans: University of Oxford
Peter Inglesby: University of Oxford
Jonathan Cockburn: TPP
Helen I. McDonald: Faculty of Epidemiology and Population Health
Brian MacKenna: University of Oxford
Laurie Tomlinson: Faculty of Epidemiology and Population Health
Ian J. Douglas: Faculty of Epidemiology and Population Health
Christopher T. Rentsch: Faculty of Epidemiology and Population Health
Rohini Mathur: Faculty of Epidemiology and Population Health
Angel Y. S. Wong: Faculty of Epidemiology and Population Health
Richard Grieve: Faculty of Epidemiology and Population Health
David Harrison: Intensive Care National Audit and Research Centre (ICNARC)
Harriet Forbes: Faculty of Epidemiology and Population Health
Anna Schultze: Faculty of Epidemiology and Population Health
Richard Croker: University of Oxford
John Parry: TPP
Frank Hester: TPP
Sam Harper: TPP
Rafael Perera: University of Oxford
Stephen J. W. Evans: Faculty of Epidemiology and Population Health
Liam Smeeth: Faculty of Epidemiology and Population Health
Ben Goldacre: University of Oxford

Nature, 2020, vol. 584, issue 7821, 430-436

Abstract: Abstract Coronavirus disease 2019 (COVID-19) has rapidly affected mortality worldwide1. There is unprecedented urgency to understand who is most at risk of severe outcomes, and this requires new approaches for the timely analysis of large datasets. Working on behalf of NHS England, we created OpenSAFELY—a secure health analytics platform that covers 40% of all patients in England and holds patient data within the existing data centre of a major vendor of primary care electronic health records. Here we used OpenSAFELY to examine factors associated with COVID-19-related death. Primary care records of 17,278,392 adults were pseudonymously linked to 10,926 COVID-19-related deaths. COVID-19-related death was associated with: being male (hazard ratio (HR) 1.59 (95% confidence interval 1.53–1.65)); greater age and deprivation (both with a strong gradient); diabetes; severe asthma; and various other medical conditions. Compared with people of white ethnicity, Black and South Asian people were at higher risk, even after adjustment for other factors (HR 1.48 (1.29–1.69) and 1.45 (1.32–1.58), respectively). We have quantified a range of clinical factors associated with COVID-19-related death in one of the largest cohort studies on this topic so far. More patient records are rapidly being added to OpenSAFELY, we will update and extend our results regularly.

Date: 2020
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DOI: 10.1038/s41586-020-2521-4

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