Factors associated with deaths due to COVID-19 versus other causes

Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform
The Lancet Regional Health - Europe 8 May 2021 https://doi.org/10.1016/j.lanepe.2021.100109

• Analysis of primary care data (England) and death registrations to identify how specific factors are differentially associated with COVID-19 mortality as compared to mortality from causes other than COVID-19. Factors examined included age, sex, deprivation, obesity, some comorbidities, smoking history, cancer, chronic liver disease and ethnicity.

Sociodemographic and lifestyle predictors of incident hospital admissions

Sociodemographic and lifestyle predictors of incident hospital admissions with multimorbidity in a general population, 1999–2019: the EPIC-Norfolk cohort

BMJ Open 2020;10:e042115. doi: 10.1136/bmjopen-2020-042115

• The EPIC-Norfolk studied incident hospital admissions with multimorbidity in 25 014 men and women aged 40–79 in a British prospective population-based study recruited in 1993–1997 and followed up until 2019. Analysis indicates that age, male sex and potentially modifiable lifestyle behaviours including smoking, body mass index, physical inactivity and low fruit and vegetable intake were associated with increased risk of future incident hospital admissions with multimorbidity.

Estimating excess mortality in people with cancer and multimorbidity in the COVID-19 emergency [Preprint]

Estimating excess mortality in people with cancer and multimorbidity in the COVID-19 emergency [Preprint]
ResearchGate accessed 29 April 2020 DOI: 10.13140/RG.2.2.34254.82242

• "The model estimated 6,270 excess deaths at 1 year in England."
• "In England, the proportion of patients with incident cancer with≥1 comorbidity was 65.2%. The number of comorbidities was strongly associated with can-cer mortality risk. "

Read a commentary on this research here:

Deaths in people with cancer could rise by at least 20%
Imperial College Health Data Research Hub for Cancer 29 April 2020

COVID-19 – exploring the implications of long-term condition type and extent of multimorbidity on years of life lost: a modelling study

COVID-19 – exploring the implications of long-term condition type and extent of multimorbidity on years of life lost: a modelling study [preprint, accessed 29 April 2020)
Wellcome Open Res 2020, 5:75, 23 April 2020

• An estimate Years of Life Lost (YLL) attributable to COVID-19, before and after adjustment for number/type of LTCs.
• Conclusion: Deaths from COVID-19 represent a substantial burden in terms of per-person YLL, more than a decade, even after adjusting for the typical number and type of LTCs found in people dying of COVID-19. The extent of multimorbidity heavily influences the estimated YLL at a given age. More comprehensive and standardised collection of data on LTCs is needed to better understand and quantify the global burden of COVID-19 and to guide policy-making and interventions.

Abstract

High-risk multimorbidity patterns on the road to cardiovascular mortality

High-risk multimorbidity patterns on the road to cardiovascular mortality.
BMC Med 18, 44 (10 March 2020). https://doi.org/10.1186/s12916-020-1508-1

• The authors aim to identify decisive events that potentially determine the future disease progression of patients through the age- and sex-specific risks that they will acquire certain sets of diseases in the future depending on their current health state.

Development and validation of the Cambridge Multimorbidity Score

Development and validation of the Cambridge Multimorbidity Score
CMAJ February 03, 2020 192 (5) E107-E114; DOI: https://doi.org/10.1503/cmaj.190757

• Researchers at the NIHR School for Primary Care Research have developed a new score for measuring multiple long-term health conditions in patients in primary care.
• The new Cambridge Multimorbidity Score is a transparent, simple measure of multimorbidity that can predict different outcomes in people with multiple conditions. The score is based on  data obtained from the UK Clinical Practice Research Datalink (CPRD)
• See NIHR news

Rising to the challenge of multimorbidity

Rising to the challenge of multimorbidity
BMJ 2020;368:l6964. 6 January 2020. doi: https://doi.org/10.1136/bmj.l6964

• Written by Christopher J M Whitty, chief medical officer for England among others, this editorial discusses need to move from thinking about multimorbidity as a random assortment of individual conditions to recognising it as a series of largely predictable clusters of disease in the same person and the need to develop clinicians who can deal with patients with multiple diseases.

Modeling the Economic Impact of Interventions for Older Populations with Multimorbidity

Modeling the Economic Impact of Interventions for Older Populations with Multimorbidity: A Method of Linking Multiple Single-Disease Models.
Med Decis Making. 2019;39(7):842-856. doi:10.1177/0272989X19868987

• A proof-of-concept method of modeling multiple conditions in a single decision-analytic model to estimate the impact of multimorbidity on the cost-effectiveness of interventions.

Abstract

Does characterising patterns of multimorbidity in stroke matter for developing collaborative care approaches in primary care?

Does characterising patterns of multimorbidity in stroke matter for developing collaborative care approaches in primary care?
Primary Health Care Research & Development, v20, e110, 16 July 2019

• This article, from researchers at the Universities of Cambridge and Birmingham, argues that it is important to understand (through research) patterns of multimorbidity, including number, common clusters and types of comorbidities, and current interprofessional practice to inform future directions to improve long-term care. 

Abstract

Predicting poorer health outcomes in older community-dwelling patients with multimorbidity:

Predicting poorer health outcomes in older community-dwelling patients with multimorbidity: prospective cohort study assessing the accuracy of different multimorbidity definitions
BMJ Open. 2019; 9(1): e023919. 4 January 2019

• This study compared the accuracy of medication classes count and diagnosis-based multimorbidity measures at higher cut-points to identify older community-dwelling patients who are at risk of poorer health outcomes based on data from 15 GP practices in Ireland. 
• Neither measure demonstrated high sensitivity. However, medication classes count using a definition of 10 or more regular medication classes to define multimorbidity had higher specificity for predicting poorer health outcomes. While having limitations, this definition could be used for proactive identification of patients who may benefit from targeted clinical care.