'Age, male sex, underlying illness validated as risk factors for death due to COVID-19'

London, May 24: Age, male sex, and underlying illnesses like diabetes have emerged as risk factors for death due to novel coronavirus infection, according to a large cohort study which can help health professionals learn more about how the COVID-19 illness progresses.

According to the study, published in the BMJ, the risk of death increases in people above the age of 50, as does being being male, obese, or having underlying heart, lung, liver and kidney disease.

In this largest prospective observational study reported to date, the scientists, including those from the University of Liverpool in the UK, noted the characteristics of patients hospitalised in the UK with COVID-19, and their outcomes. At the time of publishing the study, the scientists said the study had recruited over 43,000 patients.

While earlier studies had reported the risk factors associated with severe COVID-19 based on reports from China, the researchers said an understanding of features of patients in other parts of the world are lacking.

To address this knowledge gap, the scientists said they analysed data from 20,133 patients with COVID-19 admitted to 208 acute care hospitals in England, Wales, and Scotland between 6 February and 19 April 2020. This data, they said, represents around a third of all patients admitted to hospital with COVID-19 in the UK at the time of publishing the study. The patients, according to the researchers, had an average age of 73 years, with more men admitted to hospitals than women.

Besides age, and underlying heart, lung, liver and kidney disease, the study noted that factors already known to cause poor outcomes like obesity and gender were key factors associated with higher risk of death in hospital. The scientists said the outcomes were poorer for those requiring mechanical ventilation.

In this category, they said 37 per cent of the patients had died, and 17 per cent had been discharged alive, while 46 per cent remained in hospital. According to the scientists, reduced lung function or inflammation associated with obesity may play a role in morbidity due to COVID-19. But since the study was only observational, they cautioned that a cause cannot be established.

"Our study identifies sectors of the population that are at greatest risk of a poor outcome, and shows the importance of forward planning and investment in preparedness studies," the scientists wrote in the study. They said the results have been shared with the World Health Organisation, and are being compared with data from other countries around the world. If countries are going to be managing COVID-19 for the next several years, the researchers said "we need to understand and optimise care before, during, and beyond the hospital."