Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19

Eilidh Bruce; Ben Carter; Terence J Quinn; Alessia  Verduri; Oliver  Pearson; Arturo Vilches-Moraga; Angeline Price; Aine McGovern; Louis A Evans; Kathryn McCarthy; Jonathan Hewitt; Susan Moug; Phyo Kyaw Myint; COPE Study Team

doi:10.1093/eurpub/ckab085

Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19

Eilidh Bruce, Ben Carter, Terence J Quinn, Alessia Verduri, Oliver Pearson, Arturo Vilches-Moraga, Angeline Price, Aine McGovern, Louis A Evans, Kathryn McCarthy, Jonathan Hewitt, Susan Moug, Phyo Kyaw Myint^* (Corresponding Author), COPE Study Team

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background
In response to the COVID-19 pandemic, many countries mandated staying at home to reduce transmission. This study examined the association between living arrangements (house occupancy numbers) and outcomes in COVID-19.

Methods
Study population was drawn from the COPE Study, a multicentre cohort study. House occupancy was defined as: living alone; living with one other person; living with multiple other people; or living in a nursing/residential home. Outcomes were time from admission to mortality and discharge (Cox regression), and Day-28 mortality (logistic regression), analyses were adjusted for key comorbidities and covariates including admission: age; sex, smoking; heart failure; admission CRP; COPD; eGFR, frailty and others.

Results
1584 patients were included from 13 hospitals across UK and Italy: 676 (42.7%) were female, 907 (57.3%) were male, median age was 74 years (range: 19-101). At 28 days, 502 (31.7%) had died. Median admission CRP was 67, 82, 79.5 and 83mg/L for those living alone, with someone else, in a house of multiple occupancy and in a nursing/residential home, respectively. Compared to living alone, living with anyone was associated with increased mortality: within a couple (aHR 1.39, 95%CI 1.09-1.77, p = 0.007); living in a house of multiple occupancy (aHR=1.67, 95%CI 1.17-2.38, p = 0.005); and living in a residential home (aHR=1.36, 95%CI 1.03-1.80, p = 0.031).

Conclusion
For patients hospitalised with COVID-19, those living with one or more people had an increased association with mortality, they also exhibited higher CRP indicating increased disease severity suggesting they delayed seeking care.

Original language	English
Article number	ckab085
Pages (from-to)	133–139
Number of pages	7
Journal	European Journal of Public Health
Volume	32
Issue number	1
Early online date	17 May 2021
DOIs	https://doi.org/10.1093/eurpub/ckab085
Publication status	Published - 1 Feb 2022

Bibliographical note

Acknowledgement
We acknowledge the dedication, commitment, and sacrifice of the staff from participating centres across UK and Italy, two amongst the most severely affected countries in Europe. We gratefully acknowledge the contribution of our collaborators, National Institute of Health Research (NIHR) Health Research Authority (HRA) in the UK and Ethics Committee of Policlinico Hospital Modena, which provided rapid approval of COPE study and respective Institutions’ Research and Development Offices and Caldicott Guardians for their assistance
and guidance. We also thank COPE Study Sponsor, Cardiff University, Wales, UK.

Keywords

Covid-19
Coronavirus
Multiple House Occupancy

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10.1093/eurpub/ckab085Licence: CC BY

Bruce_etal_EJPH_Multiple_House_Occupancy_VoR
© The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Final published version, 352 KBLicence: CC BY

Cite this

Bruce, E., Carter, B., Quinn, T. J., Verduri, A., Pearson, O., Vilches-Moraga, A., Price, A., McGovern, A., Evans, L. A., McCarthy, K., Hewitt, J., Moug, S., Myint, P. K., & COPE Study Team (2022). Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19. European Journal of Public Health, 32(1), 133–139. Article ckab085. https://doi.org/10.1093/eurpub/ckab085

Bruce, E, Carter, B, Quinn, TJ, Verduri, A, Pearson, O, Vilches-Moraga, A, Price, A, McGovern, A, Evans, LA, McCarthy, K, Hewitt, J, Moug, S, Myint, PK & COPE Study Team 2022, 'Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19', European Journal of Public Health, vol. 32, no. 1, ckab085, pp. 133–139. https://doi.org/10.1093/eurpub/ckab085

@article{b1fd39dd5623401da16ea58cce042c65,

title = "Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19",

abstract = "BackgroundIn response to the COVID-19 pandemic, many countries mandated staying at home to reduce transmission. This study examined the association between living arrangements (house occupancy numbers) and outcomes in COVID-19.MethodsStudy population was drawn from the COPE Study, a multicentre cohort study. House occupancy was defined as: living alone; living with one other person; living with multiple other people; or living in a nursing/residential home. Outcomes were time from admission to mortality and discharge (Cox regression), and Day-28 mortality (logistic regression), analyses were adjusted for key comorbidities and covariates including admission: age; sex, smoking; heart failure; admission CRP; COPD; eGFR, frailty and others.Results1584 patients were included from 13 hospitals across UK and Italy: 676 (42.7%) were female, 907 (57.3%) were male, median age was 74 years (range: 19-101). At 28 days, 502 (31.7%) had died. Median admission CRP was 67, 82, 79.5 and 83mg/L for those living alone, with someone else, in a house of multiple occupancy and in a nursing/residential home, respectively. Compared to living alone, living with anyone was associated with increased mortality: within a couple (aHR 1.39, 95%CI 1.09-1.77, p = 0.007); living in a house of multiple occupancy (aHR=1.67, 95%CI 1.17-2.38, p = 0.005); and living in a residential home (aHR=1.36, 95%CI 1.03-1.80, p = 0.031).ConclusionFor patients hospitalised with COVID-19, those living with one or more people had an increased association with mortality, they also exhibited higher CRP indicating increased disease severity suggesting they delayed seeking care.",

keywords = "Covid-19, Coronavirus, Multiple House Occupancy",

author = "Eilidh Bruce and Ben Carter and Quinn, {Terence J} and Alessia Verduri and Oliver Pearson and Arturo Vilches-Moraga and Angeline Price and Aine McGovern and Evans, {Louis A} and Kathryn McCarthy and Jonathan Hewitt and Susan Moug and Myint, {Phyo Kyaw} and {COPE Study Team}",

note = "Acknowledgement We acknowledge the dedication, commitment, and sacrifice of the staff from participating centres across UK and Italy, two amongst the most severely affected countries in Europe. We gratefully acknowledge the contribution of our collaborators, National Institute of Health Research (NIHR) Health Research Authority (HRA) in the UK and Ethics Committee of Policlinico Hospital Modena, which provided rapid approval of COPE study and respective Institutions{\textquoteright} Research and Development Offices and Caldicott Guardians for their assistance and guidance. We also thank COPE Study Sponsor, Cardiff University, Wales, UK.",

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doi = "10.1093/eurpub/ckab085",

language = "English",

volume = "32",

pages = "133–139",

journal = "European Journal of Public Health",

issn = "1101-1262",

publisher = "Oxford University Press",

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TY - JOUR

T1 - Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19

AU - Bruce, Eilidh

AU - Carter, Ben

AU - Quinn, Terence J

AU - Verduri, Alessia

AU - Pearson, Oliver

AU - Vilches-Moraga, Arturo

AU - Price, Angeline

AU - McGovern, Aine

AU - Evans, Louis A

AU - McCarthy, Kathryn

AU - Hewitt, Jonathan

AU - Moug, Susan

AU - Myint, Phyo Kyaw

AU - COPE Study Team

N1 - Acknowledgement We acknowledge the dedication, commitment, and sacrifice of the staff from participating centres across UK and Italy, two amongst the most severely affected countries in Europe. We gratefully acknowledge the contribution of our collaborators, National Institute of Health Research (NIHR) Health Research Authority (HRA) in the UK and Ethics Committee of Policlinico Hospital Modena, which provided rapid approval of COPE study and respective Institutions’ Research and Development Offices and Caldicott Guardians for their assistance and guidance. We also thank COPE Study Sponsor, Cardiff University, Wales, UK.

PY - 2022/2/1

Y1 - 2022/2/1

N2 - BackgroundIn response to the COVID-19 pandemic, many countries mandated staying at home to reduce transmission. This study examined the association between living arrangements (house occupancy numbers) and outcomes in COVID-19.MethodsStudy population was drawn from the COPE Study, a multicentre cohort study. House occupancy was defined as: living alone; living with one other person; living with multiple other people; or living in a nursing/residential home. Outcomes were time from admission to mortality and discharge (Cox regression), and Day-28 mortality (logistic regression), analyses were adjusted for key comorbidities and covariates including admission: age; sex, smoking; heart failure; admission CRP; COPD; eGFR, frailty and others.Results1584 patients were included from 13 hospitals across UK and Italy: 676 (42.7%) were female, 907 (57.3%) were male, median age was 74 years (range: 19-101). At 28 days, 502 (31.7%) had died. Median admission CRP was 67, 82, 79.5 and 83mg/L for those living alone, with someone else, in a house of multiple occupancy and in a nursing/residential home, respectively. Compared to living alone, living with anyone was associated with increased mortality: within a couple (aHR 1.39, 95%CI 1.09-1.77, p = 0.007); living in a house of multiple occupancy (aHR=1.67, 95%CI 1.17-2.38, p = 0.005); and living in a residential home (aHR=1.36, 95%CI 1.03-1.80, p = 0.031).ConclusionFor patients hospitalised with COVID-19, those living with one or more people had an increased association with mortality, they also exhibited higher CRP indicating increased disease severity suggesting they delayed seeking care.

AB - BackgroundIn response to the COVID-19 pandemic, many countries mandated staying at home to reduce transmission. This study examined the association between living arrangements (house occupancy numbers) and outcomes in COVID-19.MethodsStudy population was drawn from the COPE Study, a multicentre cohort study. House occupancy was defined as: living alone; living with one other person; living with multiple other people; or living in a nursing/residential home. Outcomes were time from admission to mortality and discharge (Cox regression), and Day-28 mortality (logistic regression), analyses were adjusted for key comorbidities and covariates including admission: age; sex, smoking; heart failure; admission CRP; COPD; eGFR, frailty and others.Results1584 patients were included from 13 hospitals across UK and Italy: 676 (42.7%) were female, 907 (57.3%) were male, median age was 74 years (range: 19-101). At 28 days, 502 (31.7%) had died. Median admission CRP was 67, 82, 79.5 and 83mg/L for those living alone, with someone else, in a house of multiple occupancy and in a nursing/residential home, respectively. Compared to living alone, living with anyone was associated with increased mortality: within a couple (aHR 1.39, 95%CI 1.09-1.77, p = 0.007); living in a house of multiple occupancy (aHR=1.67, 95%CI 1.17-2.38, p = 0.005); and living in a residential home (aHR=1.36, 95%CI 1.03-1.80, p = 0.031).ConclusionFor patients hospitalised with COVID-19, those living with one or more people had an increased association with mortality, they also exhibited higher CRP indicating increased disease severity suggesting they delayed seeking care.

KW - Covid-19

KW - Coronavirus

KW - Multiple House Occupancy

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DO - 10.1093/eurpub/ckab085

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JO - European Journal of Public Health

JF - European Journal of Public Health

IS - 1

M1 - ckab085

ER -

Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19

Abstract

Bibliographical note

Keywords

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