tetano
Editor, Senior Moderator
BMJ
. 2021 Mar 18;372:n628.
doi: 10.1136/bmj.n628.
Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England
Harriet Forbes[SUP] 1 [/SUP], Caroline E Morton[SUP] 2 [/SUP], Seb Bacon[SUP] 2 [/SUP], Helen I McDonald[SUP] 1 [/SUP], Caroline Minassian[SUP] 1 [/SUP], Jeremy P Brown[SUP] 1 [/SUP], Christopher T Rentsch[SUP] 1 [/SUP], Rohini Mathur[SUP] 1 [/SUP], Anna Schultze[SUP] 1 [/SUP], Nicholas J DeVito[SUP] 2 [/SUP], Brian MacKenna[SUP] 2 [/SUP], William J Hulme[SUP] 2 [/SUP], Richard Croker[SUP] 2 [/SUP], Alex J Walker[SUP] 2 [/SUP], Elizabeth J Williamson[SUP] 1 [/SUP], Chris Bates[SUP] 3 [/SUP], Amir Mehrkar[SUP] 2 [/SUP], Helen J Curtis[SUP] 2 [/SUP], David Evans[SUP] 2 [/SUP], Kevin Wing[SUP] 1 [/SUP], Peter Inglesby[SUP] 2 [/SUP], Henry Drysdale[SUP] 2 [/SUP], Angel Y S Wong[SUP] 1 [/SUP], Jonathan Cockburn[SUP] 3 [/SUP], Robert McManus[SUP] 3 [/SUP], John Parry[SUP] 3 [/SUP], Frank Hester[SUP] 3 [/SUP], Sam Harper[SUP] 3 [/SUP], Ian J Douglas[SUP] 1 [/SUP], Liam Smeeth[SUP] 1 [/SUP], Stephen J W Evans[SUP] 1 [/SUP], Krishnan Bhaskaran[SUP] 1 [/SUP], Rosalind M Eggo[SUP] 1 4 [/SUP], Ben Goldacre[SUP] 2 [/SUP], Laurie A Tomlinson[SUP] 1 [/SUP]
Affiliations
Abstract
Objective: To investigate whether risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and outcomes of coronavirus disease 2019 (covid-19) differed between adults living with and without children during the first two waves of the UK pandemic.
Design: Population based cohort study, on behalf of NHS England.
Setting: Primary care data and pseudonymously linked hospital and intensive care admissions and death records from England, during wave 1 (1 February to 31 August 2020) and wave 2 (1 September to 18 December 2020).
Participants: Two cohorts of adults (18 years and over) registered at a general practice on 1 February 2020 and 1 September 2020.
Main outcome measures: Adjusted hazard ratios for SARS-CoV-2 infection, covid-19 related admission to hospital or intensive care, or death from covid-19, by presence of children in the household.
Results: Among 9 334 392adults aged 65 years and under, during wave 1, living with children was not associated with materially increased risks of recorded SARS-CoV-2 infection, covid-19 related hospital or intensive care admission, or death from covid-19. In wave 2, among adults aged 65 years and under, living with children of any age was associated with an increased risk of recorded SARS-CoV-2 infection (hazard ratio 1.06 (95% confidence interval 1.05 to 1.08) for living with children aged 0-11 years; 1.22 (1.20 to 1.24) for living with children aged 12-18 years) and covid-19 related hospital admission (1.18 (1.06 to 1.31) for living with children aged 0-11; 1.26 (1.12 to 1.40) for living with children aged 12-18). Living with children aged 0-11 was associated with reduced risk of death from both covid-19 and non-covid-19 causes in both waves; living with children of any age was also associated with lower risk of dying from non-covid-19 causes. For adults 65 years and under during wave 2, living with children aged 0-11 years was associated with an increased absolute risk of having SARS-CoV-2 infection recorded of 40-60 per 10 000 people, from 810 to between 850 and 870, and an increase in the number of hospital admissions of 1-5 per 10 000 people, from 160 to between 161 and 165. Living with children aged 12-18 years was associated with an increase of 160-190 per 10 000 in the number of SARS-CoV-2 infections and an increase of 2-6 per 10 000 in the number of hospital admissions.
Conclusions: In contrast to wave 1, evidence existed of increased risk of reported SARS-CoV-2 infection and covid-19 outcomes among adults living with children during wave 2. However, this did not translate into a materially increased risk of covid-19 mortality, and absolute increases in risk were small.
. 2021 Mar 18;372:n628.
doi: 10.1136/bmj.n628.
Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England
Harriet Forbes[SUP] 1 [/SUP], Caroline E Morton[SUP] 2 [/SUP], Seb Bacon[SUP] 2 [/SUP], Helen I McDonald[SUP] 1 [/SUP], Caroline Minassian[SUP] 1 [/SUP], Jeremy P Brown[SUP] 1 [/SUP], Christopher T Rentsch[SUP] 1 [/SUP], Rohini Mathur[SUP] 1 [/SUP], Anna Schultze[SUP] 1 [/SUP], Nicholas J DeVito[SUP] 2 [/SUP], Brian MacKenna[SUP] 2 [/SUP], William J Hulme[SUP] 2 [/SUP], Richard Croker[SUP] 2 [/SUP], Alex J Walker[SUP] 2 [/SUP], Elizabeth J Williamson[SUP] 1 [/SUP], Chris Bates[SUP] 3 [/SUP], Amir Mehrkar[SUP] 2 [/SUP], Helen J Curtis[SUP] 2 [/SUP], David Evans[SUP] 2 [/SUP], Kevin Wing[SUP] 1 [/SUP], Peter Inglesby[SUP] 2 [/SUP], Henry Drysdale[SUP] 2 [/SUP], Angel Y S Wong[SUP] 1 [/SUP], Jonathan Cockburn[SUP] 3 [/SUP], Robert McManus[SUP] 3 [/SUP], John Parry[SUP] 3 [/SUP], Frank Hester[SUP] 3 [/SUP], Sam Harper[SUP] 3 [/SUP], Ian J Douglas[SUP] 1 [/SUP], Liam Smeeth[SUP] 1 [/SUP], Stephen J W Evans[SUP] 1 [/SUP], Krishnan Bhaskaran[SUP] 1 [/SUP], Rosalind M Eggo[SUP] 1 4 [/SUP], Ben Goldacre[SUP] 2 [/SUP], Laurie A Tomlinson[SUP] 1 [/SUP]
Affiliations
- PMID: 33737413
- DOI: 10.1136/bmj.n628
Abstract
Objective: To investigate whether risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and outcomes of coronavirus disease 2019 (covid-19) differed between adults living with and without children during the first two waves of the UK pandemic.
Design: Population based cohort study, on behalf of NHS England.
Setting: Primary care data and pseudonymously linked hospital and intensive care admissions and death records from England, during wave 1 (1 February to 31 August 2020) and wave 2 (1 September to 18 December 2020).
Participants: Two cohorts of adults (18 years and over) registered at a general practice on 1 February 2020 and 1 September 2020.
Main outcome measures: Adjusted hazard ratios for SARS-CoV-2 infection, covid-19 related admission to hospital or intensive care, or death from covid-19, by presence of children in the household.
Results: Among 9 334 392adults aged 65 years and under, during wave 1, living with children was not associated with materially increased risks of recorded SARS-CoV-2 infection, covid-19 related hospital or intensive care admission, or death from covid-19. In wave 2, among adults aged 65 years and under, living with children of any age was associated with an increased risk of recorded SARS-CoV-2 infection (hazard ratio 1.06 (95% confidence interval 1.05 to 1.08) for living with children aged 0-11 years; 1.22 (1.20 to 1.24) for living with children aged 12-18 years) and covid-19 related hospital admission (1.18 (1.06 to 1.31) for living with children aged 0-11; 1.26 (1.12 to 1.40) for living with children aged 12-18). Living with children aged 0-11 was associated with reduced risk of death from both covid-19 and non-covid-19 causes in both waves; living with children of any age was also associated with lower risk of dying from non-covid-19 causes. For adults 65 years and under during wave 2, living with children aged 0-11 years was associated with an increased absolute risk of having SARS-CoV-2 infection recorded of 40-60 per 10 000 people, from 810 to between 850 and 870, and an increase in the number of hospital admissions of 1-5 per 10 000 people, from 160 to between 161 and 165. Living with children aged 12-18 years was associated with an increase of 160-190 per 10 000 in the number of SARS-CoV-2 infections and an increase of 2-6 per 10 000 in the number of hospital admissions.
Conclusions: In contrast to wave 1, evidence existed of increased risk of reported SARS-CoV-2 infection and covid-19 outcomes among adults living with children during wave 2. However, this did not translate into a materially increased risk of covid-19 mortality, and absolute increases in risk were small.