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Factors associated with Covid-19 deaths in records of 17M adult NHS patients

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Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#51

Post by excalibur »

ip26 wrote: post #41
mindviews wrote: post #26

Here's a link to the paper: https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v... This is interesting data. I want to see Vitamin D status included in a large population study like this because I've been following two smaller studies covering about a thousand cases total that shows Vitamin D deficiency has a risk ratio of 10 to 20 (more even than being age 80+ in the above study). The studies: [1] https://p…

The critical question remains though- is vitamin D the causal factor, or instead an indicator of something else?

Sun exposure is far more likely to be the causal factor.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#52

Post by ashtonkem »

mindviews wrote: post #26

Here's a link to the paper: https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v... This is interesting data. I want to see Vitamin D status included in a large population study like this because I've been following two smaller studies covering about a thousand cases total that shows Vitamin D deficiency has a risk ratio of 10 to 20 (more even than being age 80+ in the above study). The studies: [1] https://p…

Two takeaways.

[2] is pretty scary. As a 30 year old I know that my chance of death is low, but I’d like to avoid a “severe” or “critical” case. There are a large number of unpleasant states between “fine” and “dead” that I’d like to not experience. A 50/50 chance of it being no big deal are worse odds than I’d prefer.

[1] is sending me back out onto the patio this weekend for tanning.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#53

Post by supernova87a »

The title / headline is overstating it a little. The sample only contains 5,683 people who died of the virus. The 17M is the sample of hospital patients in general. I don't know if this is on purpose, but it makes the study sound artificially more significant. Every study could claim the "17M" figure by this practice.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#55

Post by slg »

ip26 wrote: post #41
mindviews wrote: post #26

Here's a link to the paper: https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v... This is interesting data. I want to see Vitamin D status included in a large population study like this because I've been following two smaller studies covering about a thousand cases total that shows Vitamin D deficiency has a risk ratio of 10 to 20 (more even than being age 80+ in the above study). The studies: [1] https://p…

The critical question remains though- is vitamin D the causal factor, or instead an indicator of something else?

I agree, we need better evidence on all the vitamin D claims. Comparing rich white people in the suburbs who have lots of open land to get sun and use for exercise versus poorer darker skinned people in dense inner city apartments who spend most of their time inside introduces numerous confound factors that will be highly correlated with vitamin D.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#56

Post by smt88 »

It seems like a lot of people are interpreting this data as causal. I've already had people tell me they were surprised to learn that smoking protects against Covid!

Here's a fantastic explanation of why you should not let your brain tell you that you're learning about things that cause Covid complications and death:

https://twitter.com/EpiEllie/status/1258607277357006849

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#57

Post by arethuza »

TuringNYC wrote: post #33
lettergram wrote: post #19

I think one of the key takeaways is in the abstract: > People from Asian and black groups are at markedly increased risk of in-hospital death from COVID-19, and contrary to some prior speculation is only partially attributable to pre-existing clinical risk factors or deprivation

>> is only partially attributable to pre-existing clinical risk factors or deprivation I'd expect more it is attributable to less access to premium healthcare (remember, in the UK everyone gets healthcare, but not everyone gets privately-sponsored add-on healthcare)

Private healthcare providers in the UK don't seem to be providing hospital treatment for COVID-19 - this is left to the NHS, BUPA says:

"As a public health emergency, COVID-19 is being treated through the public health system."

https://www.bupa.co.uk/coronavirus/health-insurance

Not that private healthcare providers are actually providing resources to the NHS so its possible that you could end up in a private hospital even though you don't have private health insurance.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#58

Post by tluyben2 »

xhedley wrote: post #43
TuringNYC wrote: post #33

Earlier quoted context omitted.

>> is only partially attributable to pre-existing clinical risk factors or deprivation I'd expect more it is attributable to less access to premium healthcare (remember, in the UK everyone gets healthcare, but not everyone gets privately-sponsored add-on healthcare)

UK privately-sponsored healthcare specialises in things that you cannot get free from the National Health Service or things where the wait time is long - for example knee surgery. People don’t use private healthcare for emergencies or intensive care. For example the prime minister was in intensive care in April - in an NHS hospital.

Same in countries with public healthcare in the EU; when you have an emergency, you end up in public healthcare (which, in the countries I have lived in, is excellent), when you have a knee or hip operation, you benefit from private if you have it.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#59

Post by tom_mellior »

smt88 wrote: post #56

It seems like a lot of people are interpreting this data as causal. I've already had people tell me they were surprised to learn that smoking protects against Covid! Here's a fantastic explanation of why you should not let your brain tell you that you're learning about things that cause Covid complications and death: https://twitter.com/EpiEllie/status/1258607277357006849

The thread is good, but a possible link with nicotine has been observed before. This might just be the unlikely case where smoking does indirectly confer some health benefit.

Re: Factors associated with Covid-19 deaths in records of 17M adult NHS patients

#60

Post by neilwilson »

MontagFTB wrote: post #10

From the paper: > The overall cumulative incidence of COVID-19 hospital death at 80 days from the study start date was How do those rates compare to the seasonal flu in the UK?

The flu reports are here:

https://www.gov.uk/government/statistics/annual-flu-reports

The last bad hit on the hospitals was in 2017-2018

"Through the USISS mandatory scheme, a total of 3,454 ICU/HDU admissions of confirmed influenza were reported across the UK from week 40 2017 to week 15 2018, including 372 deaths, based on combined data from England, Scotland and Northern Ireland."

The death rate from anybody admitted to ICU from flu seems to be about 10%.

Admission rates for flu during that bad season was 0.22 per 100k

From what little data there is on Covid-19 it looks like that admission rates to ICU are about 0.30 per 100k, with a wide range (0.20 to 0.40). We won't know the average until it is over.

About 30% die (and again the range is anything up to 50%).

The UK data for Covid-19 in any depth is incomplete.

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