COVID-19 is a respiratory disease caused by infection with the severe acute respiratory syndrome-coronovirus-2 (SARS-CoV-2). Since the first confirmed case in the United Kingdom in January 2020, around 865,000 people have been hospitalised and more than 195,000 have died with COVID-19 as of May 2022.
COVID-19 can place people at higher risk to other infections, such as from bacteria, other viruses or fungus (BVF). BVF infections during or in the period after COVID illness are observed in approximately 19% of patients with a COVID-19 diagnosis. Patients with COVID who get a BVF infection are at a higher risk of severe COVID or death, with healthcare costs likely to be much higher than those who do not get a BVF.
Several studies have reported healthcare use and costs in COVID-19 patients, but there is little known about the costs associated with BVF infections and within groups at higher risk to COVID-19. By understanding the frequency of secondary BVF infections, as well as the healthcare use and health outcomes among patients with and without a BVF infection, we may be able to inform future studies and healthcare policy to target interventions among those with COVID.
Aim: To use UK primary care data linked to secondary care data to describe the frequency of bacterial viral and fungal (BVF) infections associated with COVID-19 and to describe health outcomes among patients with and without a secondary BVF infection, in patients hospitalised or managed in the community in England.
Objectives: To: i) estimate incidence of COVID-19 associated BVF infections; ii) estimate mortality in COVID-19 patients with and without BVF infections; iii) quantify HCRU and associated direct healthcare costs in COVID-19 patients with and without BVF infections; iv) describe COVID-19 patient characteristics in those with and without a BVF infections, and v) describe COVID-19 severity in COVID-19 patients with and without BVF infections.
Objectives will be stratified by patient groups at risk of severe COVID-19 outcomes and reported in hospitalised, non-hospitalised and primary care patient cohorts.
Methods: A retrospective cohort study using UK primary care data (CRPD Aurum), linked to Hospital Episode Statistics (HES) and Office for National Statistics (ONS) datasets, of confirmed COVID-19 patients with and without BVF infections during the study index period (August 2020–March 2022).
Exposures: COVID-19 episode; BVF infections; chronic respiratory conditions; risk of severe COVID-19, morbid obesity, diabetes, severe mental health, chronic vascular disease, ethnicity, ≥70 years and period of COVID-19 variant dominance.
Outcomes: BVF infections; HCRU (primary care consultations, hospitalisations, ICU admissions, ICU interventions, direct healthcare costs, re-admissions); COVID-19 severity; mortality
Data Analysis: Counts, means, medians, standard deviation and 25th/75th percentile values for continuous variables; relative frequencies and proportions/percentages for categorical variables.
BVF infections; healthcare resource use (primary care general practice consultations, hospitalisations, re-admissions (<30 days from discharge), ICU admissions, ICU interventions, total direct healthcare costs); COVID-19 severity; mortality.
Kevin Naicker - Chief Investigator - Pfizer Ltd - UK
Theo Tritton - Corresponding Applicant - Adelphi Real World
Amitava Banerjee - Collaborator - University College London ( UCL )
Charles Reynard - Collaborator - Pfizer Ltd - UK
Christina Diomatari - Collaborator - Adelphi Real World
Christopher Little - Collaborator - Pfizer Ltd - UK
Gillian Kiely - Collaborator - Pfizer Ltd - UK
Jingyan Yang - Collaborator - Pfizer Inc - US Headquarters
Kamlesh Khunti - Collaborator - University of Leicester
Kiran Rai - Collaborator - Adelphi Real World
Lucy Massey - Collaborator - Adelphi Real World
Maciej Czachorowski - Collaborator - Pfizer Ltd - UK
Mary Araghi ( Gerino ) - Collaborator - Pfizer Ltd - UK
Olivia Massey - Collaborator - Adelphi Real World
Poppy Payne - Collaborator - Adelphi Real World
Robert Wood - Collaborator - Adelphi Real World
Tendai Mugwagwa - Collaborator - Pfizer Ltd - UK
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation