Hanlon, P. et al. (2021) COVID-19 – exploring the implications of long-term condition type and extent of multimorbidity on years of life lost: a modelling study. Wellcome Open Research, 5, 75. (doi: 10.12688/wellcomeopenres.15849.3) (PMID:33709037) (PMCID:PMC7927210)
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Publisher's URL: https://doi.org/10.12688/wellcomeopenres.15849.3
Abstract
Background: COVID-19 is responsible for increasing deaths globally. As most people dying with COVID-19 are older with underlying long-term conditions (LTCs), some speculate that YLL are low. We aim to estimate YLL attributable to COVID-19, before and after adjustment for number/type of LTCs, using the limited data available early in the pandemic. Methods: We first estimated YLL from COVID-19 using WHO life tables, based on published age/sex data from COVID-19 deaths in Italy. We then used aggregate data on number/type of LTCs in a Bayesian model to estimate likely combinations of LTCs among people dying with COVID-19. We used routine UK healthcare data from Scotland and Wales to estimate life expectancy based on age/sex/these combinations of LTCs using Gompertz models from which we then estimate YLL. Results: Using the standard WHO life tables, YLL per COVID-19 death was 14 for men and 12 for women. After adjustment for number and type of LTCs, the mean YLL was slightly lower, but remained high (11.6 and 9.4 years for men and women, respectively). The number and type of LTCs led to wide variability in the estimated YLL at a given age (e.g. at ≥80 years, YLL was >10 years for people with 0 LTCs, and <3 years for people with ≥6). Conclusions: Deaths from COVID-19 represent a substantial burden in terms of per-person YLL, more than a decade, even after adjusting for the typical number and type of LTCs found in people dying of COVID-19. The extent of multimorbidity heavily influences the estimated YLL at a given age. More comprehensive and standardised collection of data (including LTC type, severity, and potential confounders such as socioeconomic-deprivation and care-home status) is needed to optimise YLL estimates for specific populations, and to understand the global burden of COVID-19, and guide policy-making and interventions.
| Item Type: | Articles |
|---|---|
| Additional Information: | Version 3; peer review: 3 approved. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | McAllister, Professor David and Chadwick, Mr Fergus and Husmeier, Professor Dirk and Minton, Dr Jonathan and Matthiopoulos, Professor Jason and Mair, Professor Frances and McCartney, Professor Gerard and Hanlon, Dr Peter |
| Creator Roles: | Hanlon, P.Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Software, Writing – original draft, Writing – review and editing Chadwick, F.Data curation, Formal analysis, Investigation, Methodology, Software, Validation, Visualization, Writing – original draft, Writing – review and editing Mair, F. S.Writing – review and editing Husmeier, D.Formal analysis, Investigation, Methodology, Writing – original draft, Writing – review and editing Matthiopoulos, J.Formal analysis, Investigation, Methodology, Software, Visualization, Writing – original draft, Writing – review and editing McAllister, D. A.Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review and editing Minton, J.Investigation, Methodology, Visualization, Writing – original draft, Writing – review and editing McCartney, G.Conceptualization, Methodology, Writing – review and editing |
| Authors: | Hanlon, P., Chadwick, F., Shah, A., Wood, R., Minton, J., McCartney, G., Fischbacher, C., Mair, F. S., Husmeier, D., Matthiopoulos, J., and McAllister, D. A. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health College of Science and Engineering > School of Mathematics and Statistics > Statistics College of Social Sciences > School of Social and Political Sciences College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine |
| Journal Name: | Wellcome Open Research |
| Publisher: | F1000Research |
| ISSN: | 2398-502X |
| ISSN (Online): | 2398-502X |
| Published Online: | 23 April 2020 |
| Copyright Holders: | Copyright © 2020 Hanlon P et al. |
| First Published: | First published in Wellcome Open Research 5:75 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
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