COVID-19 – exploring the implications of long-term condition type and extent of multimorbidity on years of life lost: a modelling study

Hanlon, P. et al. (2020) 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.15849.1) (PMID:PPR153916)

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Abstract

Background: The COVID-19 pandemic is responsible for increasing deaths globally. Most estimates have focused on numbers of deaths, with little direct quantification of years of life lost (YLL) through COVID-19. As most people dying with COVID-19 are older with underlying long-term conditions (LTCs), some have speculated that YLL are low. We aim to estimate YLL attributable to COVID-19, before and after adjustment for number/type of LTCs. Methods: We first estimated YLL from COVID-19 using standard 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 to model likely combinations of LTCs among people dying with COVID-19. From these, we used routine UK healthcare data to estimate life expectancy based on age/sex/different combinations of LTCs. We then calculated YLL based on age, sex and type of LTCs and multimorbidity count. 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 (13 and 11 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 on LTCs is needed to better understand and quantify the global burden of COVID-19 and to guide policy-making and interventions.

Item Type:Articles
Additional Information:Version 1; peer review: 1 approved.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McAllister, Dr David and Chadwick, Mr Fergus and Hanlon, Dr Peter and Matthiopoulos, Professor Jason and Husmeier, Professor Dirk and Mair, Professor Frances
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
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 > Institute of Biodiversity Animal Health and Comparative Medicine
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Science and Engineering > School of Mathematics and Statistics > Statistics
Journal Name:Wellcome Open Research
Publisher:F1000Research
ISSN:2398-502X
ISSN (Online):2398-502X
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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