Comparison of COVID-19 outcomes among shielded and non-shielded populations

Jani, B. D. , Ho, F. K., Lowe, D. J. , Traynor, J. P., MacBride-Stewart, S. P., Mark, P. B. , Mair, F. S. and Pell, J. P. (2021) Comparison of COVID-19 outcomes among shielded and non-shielded populations. Scientific Reports, 11, 15278. (doi: 10.1038/s41598-021-94630-6)

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Abstract

Many western countries used shielding (extended self-isolation) of people presumed to be at high-risk from COVID-19 to protect them and reduce healthcare demand. To investigate the effectiveness of this strategy, we linked family practitioner, prescribing, laboratory, hospital and death records and compared COVID-19 outcomes among shielded and non-shielded individuals in the West of Scotland. Of the 1.3 million population, 27,747 (2.03%) were advised to shield, and 353,085 (26.85%) were classified a priori as moderate risk. COVID-19 testing was more common in the shielded (7.01%) and moderate risk (2.03%) groups, than low risk (0.73%). Referent to low-risk, the shielded group had higher confirmed infections (RR 8.45, 95% 7.44–9.59), case-fatality (RR 5.62, 95% CI 4.47–7.07) and population mortality (RR 57.56, 95% 44.06–75.19). The moderate-risk had intermediate confirmed infections (RR 4.11, 95% CI 3.82–4.42) and population mortality (RR 25.41, 95% CI 20.36–31.71) but, due to their higher prevalence, made the largest contribution to deaths (PAF 75.30%). Age ≥ 70 years accounted for 49.55% of deaths. In conclusion, in spite of the shielding strategy, high risk individuals were at increased risk of death. Furthermore, to be effective as a population strategy, shielding criteria would have needed to be widely expanded to include other criteria, such as the elderly.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pell, Professor Jill and Ho, Dr Frederick and Jani, Dr Bhautesh and Mark, Professor Patrick and Lowe, Dr David and Mair, Professor Frances and Traynor, Dr Jamie
Authors: Jani, B. D., Ho, F. K., Lowe, D. J., Traynor, J. P., MacBride-Stewart, S. P., Mark, P. B., Mair, F. S., and Pell, J. P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
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 Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Scientific Reports
Publisher:Nature Research
ISSN:2045-2322
ISSN (Online):2045-2322
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Scientific Reports 11: 15278
Publisher Policy:Reproduced under a Creative Commons License
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