Association between multimorbidity and mortality in a cohort of patients admitted to hospital with COVID-19 in Scotland

Utkarsh Agrawal, Amaya Azcoaga-Lorenzo, Adeniyi Francis Fagbamigbe, Eleftheria Vasileiou, Paul Henery, Colin R Simpson, Sarah J E Stock, Syed Ahmar Shah, Chris Robertson, Mark Woolhouse, Lewis D Ritchie, Aziz Sheikh, Ewen M Harrison, Annemarie B Docherty, Colin McCowan

Research output: Contribution to journalArticlepeer-review


Objectives: We investigated the association between multimorbidity among patients hospitalised with COVID-19 and their subsequent risk of mortality. We also explored the interaction between the presence of multimorbidity and the requirement for an individual to shield due to the presence of specific conditions and its association with mortality.
Design: We created a cohort of patients hospitalised in Scotland due to COVID-19 during the first wave (between 28th February 2020 and 22nd September 2020) of the pandemic. We identified the level of multimorbidity for the patient on admission and used logistic regression to analyse the association between multimorbidity and risk of mortality among patients hospitalised with COVID-19.
Setting: Scotland, UK
Participants: Patients hospitalised due to COVID-19
Main outcome measures: Mortality as recorded on National Records of Scotland (NRS) death certificate and being coded for COVID-19 on the death certificate or death within 28 days of a positive COVID-19 test.
Results: Almost 58% of patients admitted to the hospital due to COVID-19 had multimorbidity. Adjusting for confounding factors of age, sex, social class and presence in the shielding group, multimorbidity was significantly associated with mortality (AOR 1.48, 95%CI 1.26-1.75). The presence of multimorbidity and presence in the shielding patients list were independently associated with mortality but there was no multiplicative effect of having both (AOR 0.91, 95%CI 0.64-1.29).
Conclusions: Multimorbidity is an independent risk factor of mortality among Individuals who were hospitalised due to COVID-19. Individuals with multimorbidity could be prioritised when making preventive policies, for example, by expanding shielding advice to this group and prioritising them for vaccination.
Original languageEnglish
JournalJournal of the Royal Society of Medicine
Early online date21 Oct 2021
Publication statusE-pub ahead of print - 21 Oct 2021


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