TY - JOUR T1 - Risk of Covid-19 in shielded and nursing care home patients: cohort study in general practice JF - BJGP Open JO - BJGP Open DO - 10.3399/BJGPO.2021.0081 SP - BJGPO.2021.0081 AU - David Wingfield AU - Mansour Taghavi Azar Sharabiani AU - Azeem Majeed AU - Mariam Molokhia Y1 - 2021/08/25 UR - http://bjgpopen.org/content/early/2021/08/26/BJGPO.2021.0081.abstract N2 - Background Covid-19 cases were first detected in the UK in January 2020 and vulnerable patients were asked to shield from March to reduce their risk of Covid-19 infection.Aim To determine the risk and determinants of Covid-19 diagnosis in shielded vs. non-shielded groups adjusted for key comorbidities not explained by shielding.Design & setting Retrospective cohort study of adults with COVID-19 infection between 1/2/20-15/5/20 in West London.Method Individuals diagnosed with Covid-19 were identified in SystmOne records using clinical codes. Infection risks were adjusted for socio-demographic factors, nursing home status and comorbidities.Results Of 57,713 adults, 573 (1%) individuals were identified as shielded and 1,074 adults had documented Covid-19 infections (1.9%). Covid-19 infection rate in the shielded group individuals compared with non-shielded adult individuals was 6.5% (37/573) vs 1.8% (1,037/57, 140), P<0.0001. A multivariable fully adjusted Cox proportional hazards regression identified that Covid-19 infection was increased with aHR (95% CI): shielding status 1.52 (1.00–2.30), P=0.048. Other determinants of Covid-19 infection included nursing home residency 7.05 (4.22–11.77) p<0.001, Black African, 2.52 (1.99–3.18) p<0.001, Other 1.74 (1.42–2.13) p<0.001, Non-stated 1.70 (1.02–2.84) P=0.04, or South Asian ethnicity 1.46 (1.10–1.93) P=0.01, history of respiratory disease 1.51 (1.06–2.16), P=0.02, deprivation (third vs. least deprived IMD quintile) 1.25 (1.01–1.56) P=0.045, obesity (BMI >30 kg/m2) 1.39 (1.18–1.63) p<0.001, and age 1.02 (1.01–1.02) p<0.001. Male gender was associated with lower risk of Covid-19 infection: 0.71 (0.62–0.82) p<0.001.Conclusion Shielded individuals had a higher Covid-19 infection rate compared with non-shielded individuals, after adjusting for socio-demographic factors, nursing home status, and comorbidities. ER -