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

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 rec...

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Autores principales:	Bhautesh D. Jani, Frederick K. Ho, David J. Lowe, Jamie P. Traynor, Sean P. MacBride-Stewart, Patrick B. Mark, Frances S. Mair, Jill P. Pell
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ae93bb33ae9d4e71972d630f2d8dc4c7
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spelling	oai:doaj.org-article:ae93bb33ae9d4e71972d630f2d8dc4c72021-12-02T16:24:52ZComparison of COVID-19 outcomes among shielded and non-shielded populations10.1038/s41598-021-94630-62045-2322https://doaj.org/article/ae93bb33ae9d4e71972d630f2d8dc4c72021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-94630-6https://doaj.org/toc/2045-2322Abstract 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.Bhautesh D. JaniFrederick K. HoDavid J. LoweJamie P. TraynorSean P. MacBride-StewartPatrick B. MarkFrances S. MairJill P. PellNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Bhautesh D. Jani Frederick K. Ho David J. Lowe Jamie P. Traynor Sean P. MacBride-Stewart Patrick B. Mark Frances S. Mair Jill P. Pell Comparison of COVID-19 outcomes among shielded and non-shielded populations
description	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.
format	article
author	Bhautesh D. Jani Frederick K. Ho David J. Lowe Jamie P. Traynor Sean P. MacBride-Stewart Patrick B. Mark Frances S. Mair Jill P. Pell
author_facet	Bhautesh D. Jani Frederick K. Ho David J. Lowe Jamie P. Traynor Sean P. MacBride-Stewart Patrick B. Mark Frances S. Mair Jill P. Pell
author_sort	Bhautesh D. Jani
title	Comparison of COVID-19 outcomes among shielded and non-shielded populations
title_short	Comparison of COVID-19 outcomes among shielded and non-shielded populations
title_full	Comparison of COVID-19 outcomes among shielded and non-shielded populations
title_fullStr	Comparison of COVID-19 outcomes among shielded and non-shielded populations
title_full_unstemmed	Comparison of COVID-19 outcomes among shielded and non-shielded populations
title_sort	comparison of covid-19 outcomes among shielded and non-shielded populations
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ae93bb33ae9d4e71972d630f2d8dc4c7
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Comparison of COVID-19 outcomes among shielded and non-shielded populations

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