{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:11:15Z","timestamp":1761419475843,"version":"build-2065373602"},"reference-count":58,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T00:00:00Z","timestamp":1618790400000},"content-version":"unspecified","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/S003835\/1"],"award-info":[{"award-number":["MR\/S003835\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,3,23]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To explore risk factors associated with COVID-19 susceptibility and survival in patients with pre-existing hepato\u2013pancreato\u2013biliary (HPB) conditions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Cross-sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>East London Pancreatic Cancer Epidemiology (EL-PaC-Epidem) Study at Barts Health National Health Service Trust, UK. Linked electronic health records were interrogated on a cohort of participants (age \u226518 years), reported with HPB conditions between 1 April 2008 and 6 March 2020.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>EL-PaC-Epidem Study participants, alive on 12 February 2020, and living in East London within the previous 6\u2009months (n=15 440). The cohort represents a multi-ethnic population with 51.7% belonging to the non-White background.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measure<\/jats:title>\n                  <jats:p>COVID-19 incidence and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Some 226 (1.5%) participants had confirmed COVID-19 diagnosis between 12 February and 12 June 2020, with increased odds for men (OR 1.56; 95%\u2009CI 1.2 to 2.04) and Black ethnicity (2.04; 1.39 to 2.95) as well as patients with moderate to severe liver disease (2.2; 1.35 to 3.59). Each additional comorbidity increased the odds of infection by 62%. Substance misusers were at more risk of infection, so were patients on vitamin D treatment. The higher ORs in patients with chronic pancreatic or mild liver conditions, age &gt;70, and a history of smoking or obesity were due to coexisting comorbidities. Increased odds of death were observed for men (3.54; 1.68 to 7.85) and Black ethnicity (3.77; 1.38 to 10.7). Patients having respiratory complications from COVID-19 without a history of chronic respiratory disease also had higher odds of death (5.77; 1.75 to 19).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this large population-based study of patients with HPB conditions, men, Black ethnicity, pre-existing moderate to severe liver conditions, six common medical multimorbidities, substance misuse and a history of vitamin D treatment independently posed higher odds of acquiring COVID-19 compared with their respective counterparts. The odds of death were significantly high for men and Black people.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-045077","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T13:21:37Z","timestamp":1618838497000},"page":"e045077","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["COVID-19 in patients with hepatobiliary and pancreatic diseases: a single-centre cross-sectional study in East London"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2567-4648","authenticated-orcid":false,"given":"Abu Z M","family":"Dayem Ullah","sequence":"first","affiliation":[{"name":"Centre for Cancer Biomarker and Biotherapeutics, Barts Cancer Institute, London, UK"},{"name":"Barts and the London HPB Centre, The Royal London Hospital, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lavanya","family":"Sivapalan","sequence":"additional","affiliation":[{"name":"Centre for Cancer Biomarker and Biotherapeutics, Barts Cancer Institute, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6771-1905","authenticated-orcid":false,"given":"Hemant M","family":"Kocher","sequence":"additional","affiliation":[{"name":"Barts and the London HPB Centre, The Royal London Hospital, Barts Health NHS Trust, London, UK"},{"name":"Centre for Tumour Biology, Barts Cancer Institute, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claude","family":"Chelala","sequence":"additional","affiliation":[{"name":"Centre for Cancer Biomarker and Biotherapeutics, Barts Cancer Institute, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"2025101811374478000_11.4.e045077.1","unstructured":"World Health Organization . 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