Risk of hospitalisation or death in households with a case of COVID-19 in England: an analysis using the HOSTED data set

J. A. Hall, R. J. Harris*, A. Zaidi, G. Dabrera, J. K. Dunbar

*Corresponding author for this work

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Abstract

Objective: To determine whether household contacts of confirmed cases of COVID-19 have an increased risk of hospitalisation or death. 

Methods: We used the HOSTED data set of index cases of COVID-19 in England between June and November 2020, linked to Secondary Uses Service data on hospital episodes and Office for National Statistics’ mortality data. Multivariable logistic regression models of the odds of household contacts being hospitalised or dying within six weeks of an index case, adjusted for case type, age, sex and calendar month were calculated. Excess risk was determined by comparing the first six weeks after the index case with 6–12 weeks after the index case in a survival analysis framework. 

Results: Index cases were more likely to be hospitalised or die than either secondary cases or non-cases, having adjusted for age and sex. There was an increased risk of hospitalisation for non-cases (adjusted hazard ratio (aHR) 1.10; 95% confidence interval (CI) 1.04, 1.16) and of death (aHR 1.57; 95% CI 1.14, 2.16) in the first six weeks after an index case, compared to 6–12 weeks after. 

Conclusion: Risks of hospitalisation and mortality are predictably higher in cases compared to non-cases. The short-term increase in risks for non-case contacts following diagnosis of the index case may suggest incomplete case ascertainment among contacts, although this was relatively small.

Original languageEnglish
Pages (from-to)85-87
Number of pages3
JournalPublic Health
Volume211
Early online date8 Aug 2022
DOIs
Publication statusPublished - Oct 2022

Bibliographical note

Funding Information: This work was undertaken as part of the core functions of Public Health England in relation to the surveillance of communicable diseases and outbreak response.

Open Access: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Publisher Copyright: Crown Copyright © 2022 Published by Elsevier Ltd on behalf of The Royal Society for Public Health.

Citation: J.A. Hall, R.J. Harris, A. Zaidi, G. Dabrera, J.K. Dunbar, Risk of hospitalisation or death in households with a case of COVID-19 in England: an analysis using the HOSTED data set, Public Health, Volume 211, 2022, Pages 85-87, ISSN 0033-3506, https://doi.org/10.1016/j.puhe.2022.07.013.

DOI: https://doi.org/10.1016/j.puhe.2022.07.013

Keywords

  • COVID-19
  • England
  • HOSTED
  • Hospitalisation
  • Household contacts
  • Household transmission
  • Mortality
  • SARS-CoV-2
  • Secondary user service
  • Surveillance

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