Patterns of multimorbidity and risk of severe SARS-CoV-2 infection: an observational study in the U.K.

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1. Version published to 10.1186/s12879-021-06600-y

   Sep 4, 2021
2. 

   ScreenIT

   Oct 26, 2020

   SciScore for 10.1101/2020.10.21.20216721: (What is this?)

   Please note, not all rigor criteria are appropriate for all manuscripts.

   Table 1: Rigor

   Institutional Review Board Statement

   Consent: Written informed consent was obtained prior to data collection; UK Biobank was approved by the NHS National Research Ethics Service (16/NW/0274; ethics approval for UK Biobank studies).[18] SARS-CoV-2 laboratory confirmed test results and death data for all-cause mortality from Public Health England were linked to the UK Biobank database.[19] Data were available between March 16 and July 26, 2020, restricted to those tested in a hospital (pillar 1), since this can be regarded as a proxy for hospitalisations for severe cases of the disease as suggested by the linkage methodology.[19] Our analytical sample included study participants from England as …

   SciScore for 10.1101/2020.10.21.20216721: (What is this?)

   Please note, not all rigor criteria are appropriate for all manuscripts.

   Table 1: Rigor

   Institutional Review Board Statement	Consent: Written informed consent was obtained prior to data collection; UK Biobank was approved by the NHS National Research Ethics Service (16/NW/0274; ethics approval for UK Biobank studies).[18] SARS-CoV-2 laboratory confirmed test results and death data for all-cause mortality from Public Health England were linked to the UK Biobank database.[19] Data were available between March 16 and July 26, 2020, restricted to those tested in a hospital (pillar 1), since this can be regarded as a proxy for hospitalisations for severe cases of the disease as suggested by the linkage methodology.[19] Our analytical sample included study participants from England as testing was available and linked, we therefore excluded study members from Scotland and Wales, participants who had an outpatient test positive for COVID-19 (pillar 2) as the outcome for SARS-CoV-2 infection was uncertain (i.e. recovered, hospitalised at a later stage, or died), those who died before March 16, 2020, and those with missing data (Additional file: Figure S1).
   Randomization	not detected.
   Blinding	not detected.
   Power Analysis	not detected.
   Sex as a biological variable	not detected.

   Table 2: Resources

   Software and Algorithms
   Sentences	Resources
   Written informed consent was obtained prior to data collection; UK Biobank was approved by the NHS National Research Ethics Service (16/NW/0274; ethics approval for UK Biobank studies).[18] SARS-CoV-2 laboratory confirmed test results and death data for all-cause mortality from Public Health England were linked to the UK Biobank database.[19] Data were available between March 16 and July 26, 2020, restricted to those tested in a hospital (pillar 1), since this can be regarded as a proxy for hospitalisations for severe cases of the disease as suggested by the linkage methodology.[19] Our analytical sample included study participants from England as testing was available and linked, we therefore excluded study members from Scotland and Wales, participants who had an outpatient test positive for COVID-19 (pillar 2) as the outcome for SARS-CoV-2 infection was uncertain (i.e. recovered, hospitalised at a later stage, or died), those who died before March 16, 2020, and those with missing data (Additional file: Figure S1).	Biobank suggested: (HIV Biobank, RRID:SCR_004691)

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   Results from OddPub: Thank you for sharing your code and data.

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   Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

   Moreover, we performed a literature review to derive an evidence based COVID-19 relevant multimorbidity index which can be applied to other populations.[5-8, 20-29] This study has some limitations. Issues of the low response rate (∼5%) and selection bias, such as slightly higher representation of participants from affluent groups may suggest that the UK Biobank sample is not well representative of the UK population, and have been discussed previously.[36] However, participants may not need to be representative of the target populations when estimating relative risks, as empirically demonstrated for UK Biobank.[37] The characteristics we examined were recorded at recruitment, representing data collected in the past at study baseline, but we conducted additional sensitivity analyses using the follow-up data for 25‐hydroxyvitamin D levels and the last recorded air pollution (NO2) data, showing consistent results over time. The data on multimorbidity were appraised only at baseline but there may have been a change in the number of multimorbidity index conditions since recruitment which were not accounted for and may lead to under or overestimation of effect. We were unable to assess the severity of disease conditions but our new multimorbidity index definition included conditions that were most relevant to COVID-19. Another limitation is the lack of detail of clinical severity of those with severe SARS-CoV-2 infection: while we have accounted for hospitalisation or death during t...

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   Results from TrialIdentifier: No clinical trial numbers were referenced.

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   Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

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   Results from JetFighter: We did not find any issues relating to colormaps.

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   Results from rtransparent:

   • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
   • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
   • No protocol registration statement was detected.

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3. 

   Version published to 10.1101/2020.10.21.20216721v1 on medRxiv

   Oct 23, 2020