The health burden of COVID-19 and healthcare resource utilization in England

Conditions

COVID-19 (SARS-CoV-2 infection) Infections and Infestations

Meeraus W, Carty L, Dube S, Evans K, Evans RA, Goios A, Justo N, Lu Y, Quint JK, Taylor S, Venkatesan S, Turtle L.

2026-03-27

Immunocompromised individuals remain at risk of COVID-19: 2023 results from the observational INFORM study.

Quint JK, Dube S, Carty L, Yokota R, Bell S, Turtle L, Lu Y, Evans K, Justo N, Harley M, Peters J, Talarico C, McNulty R, Goios A, Taylor S, Evans RA.

2025-01-316 citations

10.1016/j.jinf.2025.106432

P-2006. Individuals on Immunosuppressive or Immunomodulatory Therapies Remain at Increased Risk of COVID-19 Hospitalization, Despite Vaccination: Findings from INFORM, a Retrospective Health Database Study in England

Sabada Dube, Lucy Carty, Carla Talarico, Renata Yokota, Richard McNulty et al. (14 authors)

Open Forum Infectious Diseases2025-01-29

10.1093/ofid/ofae631.2163

Impact of COVID-19 on immunocompromised populations during the Omicron era: insights from the observational population-based INFORM study.

Evans RA, Dube S, Lu Y, Yates M, Arnetorp S, Barnes E, Bell S, Carty L, Evans K, Graham S, Justo N, Moss P, Venkatesan S, Yokota R, Ferreira C, McNulty R, Taylor S, Quint JK.

2023-10-13124 citations

10.1016/j.lanepe.2023.100747

Interventions

Current intervention as of 11/07/2022: This study will use a series of de-identified patient datasets in England, accessible through National Health Services (NHS) Digital. The study period will star

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: This study will include all subjects in England who were active in all datasets described above for at least 1 day during the COVID-19 infection identification period

Exclusion criteria

Exclusion criteria: Current participant exclusion criteria as of 16/12/2022: No general exclusion criteria will be applied for defining the overall study population. Previous participant exclusion criteria: Subjects will be excluded from this study if they have less than 12 months of baseline data prior to 1 September 2020

Design outcomes

Primary

Measure	Time frame
Current primary outcome measures as of 11/07/2022: 1. Size of populations (pre-defined) in England who potentially are ineligible for vaccine or are at risk of COVID-19 infection following vaccination. This will be measure using count (N) of those at risk and the proportion (%) at risk over the baseline period. 2. Incidence of COVID-19, by age group, disease severity, and selected comorbidities during the pre-vaccination and vaccination periods of the study. Incidence will be measured in infections per 100 person-months with 95% confidence intervals. 3. Incidence of long COVID-19 syndrome, by age, disease severity, and selected comorbidities. Incidence will be measured in infections per 100 person-months with 95% confidence intervals. 4. Patterns of HCRU and cost associated with an episode of COVID-19, stratified by age, selected comorbidities, disease severity and the occurrence (vs absence) of long COVID-19 syndrome will be calculated per person per COVID-19 episode. HCRU will be measured by total cost incurred during health care visits. _____ Previous primary outcome measures: 1. Size of populations (pre-defined) in England who potentially are ineligible for vaccine or are at risk of COVID-19 infection following vaccination. This will be measure using count (N) of those at risk and the proportion (%) at risk over the baseline period. 2. Incidence of COVID-19, by age group, disease severity, and selected comorbidities during the pre-vaccination and vaccination periods of the study (1 September 2020-end of study period). Incidence will be measured in infections per 100 person months with 95% confidence intervals. 3. Incidence of long COVID-19 syndrome, by age, disease severity, and selected comorbidities during the pre-vaccination and vaccination periods of the study (1 September 2020-end of study period). Incidence will be measured in infections per 100 person months with 95% confidence intervals. 4. Patterns of HCRU and cost associated with an episode of COVI	—

Measure

Time frame

Current primary outcome measures as of 11/07/2022: 1. Size of populations (pre-defined) in England who potentially are ineligible for vaccine or are at risk of COVID-19 infection following vaccination. This will be measure using count (N) of those at risk and the proportion (%) at risk over the baseline period. 2. Incidence of COVID-19, by age group, disease severity, and selected comorbidities during the pre-vaccination and vaccination periods of the study. Incidence will be measured in infections per 100 person-months with 95% confidence intervals. 3. Incidence of long COVID-19 syndrome, by age, disease severity, and selected comorbidities. Incidence will be measured in infections per 100 person-months with 95% confidence intervals. 4. Patterns of HCRU and cost associated with an episode of COVID-19, stratified by age, selected comorbidities, disease severity and the occurrence (vs absence) of long COVID-19 syndrome will be calculated per person per COVID-19 episode. HCRU will be measured by total cost incurred during health care visits. _____ Previous primary outcome measures: 1. Size of populations (pre-defined) in England who potentially are ineligible for vaccine or are at risk of COVID-19 infection following vaccination. This will be measure using count (N) of those at risk and the proportion (%) at risk over the baseline period. 2. Incidence of COVID-19, by age group, disease severity, and selected comorbidities during the pre-vaccination and vaccination periods of the study (1 September 2020-end of study period). Incidence will be measured in infections per 100 person months with 95% confidence intervals. 3. Incidence of long COVID-19 syndrome, by age, disease severity, and selected comorbidities during the pre-vaccination and vaccination periods of the study (1 September 2020-end of study period). Incidence will be measured in infections per 100 person months with 95% confidence intervals. 4. Patterns of HCRU and cost associated with an episode of COVI

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Secondary

Measure	Time frame
Current secondary outcome measures as of 16/12/2022: Exploratory Outcome Measures 1. Patients who developed a composite outcome of COVID-19 hospitalisation or COVID-19-related death after vaccination stratified by the number of doses received and explore potential risk factors. This will be measured through estimated relative risks and corresponding 95% confidence intervals. 2. Prediction model, using a clustering algorithm, to identify risk profiles associated with a composite outcome of COVID-19 hospitalisation or COVID-19-related death after the deployment of the vaccination campaign in England and the prevalence of subgroups consistent with each identified risk profile. _____ Previous secondary outcome measures as of 11/07/2022 to 16/12/2022: Exploratory Outcome Measures 1. Patients who developed a composite outcome of COVID-19 hospitalisation or COVID-19-related death after vaccination stratified by the number of doses received and explore potential risk factors. This will be measured through estimated relative risks and corresponding 95% confidence intervals. 2. Prediction model, using cox proportional hazards regression, to identify risk profiles associated with a composite outcome of COVID-19 hospitalisation or COVID-19-related death after the deployment of the vaccination campaign in England and the prevalence of subgroups consistent with each identified risk profile. _____ Previous secondary outcome measures: Exploratory Outcome Measures 1. Patients who developed COVID-19 infection after vaccination are stratified by the number of doses received and explore potential risk factors. This will be measured through estimated relative risks and corresponding 95% confidence intervals. 2. Prediction model, using cox proportional hazards regression, to identify risk profiles associated with COVID-19 infection after the deployment of the vaccination campaign in England and the prevalence of subgroups consistent with each identified risk profile.	—

Measure

Time frame

Current secondary outcome measures as of 16/12/2022: Exploratory Outcome Measures 1. Patients who developed a composite outcome of COVID-19 hospitalisation or COVID-19-related death after vaccination stratified by the number of doses received and explore potential risk factors. This will be measured through estimated relative risks and corresponding 95% confidence intervals. 2. Prediction model, using a clustering algorithm, to identify risk profiles associated with a composite outcome of COVID-19 hospitalisation or COVID-19-related death after the deployment of the vaccination campaign in England and the prevalence of subgroups consistent with each identified risk profile. _____ Previous secondary outcome measures as of 11/07/2022 to 16/12/2022: Exploratory Outcome Measures 1. Patients who developed a composite outcome of COVID-19 hospitalisation or COVID-19-related death after vaccination stratified by the number of doses received and explore potential risk factors. This will be measured through estimated relative risks and corresponding 95% confidence intervals. 2. Prediction model, using cox proportional hazards regression, to identify risk profiles associated with a composite outcome of COVID-19 hospitalisation or COVID-19-related death after the deployment of the vaccination campaign in England and the prevalence of subgroups consistent with each identified risk profile. _____ Previous secondary outcome measures: Exploratory Outcome Measures 1. Patients who developed COVID-19 infection after vaccination are stratified by the number of doses received and explore potential risk factors. This will be measured through estimated relative risks and corresponding 95% confidence intervals. 2. Prediction model, using cox proportional hazards regression, to identify risk profiles associated with COVID-19 infection after the deployment of the vaccination campaign in England and the prevalence of subgroups consistent with each identified risk profile.

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Countries

England, United Kingdom

Outcome results

None listed