OpenSAFELY

Published Papers

Ethnic differences in SARS-CoV-2 infection and COVID-19-related hospitalisation, intensive care unit admission, and death in 17 million adults in England: an observational cohort study using the OpenSAFELY platform

May 2021. Working on behalf of NHS England, this paper used the OpenSAFELY platform to quantify ethnic differences in SARS-CoV-2 infection and COVID-19 outcomes during the first and second waves of the COVID-19 pandemic in England.

How to Cite: Mathur, Rohini, Christopher T Rentsch, Caroline E Morton, William J Hulme, Anna Schultze, Brian MacKenna, Rosalind M Eggo, et al. ‘Ethnic Differences in SARS-CoV-2 Infection and COVID-19-Related Hospitalisation, Intensive Care Unit Admission, and Death in 17 Million Adults in England: An Observational Cohort Study Using the OpenSAFELY Platform’. The Lancet 397, no. 10286 (May 2021): 1711–24. https://doi.org/10.1016/S0140-6736(21)00634-6.

Identifying Care Home Residents in Electronic Health Records - An OpenSAFELY Short Data Report

May 2021. This short data report describes the partial overlap between three methods for identifying care home residents in EHR, and provides detailed instructions for how to implement these in OpenSAFELY-TPP to support research into the impact of the COVID-19 pandemic on care home residents.

How to Cite: Schultze A, Bates C, Cockburn J et al. Identifying Care Home Residents in Electronic Health Records - An OpenSAFELY Short Data Report [version 1; peer review: awaiting peer review]. Wellcome Open Res 2021, 6:90 (https://doi.org/10.12688/wellcomeopenres.16737.1)

Case fatality risk of the SARS-CoV-2 variant of concern B.1.1.7 in England, 16 November to 5 February

March 2021. Working on behalf of NHS England, this paper uses the OpenSAFELY platform to estimate the risk of death following confirmation of SARS-CoV-2 infection in England, comparing infection with VOC to non-VOC, after accounting for demographic factors and comorbidities

How to Cite: Grint Daniel J, Wing Kevin, Williamson Elizabeth, McDonald Helen I, Bhaskaran Krishnan, Evans David, Evans Stephen JW, Walker Alex J, Hickman George, Nightingale Emily, Schultze Anna, Rentsch Christopher T, Bates Chris, Cockburn Jonathan, Curtis Helen J, Morton Caroline E, Bacon Sebastian, Davy Simon, Wong Angel YS, Mehrkar Amir, Tomlinson Laurie, Douglas Ian J, Mathur Rohini, Blomquist Paula, MacKenna Brian, Ingelsby Peter, Croker Richard, Parry John, Hester Frank, Harper Sam, DeVito Nicholas J, Hulme Will, Tazare John, Goldacre Ben, Smeeth Liam, Eggo Rosalind M. Case fatality risk of the SARS-CoV-2 variant of concern B.1.1.7 in England, 16 November to 5 February. Euro Surveill. 2021;26(11):pii=2100256. https://doi.org/10.2807/1560-7917.ES.2021.26.11.2100256

Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England

March 2021. Working on behalf of NHS England, this paper used the OpenSAFELY platform to investigate whether risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and outcomes of coronavirus disease 2019 (covid-19) differed between adults living with and without children during the first two waves of the UK pandemic.

How to Cite: Forbes H, Morton C E, Bacon S, McDonald H I, Minassian C, Brown J P et al. Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in England BMJ 2021; 372 :n628 doi:10.1136/bmj.n628

Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts

January 2021. Working on behalf of NHS England, this paper used the OpenSAFELY platform to assess the association between routinely prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and deaths from COVID-19.

How to Cite: Wong AY, MacKenna B, Morton CE, et alUse of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohortsAnnals of the Rheumatic Diseases Published Online First: 21 January 2021. doi: 10.1136/annrheumdis-2020-219517

HIV infection and COVID-19 death: a population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

December 2020. Working on behalf of NHS England, this paper used the OpenSAFELY platform to investigate the association between HIV infection and COVID-19 mortality.

How to Cite: Bhaskaran, K., Rentsch, C., MacKenna, B., Schultze, A., Mehrkar, A., Bates, C., Eggo, R., et al. ‘HIV Infection and COVID-19 Death: A Population-Based Cohort Analysis of UK Primary Care Data and Linked National Death Registrations within the OpenSAFELY Platform’. The Lancet HIV, December 2020, S2352301820303052. https://doi.org/10.1016/S2352-3018(20)30305-2.

Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform

November 2020. Working on behalf of NHS England, this paper used the OpenSAFELY platform to investigate the effectiveness of hydroxychloroquine for prevention, as opposed to treatment, of COVID-19 mortality. We found no evidence of benefit or harm after adjusting for important differences between people with the same health conditions prescribed hydroxychloroquine or not.

How to Cite: Rentsch CT, DeVito NJ, MacKenna B, Morton CE, Bhaskaran K, Brown JP, et al. Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform. Lancet Rheumatology (2020) DOI: 10.1016/S2665-9913(20)30378-7

Risk of COVID-19-related death among patients with chronic obstructive pulmonary disease or asthma prescribed inhaled corticosteroids: an observational cohort study using the OpenSAFELY platform

September 2020. Working on behalf of NHS England, this paper used the OpenSAFELY platform to investigate the association between ICS and COVID-19-related death among people with COPD or asthma using linked electronic health records (EHRs) in England, UK.

How to Cite: Schultze, Anna, Alex J Walker, Brian MacKenna, Caroline E Morton, Krishnan Bhaskaran, Jeremy P Brown, Christopher T Rentsch, et al. ‘Risk of COVID-19-Related Death among Patients with Chronic Obstructive Pulmonary Disease or Asthma Prescribed Inhaled Corticosteroids: An Observational Cohort Study Using the OpenSAFELY Platform’. The Lancet Respiratory Medicine. Accessed 9 October 2020. https://doi.org/10.1016/S2213-2600(20)30415-X.

OpenSAFELY: factors associated with COVID-19 death in 17 million patients

July 2020. Working on behalf of NHS England, this paper used the OpenSAFELY platform to quantify a range of clinical risk factors for COVID-19-related death in the largest cohort study conducted by any country to date.

How to Cite: Williamson, E.J., Walker, A.J., Bhaskaran, K. et al. OpenSAFELY: factors associated with COVID-19 death in 17 million patients. Nature (2020). https://doi.org/10.1038/s41586-020-2521-4

Pre-Prints

Rates of serious clinical outcomes in survivors of hospitalisation with COVID-19: a descriptive cohort study within the OpenSAFELY platform

April 2021. Patients with COVID-19 are thought to be at higher risk of cardiometabolic and pulmonary complications, but quantification of that risk is limited. Working on behalf of NHS England, this study aimed to describe the overall burden of these complications in survivors of severe COVID-19 using OpenSAFELY.

Association between oral anticoagulants and COVID-19 related outcomes: two cohort studies

April 2021. Working on behalf of NHS England, this study used the OpenSAFELY platform to investigate the role of routinely prescribed oral anticoagulants (OACs) in COVID-19 outcomes, comparing current OAC use versus non-use in Study 1; and warfarin versus direct oral anticoagulants (DOACs) in Study 2.

Trends and clinical characteristics of COVID-19 vaccine recipients: a federated analysis of 57.9 million patients’ primary care records in situ using OpenSAFELY

April 2021. Working on behalf of NHS England this study analysed 57.9 million patient records in situ and in near-real-time within the infrastructure of the Electronic Health Record (EHR) software vendors EMIS and TPP using OpenSAFELY. The paper describes vaccine coverage and time trends across a range of demographic and fine-grained clinical subgroups in eight Joint Committee on Vaccination and Immunisation (JCVI) priority cohorts.

OpenSAFELY: Risks of COVID-19 hospital admission and death for people with learning disabilities - a cohort study

March 2021. Working on behalf of NHS England, this paper used the OpenSAFELY platform to assess the association between learning disability and risk of hospitalisation and mortality from COVID-19 in England among adults and children.

Predicting COVID-19 related death using the OpenSAFELY platform

March 2021. Working on behalf of NHS England, this study used the OpenSAFELY platform to compare approaches for obtaining relative and absolute estimates of risk of 28-day COVID-19 mortality for adults in the general population of England in the context of changing levels of circulating infection.

Changes in the rate of cardiometabolic and pulmonary events during the COVID-19 pandemic

February 2021. Working on behalf of NHS England, this study used the OpenSAFELY platform to describe the overall rate of various key clinical events over time, and their relationship with COVID-19.

Trends, regional variation, and clinical characteristics of COVID-19 vaccine recipients: a retrospective cohort study in 23.4 million patients using OpenSAFELY

January 2021. Working on behalf of NHS England, this study used the OpenSAFELY platform to develop a framework for detailed near-real-time monitoring of COVID-19 vaccine roll-out; to describe trends and variation in coverage by geographic area, and between key clinical and demographic patient groups.

Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

January 2021. Working on behalf of NHS England, this study investigates how specific factors are differentially associated with COVID-19 mortality as compared to mortality from other causes.

OpenSAFELY: impact of national guidance on switching from warfarin to direct oral anticoagulants (DOACs) in early phase of COVID-19 pandemic in England

December 2020. Working on behalf of NHS England, this study investigates which people were switched from warfarin to DOACs following national guidance during the first wave of the COVID-19 pandemic; seeks to identify potentially unsafe co-prescribing of anticoagulants; and assesses whether abnormal clotting results have become more frequent during the pandemic.

Association between living with children and outcomes from COVID-19: an OpenSAFELY cohort study of 12 million adults in England

November 2020. Working on behalf of NHS England, this study investigates whether risk of infection with SARs-CoV-2 and severe outcomes differed between adults living with and without children

Study protocol: Comparison of different risk prediction modelling approaches for COVID-19 related death using the OpenSAFELY platform

October 2020. This protocol reports details of a planned study to explore the extent to which incorporating time-varying measures of infection burden over time improves the quality of risk prediction models for COVID-19 death in a large population of adult patients in England.

Ethnic differences in COVID-19 infection, hospitalisation, and mortality: an OpenSAFELY analysis of 17 million adults in England

September 2020. Working on behalf of NHS England, the aim of this study was to identify ethnic differences in the risk of COVID-19 infection, hospitalisation and mortality using a large general population cohort in England.

Supplemental Research

Post-publications supplement to Williamson, E.J., Walker, A.J., Bhaskaran, K. et al. OpenSAFELY: factors associated with COVID-19 death in 17 million patients. Nature (2020). https://doi.org/10.1038/s41586-020-2521-4

August 2020. In the above paper, working on behalf of NHS England, we estimated associations between a wide range of individual-level factors including demographics and comorbidities, and risk of COVID-19 death, but we did not explore interactions between variables. It is plausible that associations may depend on age, and evaluating this would inform more accurate risk prediction. The purpose of this supplement is therefore to present associations between individual-level factors and COVID-19 death,stratified by age group.

Download the supplement here.