Evidence map›Paper›PMID 34004222›Full record

ArticleThe Journal of infection2021

The impact of primary care supported shielding on the risk of mortality in people vulnerable to COVID-19: English sentinel network matched cohort study.

Azmaeen Zarif, Mark Joy, Julian Sherlock, James P Sheppard, Rachel Byford, Oluwafunmi Akinyemi, Clare R Bankhead, Alexandra Deeks, Filipa Ferreira, Nicholas Jones and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of infection, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Azmaeen ZarifNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: azmaeen.zarif@phc.ox.ac.uk.
Mark JoyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: mark.joy@phc.ox.ac.uk.
Julian SherlockNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: julian.sherlock@phc.ox.ac.uk.
James P SheppardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: james.sheppard@phc.ox.ac.uk.
Rachel ByfordNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: rachel.byford@phc.ox.ac.uk.
Oluwafunmi AkinyemiNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: oluwafunmi.akinyemi@phc.ox.ac.uk.
Clare R BankheadNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: clare.bankhead@phc.ox.ac.uk.
Alexandra DeeksNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: alexandra.deeks@phc.ox.ac.uk.
Filipa FerreiraNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: filipa.ferreira@phc.ox.ac.uk.
Nicholas JonesNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: nicholas.jones2@phc.ox.ac.uk.
Harshana LiyanageNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: harshana.liyanage@phc.ox.ac.uk.
Dylan McGaghNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: dylan.mcgagh@magd.ox.ac.uk.
Brian NicholsonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: brian.nicholson@phc.ox.ac.uk.
Jason OkeNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: jason.oke@phc.ox.ac.uk.
Cecilia OkusiNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: cecilia.okusi@phc.ox.ac.uk.
Manasa TripathyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: manasa.tripathy@phc.ox.ac.uk.
John WilliamsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: john.williams@phc.ox.ac.uk.
Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK. Electronic address: richard.hobbs@phc.ox.ac.uk.
Simon de LusignanNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; Royal College of General Practitioners, Euston Square, London NW1 2FB, UK. Electronic address: simon.delusignan@phc.ox.ac.uk.

Funding

Wellcome Trust
6 · The paper itself

Abstract

objectivesTo mitigate risk of mortality from coronavirus 2019 infection (COVID-19), the UK government recommended 'shielding' of vulnerable people through self-isolation for 12 weeks.

methodsA retrospective cohort study using a nationally representative English primary care database comparing people aged >= 40 years who were recorded as being advised to shield using a fixed ratio of 1:1, matching to people with the same diagnoses not advised to shield (n = 77,360 per group). Time-to-death was compared using Cox regression, reporting the hazard ratio (HR) of mortality between groups. A sensitivity analysis compared exact matched cohorts (n = 24,752 shielded, n = 61,566 exact matches).

resultsWe found a time-varying HR of mortality between groups. In the first 21 days, the mortality risk in people shielding was half those not (HR = 0.50, 95%CI:0.41-0.59. p < 0.0001). Over the remaining nine weeks, mortality risk was 54% higher in the shielded group (HR=1.54, 95%CI:1.41-1.70, p < 0.0001). Beyond the shielding period, mortality risk was over two-and-a-half times higher in the shielded group (HR=2.61, 95%CI:2.38-2.87, p < 0.0001).

conclusionsShielding halved the risk of mortality for 21 days. Mortality risk became higher across the remainder of the shielding period, rising to two-and-a-half times greater post-shielding. Shielding may be beneficial in the next wave of COVID-19.

Indexed as

COVID-19Cohort StudiesHumansPrimary Health CareRetrospective StudiesSARS-CoV-2computerizedCOVID-19Medical records systemMortalityShielding

Identifiers

PMID34004222
PMCPMC8123406

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.