Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19

Eilidh Bruce, Ben Carter, Terence J Quinn, Alessia Verduri, Oliver Pearson, Arturo Vilches-Moraga, Angeline Price, Aine McGovern, Louis A Evans, Kathryn McCarthy, Jonathan Hewitt, Susan Moug, Phyo Kyaw Myint* (Corresponding Author), COPE Study Team

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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In response to the COVID-19 pandemic, many countries mandated staying at home to reduce transmission. This study examined the association between living arrangements (house occupancy numbers) and outcomes in COVID-19.

Study population was drawn from the COPE Study, a multicentre cohort study. House occupancy was defined as: living alone; living with one other person; living with multiple other people; or living in a nursing/residential home. Outcomes were time from admission to mortality and discharge (Cox regression), and Day-28 mortality (logistic regression), analyses were adjusted for key comorbidities and covariates including admission: age; sex, smoking; heart failure; admission CRP; COPD; eGFR, frailty and others.

1584 patients were included from 13 hospitals across UK and Italy: 676 (42.7%) were female, 907 (57.3%) were male, median age was 74 years (range: 19-101). At 28 days, 502 (31.7%) had died. Median admission CRP was 67, 82, 79.5 and 83mg/L for those living alone, with someone else, in a house of multiple occupancy and in a nursing/residential home, respectively. Compared to living alone, living with anyone was associated with increased mortality: within a couple (aHR 1.39, 95%CI 1.09-1.77, p = 0.007); living in a house of multiple occupancy (aHR=1.67, 95%CI 1.17-2.38, p = 0.005); and living in a residential home (aHR=1.36, 95%CI 1.03-1.80, p = 0.031).

For patients hospitalised with COVID-19, those living with one or more people had an increased association with mortality, they also exhibited higher CRP indicating increased disease severity suggesting they delayed seeking care.
Original languageEnglish
Article numberckab085
Pages (from-to)133–139
Number of pages7
JournalEuropean Journal of Public Health
Issue number1
Early online date17 May 2021
Publication statusPublished - 1 Feb 2022

Bibliographical note

We acknowledge the dedication, commitment, and sacrifice of the staff from participating centres across UK and Italy, two amongst the most severely affected countries in Europe. We gratefully acknowledge the contribution of our collaborators, National Institute of Health Research (NIHR) Health Research Authority (HRA) in the UK and Ethics Committee of Policlinico Hospital Modena, which provided rapid approval of COPE study and respective Institutions’ Research and Development Offices and Caldicott Guardians for their assistance
and guidance. We also thank COPE Study Sponsor, Cardiff University, Wales, UK.


  • Covid-19
  • Coronavirus
  • Multiple House Occupancy


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