Part of COVID-19 clinical risk groups cohort 2023: Cohort identification methodology

Rule logic

Currently GPES data is being pulled from GPES v5.

Asplenia or dysfunction of the spleen

Green Book Description	Data used	Rulesets
Homozygous sickle cell disease and hereditary spherocytosis.	GPESv5, HES	All people aged 6 months and over with homozygous sickle cell disease and hereditary spherocytosis.
Asplenia; splenic dysfunction such as thalassemia major and coeliac syndrome.	GPESv5, HES	All people aged 6 months and over with asplenia or splenic dysfunction including thalassemia major and coeliac disease.

Chronic heart disease

Green Book Description	Data used	Rulesets
Congenital heart disease, hypertension with cardiac complications, and chronic heart failure.	GPESv5, HES, OPCS	All people aged 6 months and over with congenital heart disease, hypertension with cardiac complications, pulmonary hypertension, or chronic heart failure.
Individuals requiring regular medication and/or follow-up for ischaemic heart disease. This includes atrial fibrillation, peripheral vascular disease, or a history of venous thromboembolism.	GPESv5, HES	All people aged 16 years and over with a diagnosis of ischaemic heart disease including atrial fibrillation, peripheral vascular disease, or history of venous thromboembolism (irrespective of treatment or follow-up).

Chronic kidney disease

Green Book Description	Data used	Rulesets
Chronic kidney disease at stage 3, 4 or 5; chronic kidney failure; nephrotic syndrome; and kidney transplantation.	GPESv5, HES, OPCS	All people aged 6 months and over with a diagnosis of chronic kidney disease at stage 3, 4 or 5 (not superseded by a stage 1/2 diagnosis); people on renal dialysis; diagnosis of nephrotic syndrome; or history or renal transplant.

Chronic liver disease

Green Book Description	Data used	Rulesets
Cirrhosis, biliary atresia, and chronic hepatitis.	GPESv5, HES	All people aged 6 months and over with a diagnosis of liver cirrhosis, biliary atresia or chronic hepatitis.

Chronic kidney and liver disease

Green Book Description	Data used	Rulesets
Congenital malformations of the organs, metabolic disorders and neoplasms, and conditions such as severe gastroesophageal reflux that may predispose to respiratory infection.	GPESv5, HES	Children aged 6 months to 16 years with a diagnosis of congenital malformation of the organs, or metabolic diseases.

Chronic neurological disease

Description	Data used	Rulesets
Conditions in which respiratory function may be compromised due to neurological or neuromuscular disease (e.g. polio syndrome sufferers). This group also includes individuals with cerebral palsy, severe or profound and multiple learning disabilities (PMLD), Down’s syndrome, multiple sclerosis, epilepsy, dementia, Parkinson’s disease, motor neurone disease and related or similar conditions.	GPESv5, HES	All people aged 6 months and over with neurological conditions where respiratory compromise is variable such as Parkinson's disease, motor neurone disease, Huntington's chorea; and rare neurological diseases which may be associated with respiratory compromise.
Stroke or transient ischaemic attack (TIA).	GPESv5, HES	All people 6 months and over with a history of stroke or transient ischaemic attack (TIA).
Learning disabilities including severe or profound and multiple learning disabilities (PMLD), Down's syndrome and those on the learning disability register.	GPESv5, HES	All people aged 6 months and over with a learning disability.
Other rare neurological diseases. Hereditary and degenerative disease of the nervous system or muscles; or severe neurological disability.	GPESv5, HES	All people aged 6 months and over with rare neurological conditions such as hereditary or degenerative diseases of the nervous system or muscles.
Neuro-disability and/or neuromuscular disease that may occur as a result of conditions such as cerebral palsy, autism, epilepsy and muscular dystrophy.	GPESv5, HES	All people aged 6 months and over with neurodisability and/or neuromuscular diseases such as those as a result of cerebral palsy, autism, epilepsy or muscular dystrophy
Neoplasm of the brain.	GPESv5, HES	Children aged 5 to 15 years with a brain neoplasm. People over 16 are identified via their treatment records.

Chronic respiratory disease

Green Book Description	Data used	Rulesets
Those with poorly controlled asthma (≥2 courses of oral corticosteroids in the preceding 24 months or those with poorly controlled asthma on maintenance oral corticosteroids within the last month).	GPESv5, HES	All people over 6 months who have been prescribed four steroid prescriptions on separate days in the last 6 months.
Those with poorly controlled asthma (≥1 hospital admission for asthma in the preceding 24 months).	GPESv5	All people aged 6 months and over with with a hospital admission due to asthma in the last 24 months recorded in their GP records.
Individuals with a severe lung condition chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema; bronchiectasis, interstitial lung fibrosis, pneumoconiosis.	GPESv5, HES	All people age 16 years and over with a diagnosis of chronic obstructive pulmonary disease (COPD), chronic bronchitis, emphysema, interstitial lung disease or pneumoconiosis.
Cystic fibrosis.	GPESv5, HES	All people aged 6 months and over with a diagnosis of cystic fibrosis.
Bronchopulmonary dysplasia (BPD).	GPESv5, HES	All people aged 6 months and over with Bronchopulmonary dysplasia
Ciliary dyskinesias.		See non-digital pathway.

Endocrine

Green Book Description	Data used	Rulesets
Any diabetes including diet-controlled, current gestational diabetes, and Addison's disease.	GPESv5, HES	All people aged 6 months and over with a diagnosis of diabetes mellitus or Addison's disease. Gestational diabetes diagnosed within the last 6 months.
Hypopituitary syndrome.	GPESv5, HES	Children aged 5 to 15 years with hypopituary syndrome.

Immunosuppression

Green Book Description	Data used	Rulesets
Genetic disorders affecting the immune system (e.g. IRAK-4, NEMO, complement disorder, SCID).	GPESv5, HES	All people aged 6 months and over with genetic disorders affecting the immune system, or a chromosomal disorder, or a primary or acquired immune deficiency.
Serious genetic abnormalities that affect a number of systems.	GPESv5, HES	Children aged 5 to 15 years with serious genetic abnormalities including those diagnosed with mitochondrial disease and chromosomal abnormalities.
Patients undergoing chemotherapy leading to immunosuppression and patients undergoing radical radiotherapy.	GPESv5, OPCS, SACT, RTDS	Chemotherapy and/or radiotherapy within the last 12 months recorded via SACT (chemotherapy), RTDS (radiotherapy) databases or via GP records. CAR-T treatment recorded in the GP record within the last 24 months.
Individuals treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day for adults, and children treated with or likely to be treated with high or moderate dose corticosteroids.	GPESv5	All people aged 6 months and over who have been prescribed four steroid prescriptions on separate days in the last 6 months.
Individuals who are receiving immunosuppressive or immunomodulating biological therapy including, but not limited to, anti-TNF, alemtuzumab, ofatumumab, rituximab, patients receiving protein kinase inhibitors or PARP inhibitors, and individuals treated with steroid sparing agents such as cyclophosphamide and mycophenolate mofetil.	GPESv5	All people aged 6 months and over receiving immunosuppresive or immunomodulating biological therapies including biological treatment of B cell lymphoma in the last 12 months.
Those who require long term immunosuppressive treatment for conditions including, but not limited to, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, scleroderma and psoriasis.	GPESv5	All people aged 6 months and over who have been prescribed immunsuppressive and non-biological immune modulating drugs including but not limited to methotrexate, azathioprine, hydroxychloroquine, tacrolimus, sulfasalazine, mercaptopurine or mycophenolate.
Solid organ transplant recipients.	GPESv5, HES	All people aged 6 months and over who have received a solid organ transplant.
Human immunodeficiency virus (HIV) infection at all stages, and other specified immunodeficiencies.	GPESv5, HES	All people aged 6 months and over with HIV, acquired autoimmune deficiency (AIDs), and other immunodeficiencies.
People with a history of haematological malignancy including leukaemia, lymphoma and myeloma/multiple myeloma.	GPESv5, HES, SACT	All people aged 6 months and over with a history of haematological malignancy including leukaemia, lymphoma and myeloma.
Bone marrow or stem cell transplant recipients.	GPESv5, HES, OPCS	All people aged 6 months and over who are bone marrow or stem cell transplant recipients including all people with graft versus host disease

Morbid obesity

Description	Data used	Rulesets
Adults with a body mass index (BMI) codes >= 40kg/m^2.	GPESv5	All people aged 16 years and over with a body mass index greater or equal to 40kg/m^2 recorded in the last 6 months with no subsequent recorded BMI measurement lower than 40.

Severe mental illness

Description	Data used	Rulesets
Individuals with schizophrenia, bipolar disorder or any mental illness that causes severe functional impairment.	GPESv5, HES	All people aged 16 years and over with a diagnosis of schizophrenia, bipolar disorder, or mental illnesses which may lead to severe functional impairment.

Age-based cohorts

Description	Data used	Rulesets
All citizens in England aged 65 years or over	PDS	All people age 65 years or over on 31 March 2024

Last edited: 20 September 2023 1:52 pm