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 C-reactive protein (CRP), chronic obstructive pulmonary disease, estimated glomerular filtration rate, frailty and others.


A total of 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 83 mg/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 [adjusted hazard ratios (aHR) = 1.39, 95% confidence intervals (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 hospitalized 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.


© The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite as

Bruce, E., Carter, B., Quinn, T., Verduri, A., Pearson, O., Vilches-Moraga, A., Price, A., McGovern, A., Evans, L., McCarthy, K., Hewitt, J., Moug, S., Myint, P. & COPE Study Team 2021, 'Multiple House Occupancy is Associated with Mortality in Hospitalised Patients with Covid-19', European Journal of Public Health, 32(1), pp. 133-139. https://doi.org/10.1093/eurpub/ckab085

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Last updated: 06 October 2022
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