Investigating prognostic classifications of preexisting multiple long-term conditions for health outcomes 1 year after COVID-19 hospitalization: A UK prospective observational study.
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Gardiner Lucy E, Lozano-Rojas Daniel, Smith Nikki, Espley Jane, Stewart Iain D, Ntotsis Kimon, Aul Raminder, Bakerly Nawar Dair, Beirne Paul, Bolton Charlotte E, Brown Jeremy S, Briggs Andrew, Chalder Trudie, Chalmers James D, Choudhury Gourab, Davies Melanie J, De Soyza Anthony, Docherty Annemarie B, Easom Nicholas, Echevarria Carlos, Efstathiou Claudia M, Elneima Omer, Fuld Jonathan, Geddes John R, Goemans Anne F, Greenhalf William, Greening Neil J, Guillen-Guio Beatriz, Harris Victoria C, Harrison Ewen M, Hart Nicholas, Heaney Liam G, Heller Simon, Ho Ling-Pei, Horsley Alex, Houchen-Wolloff Linzy, Howard Luke, Hurst John R, Iqbal Muhammad Mamoon, Jacob Joseph, Jenkins Gisli, Jolley Caroline, Jones Mark, Kerr Steven, Khunti Kamlesh, Leavy Olivia C, Lewis Keir, Lone Nazir I, Lord Janet M, Man Will D-C, Marks Michael, McAuley Hamish J C, McCann Gerry P, Neubauer Stefan, Openshaw Peter Jm, Parekh Dhruv, Pfeffer Paul, Poinasamy Krishnah, Porter Joanna C, Quint Jennifer K, Rahman Najib M, Raman Betty, Richardson Matthew, Rowland-Jones Sarah Dm, Rowland Matthew J, Saunders Ruth M, Scott Janet T, Semple Malcolm G, Sereno Marco, Shah Ajay M, Sheikh Aziz, Shikotra Aarti, Singapuri Ananga, Taquet Maxime, Thomas David, Thompson Roger, Thorpe Mathew, Toshner Mark, Wang Lin, Wootton Dan G, Zheng Bang, Wain Louise V, Brightling Christopher E, Singh Sally J, Taylor Rod S, Evans Rachael A, PHOSP-COVID study Collaborative Group
Аннотация
METHODS: Adults post-hospitalization after COVID-19 were recruited during 2020-2021. We compared recovery at 1 year after discharge using adjusted multivariable logistic regression in 1:1 propensity-matched adults (for age, sex, ethnicity, social deprivation, obesity, and smoking history) with and without preexisting MLTCs. In adults with MLTCs, different categorization such as number of conditions, number and types of body systems involved (e.g. respiratory, cardiovascular), and latent class analysis-derived patterns of condition co-occurrence were assessed for their association with recovery at 1 year.
RESULTS: A total of 647 adults with MLTCs were matched with 647 adults without MLTCs (n = 1294; 61.9% male, 79.6% of White ethnicity, median age 59 [interquartile range 52-67] years). The presence of MLTCs was associated with lower odds of feeling fully recovered (odds ratio 0.66 [95% confidence interval 0.51-0.85], P = 0.001). In those with MLTCs, recovery was negatively affected by number and type of body systems involved (e.g. respiratory [odds ratio 0.49 (95% confidence interval 0.34-0.69), P <0.001]) but not by the number of conditions (P >0.1). Four latent classes of MLTC co-occurrence were estimated with different risks of recovery (P <0.01).
CONCLUSION: Adults with preexisting MLTCs were 34% less likely to feel fully recovered at 1 year after COVID-19 hospitalization than adults without MLTCs. We describe prognostic classifications of MLTCs, with future work needed to understand whether they have prognostication in broader post-acute infection sequalae.