The impact of long-term conditions and comorbidity patterns on COVID-19 infection and hospitalisation: a cohort study

Author:

Huang Yun-TingORCID,Steptoe Andrew,Patel Riyaz S.,Thomson Esme Fuller,Cadar DorinaORCID

Abstract

AbstractIntroductionOlder adults are usually more vulnerable to COVID-19 infections; however, little is known about which comorbidity patterns are related to a higher probability of COVID-19 infection. This study investigated the role of long-term conditions or comorbidity patterns on COVID-19 infection and related hospitalisations.MethodsThis study included 4,428 individuals from Waves 8 (2016−2017) and 9 (2018−2019) of the English Longitudinal Study of Ageing (ELSA), who also participated in the ELSA COVID-19 Substudy in 2020. Comorbidity patterns of chronic conditions were identified using an agglomerative hierarchical clustering method. The relationships between comorbidity patterns or long-term conditions and COVID-19 related outcomes were examined using multivariable logistic regression.ResultsAmong a representative sample of community-dwelling older adults in England, those with cardiovascular disease (CVD) and complex comorbidities had an almost double risk of COVID-19 infection (OR=1.87, 95% CI=1.42−2.46) but not of COVID-19 related hospitalisation. A similar pattern was observed for the heterogeneous comorbidities cluster (OR=1.56, 95% CI=1.24−1.96). The individual investigations of long-term conditions with COVID-19 infection highlighted primary associations with CVD (OR=1.46, 95% CI=1.23−1.74), lung diseases (OR=1.40, 95% CI=1.17−1.69), psychiatric conditions (OR=1.40, 95% CI=1.16−1.68), retinopathy/eye diseases (OR=1.39, 95% CI=1.18−1.64), and arthritis (OR=1.27, 95% CI=1.09−1.48). In contrast, metabolic disorders and diagnosed diabetes were not associated with any COVID-19 outcomes.Discussion/ConclusionThis study provides novel insights into the comorbidity patterns that are more vulnerable to COVID-19 infections and highlights the importance of CVD and complex comorbidities.These findings facilitate crucial new evidence for appropriate screening measures and tailored interventions for older adults in the ongoing global outbreak.

Publisher

Cold Spring Harbor Laboratory

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