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Elevated risk of multimorbidity post-COVID-19 infection: protective effect of vaccination
1Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, Centre for Safe Medication Practice and Research, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China.
Insights
Coronavirus disease 2019 (Covid-19) infection significantly increases multimorbidity risk in individuals with one chronic condition. Full vaccination substantially mitigates this elevated risk, offering crucial protection.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- The impact of the Covid-19 pandemic on multimorbidity incidence in individuals with pre-existing chronic conditions remains unclear.
- The potential modifying effect of vaccination on this association requires investigation.
Purpose of the Study:
- To investigate the association between Covid-19 infection and the incidence of multimorbidity.
- To assess the role of prior vaccination in modifying this association among individuals with one chronic condition.
Main Methods:
- A territory-wide nested case-control study utilizing Hong Kong's electronic health records and Covid-19 reports.
- Incidence density sampling matched cases (developed multimorbidity) with controls (did not develop multimorbidity).
- Conditional logistic regression analysis to determine adjusted odds ratios (aORs) for multimorbidity.
Main Results:
- A 28% increased odds of multimorbidity were observed following Covid-19 infection (CI 22%-36%).
- Prior full vaccination (BNT162b2 or CoronaVac) showed a non-significant 3% increase in multimorbidity odds (CI -2%-7%).
- These associations were consistent across different demographic groups, including age and sex.
Conclusions:
- Covid-19 infection significantly elevates the risk of developing multimorbidity in individuals with one pre-existing chronic condition.
- Full vaccination demonstrates a significant protective effect, reducing the increased risk of multimorbidity post-Covid-19.
Background:
It is unclear how the coronavirus disease 2019 (Covid-19) pandemic has affected multimorbidity incidence among those with one pre-existing chronic condition, as well as how vaccination could modify this association.
Aim:
To examine the association of Covid-19 infection with multimorbidity incidence among people with one pre-existing chronic condition, including those with prior vaccination.
Design:
Nested case-control study.
Methods:
We conducted a territory-wide nested case-control study with incidence density sampling using Hong Kong electronic health records from public healthcare facilities and mandatory Covid-19 reports. People with one listed chronic condition (based on a list of 30) who developed multimorbidity during 1 January 2020-15 November 2022 were selected as case participants and randomly matched with up to 10 people of the same age, sex and with the same first chronic condition without having developed multimorbidity at that point. Conditional logistic regression was used to estimate adjusted odds ratios (aORs) of multimorbidity.
Results:
In total, 127 744 case participants were matched with 1 230 636 control participants. Adjusted analysis showed that there were 28%-increased odds of multimorbidity following Covid-19 [confidence interval (CI) 22% to 36%] but only 3% (non-significant) with prior full vaccination with BNT162b2 or CoronaVac (95% CI -2% to 7%). Similar associations were observed in men, women, older people aged 65 or more, and people aged 64 or younger.
Conclusions:
We found a significantly elevated risk of multimorbidity following a Covid-19 episode among people with one pre-existing chronic condition. Full vaccination significantly reduced this risk increase.
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