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Lookup NU author(s): Professor Anthony De SoyzaORCiD, Dr Carlos EchevarriaORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Copyright © 2026. Published by Elsevier Ltd. Background: Preexisting multiple (two or more) long-term conditions (MLTCs) may negatively affect recovery after COVID-19. We investigated how preexisting MLTCs, including different categorization and patterns of MLTCs, affect 1-year health outcomes after severe COVID-19. 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.
Author(s): Gardiner LE, Lozano-Rojas D, Smith N, Espley J, Stewart ID, Ntotsis K, Aul R, Bakerly ND, Beirne P, Bolton CE, Brown JS, Briggs A, Chalder T, Chalmers JD, Choudhury G, Davies MJ, De Soyza A, Docherty AB, Easom N, Echevarria C, Efstathiou CM, Elneima O, Fuld J, Geddes JR, Goemans AF, Greenhalf W, Greening NJ, Guillen-Guio B, Harris VC, Harrison EM, Hart N, Heaney LG, Heller S, Ho L-P, Horsley A, Houchen-Wolloff L, Howard L, Hurst JR, Iqbal MM, Jacob J, Jenkins G, Jolley C, Jones M, Kerr S, Khunti K, Leavy OC, Lewis K, Lone NI, Lord JM, Man WD-C, Marks M, McAuley HJC, McCann GP, Neubauer S, Openshaw PJM, Parekh D, Pfeffer P, Poinasamy K, Porter JC, Quint JK, Rahman NM, Raman B, Richardson M, Rowland-Jones SDM, Rowland MJ, Saunders RM, Scott JT, Semple MG, Sereno M, Shah AM, Sheikh A, Shikotra A, Singapuri A, Taquet M, Thomas D, Thompson R, Thorpe M, Toshner M, Wang L, Wootton DG, Zheng B, Wain LV, Brightling CE, Singh SJ, Taylor RS, Evans RA
Publication type: Article
Publication status: Published
Journal: International Journal of Infectious Diseases
Year: 2026
Volume: 168
Print publication date: 01/07/2026
Online publication date: 09/04/2026
Acceptance date: 08/04/2026
Date deposited: 26/05/2026
ISSN (print): 1201-9712
ISSN (electronic): 1878-3511
Publisher: Elsevier BV
URL: https://doi.org/10.1016/j.ijid.2026.108695
DOI: 10.1016/j.ijid.2026.108695
Data Access Statement: The protocol, consent form, definition and derivation of clinical characteristics and outcomes, training materials, regulatory documents, requests for data access and other relevant study materials are available online at https://www.phosp.org
PubMed id: 41966515
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