Study examines long-term COVID-19 impact on children with multiple long-term conditions

Children with multiple long-term health conditions are almost three times (2.8) more likely to die following COVID-19 infection compared to those with none or a single condition, according to a study led by experts from ARC East Midlands.

Adults with multiple long-term conditions are also at increased risk, being two and a half times (2.6) more likely to die following COVID-19 infection. 

The authoritative systematic review and meta-analysis, involving more than four million patients with COVID-19, was led by Dr Shukrat Salisu-Olatunji, a PhD student at the University of Leicester funded by the National Institute for Health and Care Research (NIHR) ARC East Midlands.

Professor Kamlesh Khunti, Director of NIHR ARC East Midlands and a senior author of the paper, emphasised the significance of these findings, particularly in light of the recent NHS Darzi Review.

He said: "This study puts into the spotlight the high risk of poorer outcomes for people with multiple long-term conditions. This systematic review is timely as the publication of the recent NHS Darzi Review highlights the biggest challenge facing the nation as the ageing population, who are living longer often in ill-health with multiple long-term conditions."

The study, published today (DATE) in the Journal of the Royal Society of Medicine, calls for patients with multiple long-term conditions to be prioritised in healthcare policies. It is believed to be the largest cohort-based analysis of COVID-19 outcomes for individuals with multiple long-term conditions, reviewing 38,356 studies from 51 countries and including 111 of them.

While previous research has identified risk factors such as older age, male sex, socioeconomic deprivation, and ethnicity, this study is unique in its focus on outcomes for patients with multiple long-term conditions - a growing concern as over a third of adults globally, and a quarter in England, have two or more long-term conditions.

The review found the following outcomes for patients with multiple long-term conditions compared to those with a single or no condition after COVID-19 infection:

• 2.6 times higher mortality risk in adults, and 2.8 times higher in children
• 2.4 times higher chance of hospitalisation in adults, and 3.5 times higher in children
• 1.8 times greater chance of needing mechanical ventilation in adults, and 4.3 times higher in children
• 1.2 times higher chance of ICU admission in adults, and 2.9 times higher in children.

Dr. Salisu-Olatunji said: "Our systematic review and meta-analysis demonstrated a significantly higher risk of adverse COVID-19 outcomes for adults living with multiple long-term conditions compared to those without, and this risk was even higher in children and young people. This suggests vulnerabilities could be linked more to extremes of age rather than simply older age, as previously reported."

The research highlights the importance of prioritising individuals with multiple long-term conditions in public health policies, especially during global health emergencies like the COVID-19 pandemic.