Department of Epidemiology and Public Health, University College London, London, UK.
Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK.
Gerontology. 2023;69(10):1200-1210. doi: 10.1159/000531848. Epub 2023 Sep 11.
Older adults are more vulnerable to COVID-19 infections; however, little is known about which comorbidity patterns are related to a higher risk of COVID-19 infection. This study investigated the role of long-term conditions or comorbidity patterns on COVID-19 infection and related hospitalisations.
This 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 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.
Among 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.
This study provides novel insights into the comorbidity patterns that are more vulnerable to COVID-19 infections and hospitalisations, highlighting the vulnerability of those with CVD and other complex comorbidities. These findings facilitate crucial new evidence that should be considered for appropriate screening measures and tailored interventions for older adults in the ongoing global outbreak.
老年人更容易感染 COVID-19；然而，人们对哪些合并症模式与更高的 COVID-19 感染风险有关知之甚少。本研究调查了长期疾病或合并症模式对 COVID-19 感染和相关住院治疗的作用。
本研究纳入了来自英国纵向老龄化研究（ELSA）第 8 波（2016-2017 年）和第 9 波（2018-2019 年）的 4428 名参与者，他们还参加了 2020 年的 ELSA COVID-19 子研究。使用聚合层次聚类方法确定合并症模式。使用多变量逻辑回归检查合并症模式或长期疾病与 COVID-19 相关结局之间的关系。
在英格兰社区居住的老年人群代表性样本中，患有心血管疾病（CVD）和复杂合并症的人感染 COVID-19 的风险几乎增加了一倍（OR = 1.87，95%CI = 1.42-2.46），但 COVID-19 相关住院的风险并未增加。对于异质合并症聚类，观察到类似的模式（OR = 1.56，95%CI = 1.24-1.96）。对与 COVID-19 感染相关的长期疾病的个体研究突出了与 CVD（OR = 1.46，95%CI = 1.23-1.74）、肺部疾病（OR = 1.40，95%CI = 1.17-1.69）、精神疾病（OR = 1.40，95%CI = 1.16-1.68）、视网膜/眼部疾病（OR = 1.39，95%CI = 1.18-1.64）和关节炎（OR = 1.27，95%CI = 1.09-1.48）的主要关联。相比之下，代谢紊乱和确诊的糖尿病与任何 COVID-19 结局均无关。
本研究提供了有关更易感染 COVID-19 感染和住院治疗的合并症模式的新见解，突出了 CVD 和其他复杂合并症患者的脆弱性。这些发现为正在进行的全球疫情中为老年人提供适当的筛查措施和量身定制的干预措施提供了至关重要的新证据。
