Cheta Nicholas, Zakaria Dianne, Demers Alain, Abdullah Peri, Aziz Samina
Lifespan Chronic Diseases and Conditions Division (LCDC), Centre for Surveillance and Applied Research (CSAR), Health Promotion and Chronic Disease Prevention Branch (HPCDP), Public Health Agency of Canada (PHAC), Ottawa, ON, Canada.
Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
BMC Public Health. 2025 Mar 12;25(1):981. doi: 10.1186/s12889-025-22041-7.
Individuals living with chronic conditions (CC) typically have a higher risk of more severe outcomes when exposed to infection. Although many studies have investigated the relationship between CCs and COVID-19 severity, they are generally limited to clinical or hospitalized populations. There is a need to estimate the impact of pre-existing CCs on the severity of acute SARS-CoV-2 infection symptoms among the general population.
Data from the Canadian COVID-19 Antibody and Health Survey - Cycle 2, a population-based cross-sectional probability survey across 10 provinces capturing the COVID-19 experiences of respondents from January 2020 to August 2022, were used to assess whether pre-existing CCs increased the odds of more severe self-reported infection symptoms among adults living in Canada. Multivariable regression modelling identified which CCs were independently associated with more severe infection symptoms after adjusting for sex, age at infection, and other significant covariates.
Chronic lung disease (aOR = 1.64, 95% CI: 1.09, 2.46), high blood pressure (aOR = 1.35, 95% CI: 1.13, 1.62), weakened immune system (aOR = 1.46, 95% CI: 1.08, 1.98), chronic fatigue syndrome or fibromyalgia (aOR = 2.20, 95% CI: 1.39, 3.50), and arthritis (aOR = 1.28, 95% CI: 1.04, 1.56) were associated with a higher odds of more severe infection, whereas osteoporosis (aOR = 0.58, 95% CI: 0.39, 0.87) was associated with a lower odds. Limiting modelling to adults with confirmed SARS-CoV-2 infections affected some of the variables retained and adjusted associations.
Our findings contribute to a growing evidence base of associations between pre-existing CCs and adverse outcomes after SARS-CoV-2 infection. Identifying factors associated with more severe infection allows for more targeted prevention strategies and early interventions that can minimize the impact of infection.
慢性病患者在接触感染时通常面临更严重后果的风险更高。尽管许多研究调查了慢性病与新冠病毒疾病严重程度之间的关系，但这些研究通常仅限于临床或住院人群。有必要估计既往慢性病对普通人群中急性SARS-CoV-2感染症状严重程度的影响。
来自加拿大新冠病毒抗体与健康调查——第2轮的数据，这是一项基于人群的横断面概率调查，涵盖10个省份，记录了2020年1月至2022年8月受访者的新冠病毒感染经历，用于评估既往慢性病是否会增加加拿大成年人自我报告的感染症状更严重的几率。多变量回归模型确定了在调整性别、感染时年龄和其他显著协变量后，哪些慢性病与更严重的感染症状独立相关。
慢性肺病（调整后比值比[aOR]=1.64，95%置信区间[CI]：1.09，2.46）、高血压（aOR=1.35，95%CI：1.13，1.62）、免疫系统减弱（aOR=1.46，95%CI：1.08，1.98）、慢性疲劳综合征或纤维肌痛（aOR=2.20，95%CI：1.39，3.50）以及关节炎（aOR=1.28，95%CI：1.04，1.56）与更严重感染的几率较高相关，而骨质疏松症（aOR=0.58，95%CI：0.39，0.87）与较低几率相关。将模型限制在确诊SARS-CoV-2感染的成年人中，影响了一些保留的变量和调整后的关联。
我们的研究结果为既往慢性病与SARS-CoV-2感染后不良结局之间的关联提供了越来越多的证据。识别与更严重感染相关的因素有助于制定更有针对性的预防策略和早期干预措施，从而将感染的影响降至最低。
