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

Individuals with multiple long-term conditions are two and a half times more likely to die following COVID-19 infection than others.

When children were assessed separately the risk for mortality among those with multiple long-term conditions increased to almost three times (2.8) the risk of those without. The mortality rates are 22% and 8% respectively.

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 NIHR ARC East Midlands.

The results have now been published in Journal of the Royal Society of Medicine. 

The authors are now calling 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.

This major review found that following COVID-19 infection, and relative to people with a single or no long-term condition, patients with multiple long-term conditions have: 

• 2.4 times higher chance of hospitalisation in all ages and specifically 3.5 times higher in children.
• 1.8 times greater chance of needing mechanical ventilation in all ages and 4.3 times higher in children, specifically.
• 1.2 times higher chance of admission to Intensive Care Unit in all ages and 2.9 times greater in children.

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."

Dr Salisu-Olatunji said: "Our systematic review and meta-analysis demonstrated a significantly higher risk of adverse COVID-19 outcomes for people 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. 

To read the full paper, click here.