Having multiple long-term conditions triples children’s risk for death after COVID-19

Key takeaways:

• People with multiple long-term conditions were 2.61 times more likely to die after having COVID-19.
• Children with multiple long-term conditions had a 2.84-times higher risk for death.

Children who have multiple long-term conditions are as almost three times more likely to die after COVID-19 compared with children who do not, according to data published in Journal of the Royal Society of Medicine.

“There is limited reporting of the health outcomes following COVID-19 infection in individuals with multiple long-term conditions,” Shukrat O. Salisu-Olatunji, MBBS, MPH, MSc, a PhD student at the Leicester Diabetes Center at University of Leicester, and colleagues wrote. “This information would be useful to guide clinical management and public health interventions targeting people with multiple long-term conditions in times of such public health crises.”

The researchers performed a systematic review and meta-analysis of 111 studies that took place between Jan. 1, 2020, and May 4, 2023. The studies included 4,084,469 patients from 51 countries; 723,402 patients were children and adults aged younger than 23 years.

Among all patients, those with multiple long-term conditions were more than twice as likely to die after having COVID-19 compared with patients without multiple long-term conditions (RR = 2.61; 95% CI, 2.27-3), Salisu-Olatunji and colleagues found. They were also more likely to be hospitalized (RR = 2.4; 95% CI, 1.92-2.99), admitted to the ICU (RR = 1.22; 95% CI 1.07-1.39) or need mechanical ventilation (RR = 1.83; 95% CI, 1.18-2.84).

The researchers learned that children with multiple long-term conditions who had COVID-19 had an even higher risk for hospitalization (RR = 3.53; 95% CI, 1.07-11.66), ICU admission (RR = 2.9; 95% CI, 1.96-4.29), mechanical ventilation (RR = 4.29; 95% CI, 1.14-16.18) and death (RR = 2.84; 95% CI, 1.41-5.7).

Patients with multiple long-term conditions were more than twice as likely to die following COVID-19 in lower middle (RR = 2.5; 95% CI, 1.97-3.17), upper middle (RR = 2.3; 95% CI, 1.88-2.81) and high-income countries (RR = 2.66; 95% CI, 2.35-3). One study reported that those with multiple long-term conditions in low-income countries were 16 times more likely to die after contracting COVID-19 (RR = 15.96; 95% CI, 13.27-19.21).

The risk for death and hospitalization were similar in studies with low risk of bias and moderate risk of bias, whereas moderate risk of bias studies reported higher risk ratios for ICU admission and mechanical ventilation, the researchers wrote. However, there was small number of moderate risk of bias studies, “thus limiting the inclusion in the interpretation of a meta-analysis,” Salisu-Olatanji and colleagues wrote.

In a meta-regression analysis, the researchers found that men had a higher risk for being admitted to the ICU (P = .013) and requiring mechanical ventilation (P = .002).

“This may suggest that increased vulnerabilities could be associated more with the extremes of age rather than simply older age, as has been previously reported,” Salisu-Olatunji said in a press release. “We hope that health policies will prioritize people with multiple long-term conditions, especially in times of public health emergencies such as the COVID-19 pandemic.”

References:

• Children with multiple long-term conditions hospitalized with COVID are almost three times more likely to die: New study. https://www.eurekalert.org/news-releases/1061364. Published Oct. 16, 2024. Accessed Nov. 1, 2024.
• Salisu-Olatunji SO, et al. J R Soc Med. 2024;doi:10.1177/01410768241261507.