Multiple long-term conditions cut year-one recovery from COVID-19 hospitalisation by a third, UK cohort finds

Gardiner and colleagues (International Journal of Infectious Diseases; PMID 41966515) conducted a UK prospective observational study, propensity-matched for age, sex, ethnicity, social deprivation, obesity and smoking history, comparing 647 adults with pre-existing multiple long-term conditions (MLTCs) against 647 adults without, all recruited after hospitalisation for COVID-19 during 2020–2021 (n=1,294 total). Pre-existing MLTCs were associated with lower odds of feeling fully recovered at one year (odds ratio 0.66, 95% CI 0.51–0.85, p=0.001) — a 34% reduction in the odds of full recovery. Among adults with MLTCs, recovery was negatively affected by the number and type of body systems involved — respiratory-system involvement carried an odds ratio of 0.49 (95% CI 0.34–0.69) — but not by the number of conditions alone. [Primary Study]

This is a national UK cohort with propensity matching to control for confounding, among the more robust observational designs available for this question. The source does not provide an international comparator against which to benchmark UK-specific recovery rates, and none is invented here.

The finding is directly relevant to planning community rehabilitation and psychological-support capacity for populations recovering from severe respiratory illness who also carry a high burden of pre-existing long-term conditions, since it is the type of condition — respiratory disease specifically — rather than condition count alone that predicts poorer recovery. The finding applies to the hospitalised-with-COVID-19 population studied and should not be read as extending to non-hospitalised populations or to conditions other than those assessed in the cohort.