Relationship between multimorbidity, SARS-COV-2 infection and long COVID: a cross-sectional population-based French survey

Abstract Background Understanding the risks of COVID-19-related consequences for vulnerable groups such as people with multimorbidity is crucial to better tailor health care and public health measures. The main objective of this study was to explore the association between multimorbidity and WHO-def...

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Main Authors: Tatjana T. Makovski, Olivier Steichen, Melissa Rushyizekera, Marjan van den Akker, Joël Coste
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Medicine
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Online Access:https://doi.org/10.1186/s12916-025-04027-9
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author Tatjana T. Makovski
Olivier Steichen
Melissa Rushyizekera
Marjan van den Akker
Joël Coste
author_facet Tatjana T. Makovski
Olivier Steichen
Melissa Rushyizekera
Marjan van den Akker
Joël Coste
author_sort Tatjana T. Makovski
collection DOAJ
description Abstract Background Understanding the risks of COVID-19-related consequences for vulnerable groups such as people with multimorbidity is crucial to better tailor health care and public health measures. The main objective of this study was to explore the association between multimorbidity and WHO-defined post-COVID condition (PCC), while also considering the association with SARS-COV-2 infection given that the infection is a prerequisite of PCC. Methods This population-representative cross-sectional study was conducted in the general adult population in mainland France between 29 August and 31 December 2022 (N = 1813). The analyses of the association between multimorbidity (defined as disease count and most prevalent dyads/triads) and PCC or SAR-COV-2 infection were adjusted for age, sex, socioeconomic variables and number of infections (for PCC only) using adjusted Poisson regression with robust variance. Results The study population had a mean age (SD) of 53 (± 18.5) years, while 53.6% were women. The likelihood of SARS-COV-2 infection increased with disease count but was only significant for ≥ 4 diseases. Five dyads and one triad presented a higher risk; almost all included anxiety. The likelihood of PCC increased with disease count, prevalence ratios (PRs) (95% CI) for 1, 2–3 and ≥ 4 diseases versus 0 were 1.90 (1.16–3.13), 3.32 (2.07–5.35) and 5.65 (3.41–9.38), respectively, and for 19 of 26 most prevalent dyads and the triad. The association was strongest for cardiac rhythm disorder and either low back pain (PR (95%CI) 4.17 (2.03–8.53)) or anxiety (PR (95%CI) 3.73 (1.98–7.01)). Conclusions Multimorbidity, most frequently in combination with anxiety or low back pain, presented a significant association with PCC beyond that of SARS-CoV-2 infection underscoring the importance of implementing strategies to prevent and manage persistent symptoms in vulnerable groups.
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spelling doaj-art-9bb5aa1dc3a3423d9343f4b883e3b6082025-08-20T03:18:34ZengBMCBMC Medicine1741-70152025-04-0123111210.1186/s12916-025-04027-9Relationship between multimorbidity, SARS-COV-2 infection and long COVID: a cross-sectional population-based French surveyTatjana T. Makovski0Olivier Steichen1Melissa Rushyizekera2Marjan van den Akker3Joël Coste4Department of Non-Communicable Diseases and Injuries, French Public Health Agency (Sante Publique France)UMR-S 1136, Sorbonne Universite, INSERM, Institut Pierre Louis d’Epidemiologie Et de Sante Publique, IPLESPDepartment of Non-Communicable Diseases and Injuries, French Public Health Agency (Sante Publique France)Institute of General Practice, Goethe-UniversityDepartment of Non-Communicable Diseases and Injuries, French Public Health Agency (Sante Publique France)Abstract Background Understanding the risks of COVID-19-related consequences for vulnerable groups such as people with multimorbidity is crucial to better tailor health care and public health measures. The main objective of this study was to explore the association between multimorbidity and WHO-defined post-COVID condition (PCC), while also considering the association with SARS-COV-2 infection given that the infection is a prerequisite of PCC. Methods This population-representative cross-sectional study was conducted in the general adult population in mainland France between 29 August and 31 December 2022 (N = 1813). The analyses of the association between multimorbidity (defined as disease count and most prevalent dyads/triads) and PCC or SAR-COV-2 infection were adjusted for age, sex, socioeconomic variables and number of infections (for PCC only) using adjusted Poisson regression with robust variance. Results The study population had a mean age (SD) of 53 (± 18.5) years, while 53.6% were women. The likelihood of SARS-COV-2 infection increased with disease count but was only significant for ≥ 4 diseases. Five dyads and one triad presented a higher risk; almost all included anxiety. The likelihood of PCC increased with disease count, prevalence ratios (PRs) (95% CI) for 1, 2–3 and ≥ 4 diseases versus 0 were 1.90 (1.16–3.13), 3.32 (2.07–5.35) and 5.65 (3.41–9.38), respectively, and for 19 of 26 most prevalent dyads and the triad. The association was strongest for cardiac rhythm disorder and either low back pain (PR (95%CI) 4.17 (2.03–8.53)) or anxiety (PR (95%CI) 3.73 (1.98–7.01)). Conclusions Multimorbidity, most frequently in combination with anxiety or low back pain, presented a significant association with PCC beyond that of SARS-CoV-2 infection underscoring the importance of implementing strategies to prevent and manage persistent symptoms in vulnerable groups.https://doi.org/10.1186/s12916-025-04027-9MultimorbidityMultiple conditionsSARS-COV-2Long COVIDPost COVID-19 conditionFrance
spellingShingle Tatjana T. Makovski
Olivier Steichen
Melissa Rushyizekera
Marjan van den Akker
Joël Coste
Relationship between multimorbidity, SARS-COV-2 infection and long COVID: a cross-sectional population-based French survey
BMC Medicine
Multimorbidity
Multiple conditions
SARS-COV-2
Long COVID
Post COVID-19 condition
France
title Relationship between multimorbidity, SARS-COV-2 infection and long COVID: a cross-sectional population-based French survey
title_full Relationship between multimorbidity, SARS-COV-2 infection and long COVID: a cross-sectional population-based French survey
title_fullStr Relationship between multimorbidity, SARS-COV-2 infection and long COVID: a cross-sectional population-based French survey
title_full_unstemmed Relationship between multimorbidity, SARS-COV-2 infection and long COVID: a cross-sectional population-based French survey
title_short Relationship between multimorbidity, SARS-COV-2 infection and long COVID: a cross-sectional population-based French survey
title_sort relationship between multimorbidity sars cov 2 infection and long covid a cross sectional population based french survey
topic Multimorbidity
Multiple conditions
SARS-COV-2
Long COVID
Post COVID-19 condition
France
url https://doi.org/10.1186/s12916-025-04027-9
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