Post-COVID-19 multimorbidity incidence by prior vaccination status in people with a pre-existing comorbidity: A population-based cohort study

作者：Boyan Liu, Song Song, Wenlong Liu, Yuqi Hu, Cuiling Wei, Lingyue Zhou, Qi Sun, Wenxin Tian, Rachel Yui Ki Chu, Ian Chi Kei Wong, Ivan Fan‐Ngai Hung, Eric Yuk Fai Wan, Xue Li, Celine Sze Ling Chui, Esther W. Chan, Carlos King Ho Wong, Francisco Tsz Tsun Lai · 发表于：Journal of Infection · 年份：2025 · DOI：10.1016/j.jinf.2025.106597 · 被引用次数：2 · 研究领域：SARS-CoV-2 and COVID-19 Research、Long-Term Effects of COVID-19、Chronic Disease Management Strategies

BACKGROUND: Long-term health consequences of COVID-19, particularly among individuals with pre-existing chronic diseases, are not fully understood. This study investigates whether SARS-CoV-2 infection increases the risk of developing multimorbidity (≥2 chronic conditions) and evaluates protective effects of vaccination. METHODS: We analyzed territory-wide electronic health records from Hong Kong, linking Hospital Authority data with COVID-19 infection and vaccination records from the Department of Health. A retrospective matched-cohort study was conducted among patients with one pre-existing chronic condition. Participants were stratified into three groups: (1) no documented COVID-19 infection, (2) COVID-19 infection with incomplete vaccination (<3 doses), and (3) COVID-19 infection with full vaccination (≥3 doses). The primary outcome was the incidence of a second chronic condition from a pre-specified list. RESULTS: Among 1,038,175 eligible individuals, 68,975 (6.64%) developed multimorbidity over a median follow-up of 192 days (IQR: 96-313). The non-COVID-19 group (51,288 cases) had an incidence rate of 68.88 per 1000 person-years (95% CI: 68.18-69.37). In contrast, the COVID-19/unvaccinated group (9455 cases) exhibited a significantly higher rate (86.58; 95% CI: 84.85-88.35). The COVID-19/vaccinated group (8232 cases) showed a moderated rate (72.84; 95% CI: 71.27-74.43). Adjusted incidence rate ratios were 1.26 (95% CI: 1.23-1.29) for unvaccinated and 1.08 (95% CI: 1.05-1...