Multimorbidity incidence following hospitalization for SARS-CoV-1 infection or influenza over two decades: a territory-wide retrospective cohort study

Abstract

An infection of SARS-CoV-1, the causative agent of Severe Acute Respiratory Syndrome (SARS), may be followed by long-term clinical sequala. We hypothesized a greater 20-year multimorbidity incidence in people hospitalized for SARS-CoV-1 infection than those for influenza during similar periods. We conducted a retrospective cohort study using a territory-wide public healthcare database in Hong Kong. All patients aged ≥15 hospitalized for SARS in 2003 or influenza in 2002 or 2004 with no more than one of 30 listed chronic disease were included. Demographics, clinical history, and medication use were adjusted for in the inverse-probability-of-treatment-weighted Poisson regression analyses. We identified 1255 hospitalizations for SARS-CoV-1 infection and 687 hospitalizations for influenza. Overall crude multimorbidity incident rates were 1.5 per 100 person-years among SARS patients and 5.6 among influenza patients. Adjusted multimorbidity incidence rate ratio (IRR) was estimated at 0.78 [95% confidence interval (CI), 0.70–0.86) for SARS patients compared with influenza patients. Analysis by follow-up period shows a potentially greater risk among SARS patients in the first year of follow-up (IRR 1.33, 95% CI 0.97–1.84), with the risk in influenza patients increasing in subsequent years. Subgroup analyses by age and sex showed consistent results with the main analysis that SARS-CoV-1 infection was not followed by a higher incidence of multimorbidity than influenza. Notable differences in the patterns of multimorbidity were identified between the two arms. To conclude, we found no evidence of a higher multimorbidity incidence after hospitalization for SARS than for influenza over the long-term.

Publication DOI: https://doi.org/10.1038/s41533-025-00424-y
Divisions: College of Health & Life Sciences > Aston Pharmacy School
Additional Information: Copyright © The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directlyfrom the copyright holder. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/
Uncontrolled Keywords: Adolescent,Adult,Aged,Aged, 80 and over,COVID-19/epidemiology,Cohort Studies,Female,Hong Kong/epidemiology,Hospitalization/statistics & numerical data,Humans,Incidence,Influenza, Human/epidemiology,Male,Middle Aged,Multimorbidity,Retrospective Studies,Young Adult
Publication ISSN: 2055-1010
Last Modified: 01 Apr 2025 12:02
Date Deposited: 27 Mar 2025 08:11
Full Text Link:
Related URLs: https://www.nat ... 533-025-00424-y (Publisher URL)
PURE Output Type: Article
Published Date: 2025-03-25
Published Online Date: 2025-03-25
Accepted Date: 2025-03-13
Authors: Wei, Cuiling
Sing, Chor Wing
Wan, Eric Yuk Fai
Cheung, Ching Lung
Wong, Ian Chi Kei (ORCID Profile 0000-0001-8242-0014)
Lai, Francisco Tsz Tsun

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