Journal of multimorbidity and comorbidity最新文献

{"title":"Functional mobility and cardiometabolic multimorbidity: Evidence from the China health and retirement longitudinal study.","authors":"Shuhan Guo","doi":"10.1177/26335565261490115","DOIUrl":"10.1177/26335565261490115","url":null,"abstract":"<p><strong>Background: </strong>Population ageing has increased the burden of cardiometabolic multimorbidity (CMM), defined as the presence of two or more cardiometabolic diseases. Functional mobility is a marker of systemic ageing and adverse health outcomes, but its association with CMM remains unclear among Chinese adults.</p><p><strong>Methods: </strong>Data were from 16,032 adults aged ≥45 years in the China Health and Retirement Longitudinal Study (2011-2018). Functional limitation was assessed using Activities of Daily Living and a seven-item mobility scale. The primary exposure was a standardised composite score based on the equal-weighted average of the two standardised indicators. PCA-derived, ADL-only, mobility-only, and Winsorised composite scores were examined in sensitivity analyses. Cross-sectional associations were estimated using multivariable logistic regression, and longitudinal associations using generalised estimating equations with time-varying covariates.</p><p><strong>Results: </strong>Higher functional limitation was consistently associated with increased odds of CMM. In cross-sectional analyses, each standard-deviation increment in the functional limitation composite score was associated with 46% higher odds of CMM (odds ratio = 1.46; 95% confidence interval: 1.35-1.58; p < 0.001). In longitudinal analyses with time-varying covariates, the corresponding increase was 37% (odds ratio = 1.37; 95% confidence interval: 1.28-1.46; p < 0.001). A graded pattern was also observed across functional limitation tertiles.</p><p><strong>Conclusions: </strong>Poorer functional mobility was associated with CMM among middle-aged and older adults in China in both cross-sectional and longitudinal analyses. Simple functional assessments may help characterize groups with greater cardiometabolic burden and may be useful in clinical assessment and monitoring in ageing populations.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261490115"},"PeriodicalIF":2.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining therapeutic inertia patterns in type 2 diabetes patients with multiple chronic conditions: Time-to-event analysis.","authors":"Helen Chen, Lap Pui Chung, Patrick Balius, Aishwarya Shishir Budhkar, Paras Punater, Mark Fu, Titus Schleyer, Elaine Sang, Isaac Nkrumah, Julian Wolfson","doi":"10.1177/26335565261469776","DOIUrl":"10.1177/26335565261469776","url":null,"abstract":"<p><strong>Objective: </strong>Therapeutic inertia (TI) in type 2 diabetes (T2D)-delayed treatment adjustment despite elevated A1C-is often complicated by multiple chronic conditions (MCC). We examined how clinicians address TI in patients with T2D and MCC and evaluated association with patient, clinic, and neighborhood factors.</p><p><strong>Methods: </strong>Using electronic health records from two Midwestern U.S. health systems, we identified a retrospective six-year cohort of adults with T2D, MCC, and above-target A1C (>7% [53 mmol/mol] for age < 65; >8% [64 mmol/mol] for age <math><mrow><mo>≥</mo></mrow> </math> 65). Time-to-event analyses assessed factors associated with clinicians addressing TI. The event was defined as maintaining TI <math><mrow><mo>≤</mo></mrow> </math> 0.5 for two consecutive years indicating prescription changes occurred in more than 50% of opportunities following above-target A1C. Covariates included demographics, comorbidity, insulin use, number of diabetes drug classes, clinic rurality, and neighborhood social deprivation.</p><p><strong>Findings: </strong>A cohort of 18,003 adults met eligibility criteria (mean age 59; 78% White). Among patients with T2D and MCC<b>,</b> clinicians addressed TI in 17% of cases at two-year, 31% at four-year, and 38% at five-year follow-up. Clinicians were more likely to address TI with MCC in patients experiencing greater social deprivation and being prescribed with more diabetes drug classes at baseline (<i>p</i><0.05). Despite addressing TI, patients aged 18-44 had the worst glycemic control (8.3% [67 mmol/mol]) and high prevalence of depression (82%).</p><p><strong>Conclusion: </strong>Therapeutic inertia varied by patient, clinic, and neighborhood factors, emphasizing the need for targeted, multifaceted interventions to reduce TI, especially among populations facing socioeconomic and mental health challenges.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261469776"},"PeriodicalIF":2.7,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13500946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of change in poor mental health and obesity (including overweight) comorbidity in mid-adolescence: A longitudinal analysis using the millennium cohort study.","authors":"Afrin Khan, Alexis Karamanos, Amal R Khanolkar","doi":"10.1177/26335565261466283","DOIUrl":"10.1177/26335565261466283","url":null,"abstract":"<p><strong>Background: </strong>Depression and obesity are common chronic conditions in adolescence with major health consequences. While adverse childhood experiences (ACEs), socioeconomic disadvantage, and sexual minority (SM) identity are linked to higher mental health-obesity (MH-OB) comorbidity, evidence on predictors of change during adolescence is limited.</p><p><strong>Methods: </strong>Data came from 10,353 UK adolescents (49% male, 80.9% White, 9.1% SM) in the Millennium Cohort Study. MH-OB comorbidity was defined using overweight/obesity (International Obesity Task Force criteria) and depression/anxiety symptoms (Strengths and Difficulties Questionnaire emotional symptoms subscale) at ages 14 and 17. Change in comorbidity was categorised as none, persistent, resolved, or newly developed. Predictors included sex at birth, ethnicity, sexual identity, socioeconomic position, and cumulative ACEs. Multinomial logistic regression estimated adjusted relative risk ratios (aRRRs).</p><p><strong>Results: </strong>At age 14, 7.7% of adolescents were obese, 19.5% overweight, and 27.8% reported depression/anxiety symptoms. By age 17, 2.5% had persistent MH-OB comorbidity, 6.2% newly developed comorbidity, and 2.8% resolved; 88.0% had no comorbidity. Female sex, SM identity, lower household income, and increasing ACE exposure were associated with persistent and newly developed comorbidity. Associations were strongest among SM adolescents and females. Exposure to three or more ACEs increased risk of persistent comorbidity.</p><p><strong>Conclusion: </strong>Adolescents who experienced socioeconomic disadvantage, exposure to adversity, and with SM identity were more likely to show persistent or new-onset MH-OB comorbidity, with associations generally stronger in females than in males. These findings highlight the importance of early, integrated interventions that address both mental health and weight-related risks in structurally disadvantaged groups.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261466283"},"PeriodicalIF":2.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ALT/AST ratio as an early marker of metabolic multimorbidity in young adults: A community-based study.","authors":"Yi-Hung Lin, Ming-Shyan Lin, Meng-Shu Tsai, Jr-Hau Lung, Po-Chang Wang, Yi-Fang Wu, Yung-Yu Hsieh, Chia-Hao Chang, Ming-Horng Tsai, Mei-Yen Chen","doi":"10.1177/26335565261476716","DOIUrl":"10.1177/26335565261476716","url":null,"abstract":"<p><strong>Background: </strong>Metabolic multimorbidity, characterized by the clustering of metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD) and metabolic syndrome (MetS), is increasingly recognized in young adults and may reflect early systemic metabolic dysfunction. However, simple biomarkers for identifying metabolic abnormalities in asymptomatic populations remain limited.</p><p><strong>Objective: </strong>To evaluate the ALT/AST ratio as a marker of metabolic multimorbidity and examine its association with modifiable behavioral factors.</p><p><strong>Methods: </strong>This community-based cross-sectional study included 3,796 asymptomatic adults aged 20-40 years. Moderate-to-severe fatty liver was assessed by ultrasonography. The discriminatory performance of the ALT/AST ratio was evaluated using ROC analysis and compared with ALT, white blood cell count, and neutrophil-to-lymphocyte ratio. Multivariable logistic regression identified independent associations.</p><p><strong>Results: </strong>An ALT/AST ratio >1.3 showed moderate discriminatory performance for fatty liver (AUC 0.791) and MetS (AUC 0.780), with modestly improved discrimination compared with ALT alone and inflammatory markers, particularly in reclassification analyses. Individuals with ALT/AST >1.3 were more likely to have fatty liver (OR 6.13, 95% CI 5.15-7.30) and MetS (OR 5.81, 95% CI 4.61-7.34). Regular physical activity and dental scaling were associated with lower odds of metabolic abnormalities, whereas smoking and betel nut chewing were associated with higher odds of metabolic abnormalities.</p><p><strong>Conclusion: </strong>The ALT/AST ratio was associated with fatty liver and metabolic syndrome in young adults and showed moderate discriminatory performance. Further longitudinal and external validation is needed before clinical implementation.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261476716"},"PeriodicalIF":2.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between adherence to cancer primary prevention recommendations and multimorbidity among a cohort of British Columbians.","authors":"Md Sabbir Hossain, Hugh W Davies, Rachel A Murphy, Trevor J B Dummer","doi":"10.1177/26335565261476717","DOIUrl":"10.1177/26335565261476717","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the association between adherence to cancer primary prevention recommendations and multimorbidity prevalence in adults aged 34-73 years in a population-based cohort of British Columbians, Canada.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of baseline data collected between 2009 and 2016 from a population-based cohort (n=27,268). Multimorbidity was defined as the presence of two or more chronic conditions from 17 self-reported diseases. Adherence to four cancer primary prevention recommendations was assessed: maintaining a healthy body weight, being physically active, eating a healthy diet, and limiting alcohol consumption. Multivariable logistic regression was used to examine the association between adherence to cancer prevention recommendations and multimorbidity.</p><p><strong>Results: </strong>Prevalence of multimorbidity in the cohort was 36% and adherence to cancer prevention recommendations was generally high: maintaining a healthy body weight (69%), being physically active (51%), eating a healthy diet (86%), limiting alcohol consumption (73%). Greater adherence to a composite cancer prevention score was associated with significantly lower odds of multimorbidity (adjusted OR: 0.83, 95% CI: 0.76-0.90). Adherence to the healthy body weight recommendation reduced the odds of multimorbidity by 54% (adjusted OR: 0.46, 95% CI: 0.43-0.50).</p><p><strong>Conclusions: </strong>Adherence to cancer primary prevention recommendations was significantly associated with reduced multimorbidity prevalence in a cohort of Canadian adults.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261476717"},"PeriodicalIF":2.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity as a risk factor for multimorbidity: a 23-years population-based prospective study.","authors":"Jussa-Pekka Välitalo, Paula Pesonen, Jouko Saramies, Sirkka Keinänen-Kiukaanniemi, Hannu Uusitalo, Julia Lybeck, Esko Hussi, Kadri Suija, Jaakko Tuomilehto, Juha Auvinen","doi":"10.1177/26335565261478101","DOIUrl":"https://doi.org/10.1177/26335565261478101","url":null,"abstract":"<p><strong>Background: </strong>Obesity and multimorbidity are increasing challenges for public health. While obesity is a well-recognized risk factor for multimorbidity, evidence commonly comes from cross-sectional studies using body mass index (BMI). Evidence on the body roundness index (BRI), a novel indicator of central obesity, remains limited.</p><p><strong>Objectives: </strong>This study assessed midlife obesity as a risk factor for multimorbidity in a Finnish population cohort during 23 years of follow-up.</p><p><strong>Methods: </strong>A total of 1007 participants born between 1933 and 1956 and living in the Savitaipale municipality were enrolled between 1994 and 1996. Baseline data were collected using questionnaires and clinical examinations. Information on 38 chronic diseases was obtained from health registers. Obesity was assessed using BMI, waist circumference (WC), and BRI. Cox proportional hazards models estimated associations with incident multimorbidity, and receiver operating characteristic (ROC) analysis was used to derive BMI, WC and BRI thresholds with the best sensitivity-specificity balance.</p><p><strong>Results: </strong>Over 23 years, obesity defined by BMI and WC, as well as higher BRI, was associated with increased multimorbidity risk. Hazard ratios ranged from 1.52 (95% CI: 1.21-1.92) to 2.17 (95% CI: 1.59-2.97) in women and from 2.41 (95% CI: 1.82-3.19) to 2.79 (95% CI: 2.00-3.90) in men, depending on obesity and multimorbidity definitions. ROC-derived thresholds for multimorbidity prediction were: BMI 26.4 in women and 26.1 in men; WC 76.3 cm and 93.3 cm; and BRI 3.41 and 3.70, respectively.</p><p><strong>Conclusion: </strong>This 23-year study highlights midlife obesity as a risk factor for multimorbidity in later life.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261478101"},"PeriodicalIF":2.7,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of primary care data in multimorbidity estimates using administrative health data.","authors":"Clare Tazzeo, Katharina Schmidt-Mende, Karin Modig","doi":"10.1177/26335565261477731","DOIUrl":"10.1177/26335565261477731","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate the extent to which two frequently used multimorbidity measures, the Charlson Comorbidity Index (CCI) and the 2+ count of chronic diseases, are underestimated when primary care data are absent, and to examine if this varies by sociodemographic factors.</p><p><strong>Methods: </strong>This register-based study included adults, aged 60 years and older, living in Stockholm, Sweden from 2017-2022 (n=497736). Multimorbidity was operationalized as 1) 2+ chronic diseases from a list of 60 and 2) CCI score of 2+. The multimorbidity prevalences were calculated using only outpatient specialist and hospital data, then after adding primary care data. The proportion of the prevalence underestimated without primary care data was estimated for both measures. Stratified analyses were conducted to assess the underestimation by age, sex, education, cohabitation, and care status.</p><p><strong>Findings: </strong>Without primary care data, approximately 20% of individuals with multimorbidity were missed (2+count: 19.4%,95%CI:19.3%-19.5%; 2+CCI: 23.9%,95%CI:23.8%-24.0%). The proportion of missed cases was highest among community-dwelling individuals (2+count: 21.0%,95%CI:20.8%-21.1%; 2+CCI: 25.5%,95%CI:25.3%-25.6%) and decreased with greater social care need (home care: 2+count: 4.33%,95%CI:4.09%-4.58%; 2+CCI: 16.0%,95%CI:15.5%-16.4%; nursing homes: 2+count: 7.78%,95%CI:7.35%-8.22%, 2+CCI: 18.0%,95%CI:17.3%-18.6%). The underestimation without primary care was greater among younger age groups for the 2+count, and women and older individuals for the 2+CCI.</p><p><strong>Interpretation: </strong>Multimorbidity is underestimated without primary care data, particularly among community-dwelling and independent older adults, as well as the youngest and oldest segments of the older population. Caution is warranted when comparing multimorbidity across age groups, care status, or social factors in the absence of primary care data.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261477731"},"PeriodicalIF":2.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13462637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbid heart failure (HF) and cardiorenal metabolic (CaReMe) syndrome, exploring integrated models of care: A scoping review.","authors":"Joanna Lavery, Clare Van Miert, Lyndsey McCunnell, Julie Ann Hayes, Karen Higginbotham, Ian Jones","doi":"10.1177/26335565261458448","DOIUrl":"10.1177/26335565261458448","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) remains a global cause of morbidity and mortality and is increasingly complex to manage due to high prevalence of multimorbidity and coexisting cardiorenal and metabolic (CaReMe) syndrome. Individualised care through integrated service models can improve quality and maximise patient outcomes. This scoping review identifies and synthesises models of integrated care for multimorbid HF and CaReMe syndrome, analysing organisation, implementation, and reported outcome measures.</p><p><strong>Methods: </strong>A systematic search was conducted in MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), COCHRANE library, and grey literature. Eligible studies included primary research published between 2014 and 2025 describing integrated, multispecialty, or multidisciplinary team (MDT) models of care for adults with multimorbid HF and CaReMe disease. The search followed PRISMA-ScR reporting standards and studies reviewed using standardised tools informed by Joanna Briggs Institute (JBI) and Cochrane Collaborations Tool methodologies.</p><p><strong>Results: </strong>Five studies were identified from upper-middle and high-income countries that incorporated MDT integrated care models. Models were mapped to the Effective Practice and Organisation of Care (EPOC) framework explaining key components of integrated care. Positive outcomes included reduced hospitalisations, improved treatment adherence, enhanced collaborative processes, and patient engagement. Limited governance structures, variable outcome measures, gaps in financial and technological evaluations were also identified.</p><p><strong>Conclusion: </strong>Integrated care models for multimorbid HF and CaReMe syndrome demonstrate potential to enhance care coordination and quality of life. Evidence gaps persist regarding practical implementation, economic viability, and flexibility across healthcare settings. Future research should prioritise patient co-design, standardised outcomes, and shared decision-making frameworks.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261458448"},"PeriodicalIF":2.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity clusters and their association with secondary bacterial infections and disease severity among hospitalised COVID-19 patients in Victoria, Australia: Insights from population-wide linked data.","authors":"Michael Muleme, Mark Hayes, Bridgette McNamara, Naomi Clarke, Eugene Athan, Mohammad Akhtar Hussain","doi":"10.1177/26335565261474085","DOIUrl":"10.1177/26335565261474085","url":null,"abstract":"<p><strong>Background: </strong>Limited evidence exists on how multimorbidity combinations influence the risk of secondary bacterial infections. This study identified multimorbidity clusters among hospitalised COVID-19 patients in Victoria (2020-2023) and examined their association with secondary bacterial infections and admission outcomes, including ICU admission, hospital and ICU length of stay, and mortality.</p><p><strong>Methods: </strong>We used population-wide linked hospital data and applied cluster analysis to ICD-10 coded chronic conditions to identify multimorbidity clusters. Risks of secondary bacterial infection across clusters were compared to patients with one or no chronic conditions. We used multivariate logistic regression, negative binomial regression, Kaplan-Meier curves, and Cox proportional hazards models to analyse associations with secondary bacterial infection and admission outcomes.</p><p><strong>Results: </strong>Among 179,688 COVID-19 hospital admissions, three multimorbidity clusters were identified: neuropsychiatric, cardiometabolic-multisystem, and neoplastic. Compared to no multimorbidity, each cluster was associated with significantly higher odds of secondary bacterial infection: neuropsychiatric (Odds Ratio (OR) 2.74, 95% CI 2.59-2.89), cardiometabolic-multisystem (OR 3.87, 95% CI 3.63-4.13), and neoplastic (OR 1.98, 95% CI 1.84-2.14; all p<0.001). For patients with secondary bacterial infection, cardiometabolic-multisystem multimorbidity had the highest increase in hospital length of stay (Incident Rate Ratio (IRR) 1.94, 95% CI 1.82-2.05) and ICU length of stay (IRR 2.75, 95% CI 2.36-3.20). Mortality was significantly elevated across all clusters and was highest in the cardiometabolic-multisystem group.</p><p><strong>Conclusions: </strong>Multimorbidity was associated with increased risk of secondary bacterial infection and poorer clinical outcomes in hospitalised COVID-19 patients. Integrating multimorbidity profiles into clinical decision-making may enhance antimicrobial stewardship by identifying patients most likely to benefit from antibiotic therapy.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261474085"},"PeriodicalIF":2.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From community of practice to methodological governance: Building a living infrastructure for qualitative multiple long-term conditions research.","authors":"Jomel Mabborang","doi":"10.1177/26335565261475371","DOIUrl":"10.1177/26335565261475371","url":null,"abstract":"","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261475371"},"PeriodicalIF":2.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}