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- Title
Long-term Cardiovascular, Cerebrovascular, and Other Thrombotic Complications in COVID-19 Survivors: A Retrospective Cohort Study.
- Authors
Lim, Jue Tao; En, Wee Liang; Tay, An Ting; Pang, Deanette; Chiew, Calvin J; Ong, Benjamin; Lye, David Chien Boon; Tan, Kelvin Bryan
- Abstract
Background Growing evidence suggests that some coronavirus disease 2019 (COVID-19) survivors experience a wide range of long-term postacute sequelae. We examined the postacute risk and burden of new-incident cardiovascular, cerebrovascular, and other thrombotic complications after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a highly vaccinated multiethnic Southeast Asian population, during Delta predominance. Methods This cohort study used national testing and healthcare claims databases in Singapore to build a cohort of individuals who had a positive SARS-CoV-2 test between 1 September and 30 November 2021 when Delta predominated community transmission. Concurrently, we constructed a test-negative control group by enrolling individuals between 13 April 2020 and 31 December 2022 with no evidence of SARS-CoV-2 infection. Participants in both groups were followed up for a median of 300 days. We estimated risks of new-incident cardiovascular, cerebrovascular, and other thrombotic complications using doubly robust competing-risks survival analysis. Risks were reported using 2 measures: hazard ratio (HR) and excess burden (EB) with 95% confidence intervals. Results We included 106 012 infected cases and 1 684 085 test-negative controls. Compared with the control group, individuals with COVID-19 exhibited increased risk (HR, 1.157 [1.069–1.252]) and excess burden (EB, 0.70 [.53–.88]) of new-incident cardiovascular and cerebrovascular complications. Risks decreased in a graded fashion for fully vaccinated (HR, 1.11 [1.02–1.22]) and boosted (HR, 1.10 [.92–1.32]) individuals. Conversely, risks and burdens of subsequent cardiovascular/cerebrovascular complications increased for hospitalized and severe COVID-19 cases (compared to nonhospitalized cases). Conclusions Increased risks and excess burdens of new-incident cardiovascular/cerebrovascular complications were reported among infected individuals; risks can be attenuated with vaccination and boosting.
- Subjects
SINGAPORE; THROMBOSIS risk factors; RISK assessment; IMMUNIZATION; CARDIOVASCULAR diseases; SOUTHEAST Asians; RESEARCH funding; POST-acute COVID-19 syndrome; CARDIOVASCULAR diseases risk factors; SYMPTOM burden; COVID-19 vaccines; RETROSPECTIVE studies; DESCRIPTIVE statistics; LONGITUDINAL method; MEDICAL records; ACQUISITION of data; CASE-control method; CEREBROVASCULAR disease; CONFIDENCE intervals; SURVIVAL analysis (Biometry); COVID-19; THROMBOSIS; DISEASE risk factors; DISEASE complications
- Publication
Clinical Infectious Diseases, 2024, Vol 78, Issue 1, p70
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciad469