Year: 2022
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: To examine association of COVID-19 with incident cardiovascular events in 17 871 UK Biobank cases between March 2020 and 2021. METHODS: COVID-19 cases were defined using health record linkage. Each case was propensity score-matched to two uninfected controls on age, sex, deprivation, body mass index, ethnicity, diabetes, prevalent ischaemic heart disease (IHD), smoking, hypertension and high cholesterol. We included the following incident outcomes: myocardial infarction, stroke, heart failure, atrial fibrillation, venous thromboembolism (VTE), pericarditis, all-cause death, cardiovascular death, IHD death. Cox proportional hazards regression was used to estimate associations of COVID-19 with each outcome over an average of 141 days (range 32-395) of prospective follow-up. RESULTS: Non-hospitalised cases (n=14 304) had increased risk of incident VTE (HR 2.74 (95% CI 1.38 to 5.45), p=0.004) and death (HR 10.23 (95% CI 7.63 to 13.70), p<0.0001). Individuals with primary COVID-19 hospitalisation (n=2701) had increased risk of all outcomes considered. The largest effect sizes were with VTE (HR 27.6 (95% CI 14.5 to 52.3); p<0.0001), heart failure (HR 21.6 (95% CI 10.9 to 42.9); p<0.0001) and stroke (HR 17.5 (95% CI 5.26 to 57.9); p<0.0001). Those hospitalised with COVID-19 as a secondary diagnosis (n=866) had similarly increased cardiovascular risk. The associated risks were greatest in the first 30 days after infection but remained higher than controls even after this period. CONCLUSIONS: Individuals hospitalised with COVID-19 have increased risk of incident cardiovascular events across a range of disease and mortality outcomes. The risk of most events is highest in the early postinfection period. Individuals not requiring hospitalisation have increased risk of VTE, but not of other cardiovascular-specific outcomes.
Source: Heart
Institutions: St Bartholomew's Hospital, Queen Mary University of London, Barts Health NHS Trust, William Harvey Research Institute, National Institute for Health and Care Research, University of Oxford, University Hospital Southampton NHS Foundation Trust, NIHR Southampton Biomedical Research Centre, University of Southampton, The Alan Turing Institute, Health Data Research UK
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funders: Barts Charity, National Institute for Health and Care Research, British Heart Foundation, European Commission, BHF Centre of Research Excellence, Oxford, National Institute for Health Research Southampton Biomedical Research Centre, Medical Research Council, Engineering and Physical Sciences Research Council
Awards: G2001906109, SmartHeart: Next-generation cardiovascular healthcare via integrated image acquisition, reconstruction, analysis and learning, Research Excellence (round 3), G3595237711, G3764914307, Long-term effects of SARS-CoV-2 infection on cardiovascular morbidity and its determinants, G4148207017, G4199028342, An EU-Canada joint infrastructure for next-generation multi-Study Heart research, G4414227456, G4842068297, NIHR Senior Investigator Award, G5847502682, G5850737185, G6263224185, G6276181198, G680566116, NIHR Senior Investigator Award, Broken bones and broken hearts: relationships between osteoporosis and cardiovascular structure and function in UK Biobank, G7907369414, G8268424837
OpenAlex ID: W4307228552