COVID-19 Is a Coronary Artery Disease Risk Equivalent and Exhibits a Genetic Interaction With ABO Blood Type

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Genetics

Background:

• COVID-19 (Coronavirus Disease 2019) is linked to an increased risk of major adverse cardiac events (MACE), including heart attack, stroke, and death.
• The long-term cardiovascular disease (CVD) risk and MACE determinants following COVID-19 infection remain unclear.

Purpose of the Study:

• To assess the long-term risk of MACE after COVID-19 infection.
• To determine if COVID-19 hospitalization is a risk equivalent for coronary artery disease (CAD).
• To investigate potential interactions between genetic factors and COVID-19 in MACE development.

Main Methods:

• Utilized UK Biobank data from February 1, 2020, to December 31, 2020.
• Identified COVID-19 cases (n=10,005) via PCR testing or ICD-10 codes.
• Employed proportional hazard models and propensity score-matched controls (n=38,860) to analyze long-term MACE risk (>1000 days).

Main Results:

• COVID-19 cases exhibited elevated MACE risk across all severities (HR 2.09), significantly higher in hospitalized cases (HR 3.85).
• Hospitalization for COVID-19 was a CAD risk equivalent, with higher MACE risk in non-CVD patients than in CVD patients without COVID-19 (HR 1.21).
• A significant interaction between the ABO blood group locus and COVID-19 hospitalization was found (P=0.01), increasing thrombotic event risk in non-O blood types (HR 1.65).

Conclusions:

• Hospitalization for COVID-19 equates to a CAD risk equivalent, with elevated post-acute myocardial infarction and stroke risk observed.
• Non-O blood types show a particularly heightened risk for thrombotic events after COVID-19 hospitalization.
• This study presents one of the first documented gene-pathogen interactions influencing thrombotic events.