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Updated: Sep 16, 2025
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
The short-, medium- and long-term risk and the multi-organ involvement of clinical sequelae after COVID-19 infection:
Ivan Chun Hang Lam1,2, Yi Chai1,3,4, Kenneth Keng Cheung Man1,5,6,7
1Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Abstract:
ObjectivesTo generate comprehensive evidence on the risk of clinical sequelae involving different organ systems over time after coronavirus disease 2019 (COVID-19) infection.DesignMultinational retrospective cohort study.SettingElectronic medical records from the US, UK, France, Germany and Italy standardised to the Observational Medical Outcomes Partnership Common Data Model.ParticipantsA total of 303,251 individuals with a COVID-19 infection between 1 December 2019 and 1 December 2020 and propensity score matched non-COVID-19 comparators from 22,108,925 eligible candidates.Main outcome measuresIncidence of 73 clinical sequelae involving multiple organ systems including the respiratory, cardiovascular, dermatological and endocrine systems over the short- (0-6 months), medium- (6-12 months) and long-term (1-2 years) after COVID-19 infection. The hazard ratio (HR) and 95% confidence interval (95% CI) of individual disease outcomes were estimated using Cox proportional hazard regression.ResultsIndividuals with COVID-19 incurred a greater risk of clinical sequelae involving multiple organ systems including respiratory (France HR 2.23, 95%CI [2.10,2.37] to Italy 13.13 [11.80,14.63]), cardiovascular (Germany 1.39 [1.30,1.50] to US 1.79 [1.74,1.85]) and dermatological (UK 1.13 [1.01,1.25] to Italy 1.77 [1.42,2.21]) disorder over the short-term. While the risk of clinical sequelae has largely subsided during the medium-term, the risk of cardiovascular- (US 1.16 [1.11,1.21], France 1.10 [1.01,1.19]) and endocrine- (US 1.18 [1.12,1.24], Germany 1.15 [1.03,1.29]) related complications may continue to persist for up to two years.ConclusionsThrough a network of multinational healthcare databases, this study generated comprehensive and robust evidence supporting the extensive multi-organ involvement of post-COVID-19 condition over the short-term period and the reduction in risk for most complications over the medium- and long-term.
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