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Cardiovascular, Renal, and Pulmonary Risks of Long COVID: A Retrospective Cohort Study Stratified by Age and Sex
Akash Pradeep1, Izola Ramalho1, Martha L Carvour1,2
1Department of Internal Medicine University of Iowa Carver College of Medicine Iowa City IA USA.
Insights
Long COVID significantly increases the risk of cardiovascular, renal, and pulmonary issues, particularly in younger adults. Ongoing monitoring and risk reduction are crucial for managing these post-COVID conditions.
Area of Science:
- Cardiovascular and Pulmonary Medicine
- Infectious Diseases
- Public Health
Background:
- A significant number of COVID-19 survivors develop Long COVID, a condition with unclear cardiovascular risks.
- The long-term impact of SARS-CoV-2 infection on cardiovascular, renal, and pulmonary health requires further investigation.
Purpose of the Study:
- To investigate the association between Long COVID and adverse cardiovascular, renal, and pulmonary (CRP) outcomes.
- To compare the risk of CRP outcomes in individuals with and without Long COVID.
Main Methods:
- A retrospective cohort study utilizing the TriNetX network (>150 million patients).
- Adults with COVID-19 were categorized by the presence or absence of clinically recognized Long COVID.
- Propensity score matching was employed to control for confounders, analyzing 15 CRP outcomes across different age groups.
Main Results:
- Long COVID was linked to an increased risk of most CRP outcomes across all age groups and sexes.
- Younger adults, particularly young women (cardiovascular/renal) and young men (pulmonary), exhibited disproportionately higher relative risks.
- Prior SARS-CoV-2 vaccination did not show a consistent association with reduced CRP risk.
Conclusions:
- Clinically diagnosed Long COVID is associated with a higher incidence of CRP outcomes.
- Younger adults face relatively higher risks, underscoring the need for targeted surveillance and risk mitigation strategies for Long COVID patients.
Background:
A substantial proportion of patients with acute COVID-19 develop postacute sequelae of SARS-CoV-2 infection (Long COVID). The risk of adverse cardiovascular and related outcomes in Long COVID remains elusive. We hypothesized that individuals with Long COVID are at elevated risk for adverse cardiovascular, renal, and pulmonary (CRP) outcomes compared with those who recovered from COVID-19 without developing Long COVID.
Methods:
We performed a retrospective cohort study using the global TriNetX network (>150 million patients). Adults with documented COVID-19 were classified by the presence/absence of clinically recognized Long COVID. We analyzed absolute risks and relative risks for 15 CRP outcomes, stratified by age (18-50, 51-64, ≥65 years). After excluding patients with preexisting outcomes of interest, propensity score matching was applied for age, sex, and common confounders.
Results:
Among 2 613 432 adults identified with COVID-19 within TriNetX network, 315 612 matched individuals were included in the study. Long COVID was associated with higher risk of most CRP outcomes across all ages regardless of sex. Relative risks were disproportionately higher in younger adults, especially in young women for cardiovascular and renal outcomes and in young men for pulmonary outcomes. Findings remained directionally consistent across sensitivity analyses. Prior SARS-CoV-2 vaccination was not consistently associated with reduced CRP risk.
Conclusions:
Clinically recognized Long COVID was associated with increased risk of CRP outcomes, with relatively higher relative risks observed in younger adults. These findings support the need for continuing surveillance and risk-reduction strategies for cardiovascular and related disorders in Long COVID.
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