Details

Autor(en) / Beteiligte

• Knight, Rochelle
• Walker, Venexia
• Ip, Samantha
• Cooper, Jennifer A
• Bolton, Thomas
• Keene, Spencer
• Denholm, Rachel
• Akbari, Ashley
• Abbasizanjani, Hoda
• Torabi, Fatemeh
• Omigie, Efosa
• Hollings, Sam
• North, Teri-Louise
• Toms, Renin
• Jiang, Xiyun
• Angelantonio, Emanuele Di
• Denaxas, Spiros
• Thygesen, Johan H
• Tomlinson, Christopher
• Bray, Ben
• Smith, Craig J
• Barber, Mark
• Khunti, Kamlesh
• Davey Smith, George
• Chaturvedi, Nishi
• Sudlow, Cathie
• Whiteley, William N
• Wood, Angela M
• Sterne, Jonathan A C

Titel

Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales

Ist Teil von

• Circulation (New York, N.Y.), 2022-09, Vol.146 (12), p.892-906

Ort / Verlag

United States: Lippincott Williams & Wilkins

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces a prothrombotic state, but long-term effects of COVID-19 on incidence of vascular diseases are unclear. We studied vascular diseases after COVID-19 diagnosis in population-wide anonymized linked English and Welsh electronic health records from January 1 to December 7, 2020. We estimated adjusted hazard ratios comparing the incidence of arterial thromboses and venous thromboembolic events (VTEs) after diagnosis of COVID-19 with the incidence in people without a COVID-19 diagnosis. We conducted subgroup analyses by COVID-19 severity, demographic characteristics, and previous history. Among 48 million adults, 125 985 were hospitalized and 1 319 789 were not hospitalized within 28 days of COVID-19 diagnosis. In England, there were 260 279 first arterial thromboses and 59 421 first VTEs during 41.6 million person-years of follow-up. Adjusted hazard ratios for first arterial thrombosis after COVID-19 diagnosis compared with no COVID-19 diagnosis declined from 21.7 (95% CI, 21.0-22.4) in week 1 after COVID-19 diagnosis to 1.34 (95% CI, 1.21-1.48) during weeks 27 to 49. Adjusted hazard ratios for first VTE after COVID-19 diagnosis declined from 33.2 (95% CI, 31.3-35.2) in week 1 to 1.80 (95% CI, 1.50-2.17) during weeks 27 to 49. Adjusted hazard ratios were higher, for longer after diagnosis, after hospitalized versus nonhospitalized COVID-19, among Black or Asian versus White people, and among people without versus with a previous event. The estimated whole-population increases in risk of arterial thromboses and VTEs 49 weeks after COVID-19 diagnosis were 0.5% and 0.25%, respectively, corresponding to 7200 and 3500 additional events, respectively, after 1.4 million COVID-19 diagnoses. High relative incidence of vascular events soon after COVID-19 diagnosis declines more rapidly for arterial thromboses than VTEs. However, incidence remains elevated up to 49 weeks after COVID-19 diagnosis. These results support policies to prevent severe COVID-19 by means of COVID-19 vaccines, early review after discharge, risk factor control, and use of secondary preventive agents in high-risk patients.