Journal Article

Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank

Petersen, Steffen E., Lee, Aaron Mark, Cooper, Jackie, Raman, Betty, Neubauer, Stefan, Harvey, Nicholas C., Salih, Ahmed, Raisi-Estabragh, Zahra

2023

Overview

ObjectiveTo examine association of COVID-19 with incident cardiovascular events in 17 871 UK Biobank cases between March 2020 and 2021.MethodsCOVID-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.ResultsNon-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.ConclusionsIndividuals 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.

• Publisher: BMJ Publishing Group Ltd and British Cardiovascular Society,BMJ Publishing Group LTD,BMJ Publishing Group
• Subject: Biobanks / Biological Specimen Banks / Body mass index / Cardiac arrhythmia / Cardiac Risk Factors and Prevention / Cardiovascular disease / Cardiovascular Diseases - etiology / Coronary Artery Disease - complications / Coronaviruses / COVID-19 / COVID-19 - complications / Diabetes / epidemiology / Heart failure / Heart Failure - complications / Hospitalization / Hospitals / Humans / Hyperlipidemia / Hypertension / Infections / Ischemia / Mortality / Myocardial Ischemia - complications / Pericarditis / Population / Primary care / Prospective Studies / Public health / Risk Factors / Stroke - complications / Thromboembolism / United Kingdom - epidemiology / Variables / Venous Thromboembolism - complications / Venous Thromboembolism - epidemiology