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Acute Cardiovascular Events After COVID-19 in England in 2020: A Self-Controlled Case Series Study

Davidson, Jennifer A; Banerjee, Amitava; Strongman, Helen; Herrett, Emily; Smeeth, Liam; Breuer, Judith; Warren-Gash, Charlotte; (2023) Acute Cardiovascular Events After COVID-19 in England in 2020: A Self-Controlled Case Series Study. Clinical Epidemiology , 15 pp. 911-921. 10.2147/CLEP.S421062. Green open access

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Abstract

PURPOSE: To assess the risk of incident cardiovascular outcomes after COVID-19 by level of cardiovascular risk in waves one and two of the pandemic in England in 2020. PATIENTS AND METHODS: We conducted a self-controlled case-series study among adults aged 40-84 years with no pre-existing cardiovascular disease using linked data from the Clinical Practice Research Datalink. We generated season-adjusted incidence ratios (IRs) for first acute cardiovascular event after SARS-CoV-2 infection compared with baseline time before and >91 days after infection. We used composite and individual acute cardiovascular event outcomes including myocardial infarction, major ventricular arrhythmia, left ventricular heart failure, and ischemic stroke. We stratified by cardiovascular risk, using diagnosed hypertension and QRISK3 predicted risk, and by wave one and two of the pandemic. RESULTS: We included 1762 individuals, 76.6% had a QRISK3 score ≥10% and 59.4% had hypertension. The risk of any cardiovascular event was elevated in the 1-7 days after infection (IR 7.14 [95% CI 6.06-8.41]) and, while the effect size tapered, the risk remained for 15-28 days after infection (1.74 [1.33-2.26]). Risks were similar for individual event type, differing by level of cardiovascular risk, and in wave one and two of the pandemic.  . CONCLUSION: SARS-CoV-2 infection is associated with early elevations in the risk of first acute cardiovascular event, across cardiovascular risk levels and in both wave one and two of the pandemic. Prevention of COVID-19 is important to avert cardiovascular complications.

Type: Article
Title: Acute Cardiovascular Events After COVID-19 in England in 2020: A Self-Controlled Case Series Study
Location: New Zealand
Open access status: An open access version is available from UCL Discovery
DOI: 10.2147/CLEP.S421062
Publisher version: https://doi.org/10.2147/CLEP.S421062
Language: English
Additional information: © 2023 The Author(s). This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: COVID-19, acute coronary syndrome, electronic health records, epidemiology, heart failure
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10177024
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