Lam, Ivan Chun Hang; Chai, Yi; Man, Kenneth Keng Cheung; Lau, Wallis Cheuk Yin; Luo, Hao; Lin, Xiaoyu; Yin, Can; ... Wong, Ian Chi Kei; + view all Lam, Ivan Chun Hang; Chai, Yi; Man, Kenneth Keng Cheung; Lau, Wallis Cheuk Yin; Luo, Hao; Lin, Xiaoyu; Yin, Can; Chui, Celine Sze Ling; Li, Xue; Zhang, Qingpeng; Chan, Esther Wai Yin; Wan, Eric Yuk Fai; Wong, Ian Chi Kei; - view fewer (2025) The short-, medium- and long-term risk and the multi-organ involvement of clinical sequelae following COVID-19 infection: a multinational network cohort study. Journal of the Royal Society of Medicine (In press).

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Abstract

Objectives: To generate comprehensive evidence on the risk of clinical sequelae involving different organ systems over time following COVID-19 infection. / Design: Multinational retrospective cohort study / Setting: Electronic medical records from the US, UK, France, Germany and Italy standardised to the Observational Medical Outcomes Partnership Common Data Model / Participants: 303,251 individuals with a COVID-19 infection between December 01, 2019 and December 01, 2020 and propensity score matched non-COVID-19 comparators from 22,108,925 eligible candidates / Main outcome measures: Incidence 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) following COVID-19 infection. The hazard ratio (HR) and 95% confidence interval (95% CI) of individual disease outcomes were estimated using Cox proportional hazard regression. / Results: Individuals 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. Whilst 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. / Conclusion: Through 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 subside in risk for most complications over the medium and long-term.

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