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Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales
Rochelle Knight,
Venexia Walker 
,
Samantha Ip,
Jennifer A Cooper,
Thomas Bolton,
Spencer Keene,
Rachel Denholm,
Ashley Akbari ,
Hoda Abbasizanjani ,
Fatemeh Torabi ,
Efosa Omigie,
Sam Hollings,
Teri-Louise North,
Renin Toms,
Emanuele Di Angelantonio ,
Spiros Denaxas ,
Johan H Thygesen,
Christopher Tomlinson ,
Ben Bray,
Craig J Smith,
Mark Barber,
George Davey Smith,
Nishi Chaturvedi,
Cathie Sudlow,
William N Whiteley ,
Angela Wood,
Jonathan A C Sterne,
(for the CVD-COVID-UK/COVID-IMPACT consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study),
Jonathan A.C. Sterne ,
(for the CVD-COVID-UK/COVID-IMPACT Consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study)
,
Samantha Ip,
Jennifer A Cooper,
Thomas Bolton,
Spencer Keene,
Rachel Denholm,
Ashley Akbari ,
Hoda Abbasizanjani ,
Fatemeh Torabi ,
Efosa Omigie,
Sam Hollings,
Teri-Louise North,
Renin Toms,
Emanuele Di Angelantonio ,
Spiros Denaxas ,
Johan H Thygesen,
Christopher Tomlinson ,
Ben Bray,
Craig J Smith,
Mark Barber,
George Davey Smith,
Nishi Chaturvedi,
Cathie Sudlow,
William N Whiteley ,
Angela Wood,
Jonathan A C Sterne,
(for the CVD-COVID-UK/COVID-IMPACT consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study),
Jonathan A.C. Sterne ,
(for the CVD-COVID-UK/COVID-IMPACT Consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study)
Circulation, Volume: 146, Issue: 12, Pages: 892 - 906
Swansea University Authors:
Ashley Akbari , Hoda Abbasizanjani , Fatemeh Torabi
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DOI (Published version): 10.1161/circulationaha.122.060785
Abstract
Background: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.Methods:We studied vascular diseases after COVID-19 diagnosis in population-wide anonymized linked Eng...
| Published in: | Circulation |
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| ISSN: | 0009-7322 1524-4539 |
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Ovid Technologies (Wolters Kluwer Health)
2022
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<?xml version="1.0"?><rfc1807><datestamp>2022-10-19T12:03:00.0244459</datestamp><bib-version>v2</bib-version><id>58867</id><entry>2021-12-02</entry><title>Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales</title><swanseaauthors><author><sid>aa1b025ec0243f708bb5eb0a93d6fb52</sid><ORCID>0000-0003-0814-0801</ORCID><firstname>Ashley</firstname><surname>Akbari</surname><name>Ashley Akbari</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>93dd7e747f3118a99566c68592a3ddcc</sid><ORCID>0000-0002-9575-4758</ORCID><firstname>Hoda</firstname><surname>Abbasizanjani</surname><name>Hoda Abbasizanjani</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>f569591e1bfb0e405b8091f99fec45d3</sid><ORCID>0000-0002-5853-4625</ORCID><firstname>Fatemeh</firstname><surname>Torabi</surname><name>Fatemeh Torabi</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2021-12-02</date><deptcode>HDAT</deptcode><abstract>Background: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.Methods: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.Results: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.Conclusions: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.</abstract><type>Journal Article</type><journal>Circulation</journal><volume>146</volume><journalNumber>12</journalNumber><paginationStart>892</paginationStart><paginationEnd>906</paginationEnd><publisher>Ovid Technologies (Wolters Kluwer Health)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0009-7322</issnPrint><issnElectronic>1524-4539</issnElectronic><keywords/><publishedDay>20</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-09-20</publishedDate><doi>10.1161/circulationaha.122.060785</doi><url/><notes/><college>COLLEGE NANME</college><department>Health Data Science</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HDAT</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This work was funded by the Longitudinal Health and Wellbeing COVID-19 National Core Study, which was established by the UK Chief Scientific Officer in October 2020 and funded by UK Research and Innovation (grant references MC_PC_20030 and MC_PC_20059); by the British Heart Foundation as part of the British Heart Foundation Data Science Center led by Health Data Research UK (British Heart Foundation grant number SP/19/3/34678); by the Data and Connectivity National Core Study led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant reference MC_PC_20058); by the CONVALESCENCE study of long COVID-19 funded by National Institute for Health and Care Research (NIHR)/UK Research and Innovation; by the Con-COV team funded by the Medical Research Council (grant number MR/V028367/1); by Health Data Research UK, which receives its funding from Health Data Research UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and the Wellcome Trust; by core funding from the British Heart Foundation (RG/13/13/30194; RG/18/13/33946), British Heart Foundation Cambridge CRE (RE/13/6/30180), and NIHR Cambridge Biomedical Research Center (BRC-1215-20014); by the ADR Wales program of work, which is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All (ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods at Cardiff University, and specialist teams within the Welsh Government to develop new evidence that supports Prosperity for All by using the SAIL Databank at Swansea University to link and analyze anonymized data; ADR Wales is part of the Economic and Social Research Council [part of UK Research and Innovation] funded ADR UK [grant ES/S007393/1]); by the Wales COVID-19 Evidence Center, funded by Health and Care Research Wales; and by the BigData@Heart Consortium, funded by the Innovative Medicines Initiative-2 Joint Undertaking under grant agreement 116074. Dr Ip was funded by a British Heart Foundation–Turing Cardiovascular Data Science 419 Award (BCDSA/100005) and is funded by the International Alliance for Cancer Early Detection, a partnership among Cancer Research UK C18081/A31373, Canary Center at Stanford University, the University of Cambridge, OHSU Knight Cancer Institute, University College London, and the University of Manchester. R. Knight and Drs Cooper and Sterne were supported by the NIHR Bristol Biomedical Research Center. R. Knight and Drs Walker and Davey Smith were supported by the Medical Research Council Integrative Epidemiology Unit at the University of Bristol (MC_UU_00011/1). R. Knight was supported by NIHR ARC West. Drs Denholm and Sterne were supported by Health Data Research UK. S. Keene is funded by the NIHR Blood and Transplant Research Unit in Donor Health and Genomics (NIHR BTRU-2014-10024). X. Jiang was funded by the Health Data Research UK–Turing Wellcome PhD Programme in Health Data Science. Dr Wood was supported by the British Heart Foundation–Turing Cardiovascular Data Science Award (BCDSA/100005). Dr Whiteley is supported by the Chief Scientist’s Office (CAF/01/17). Drs Sudlow, Smith, Barber, Wood, and Whiteley are supported by the Stroke Association (SA CV 20/100018). C. Tomlinson is supported by a University College London UK Research and Innovation Center for Doctoral Training in AI-Enabled Healthcare studentship (EP/S021612/1), Medical Research Council Clinical Top-Up, and a studentship from the NIHR Biomedical Research Center at University College London Hospital National Health Service Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.</funders><projectreference/><lastEdited>2022-10-19T12:03:00.0244459</lastEdited><Created>2021-12-02T09:38:13.1674919</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Rochelle</firstname><surname>Knight</surname><order>1</order></author><author><firstname>Venexia</firstname><surname>Walker</surname><orcid>0000-0001-5064-446x</orcid><order>2</order></author><author><firstname>Samantha</firstname><surname>Ip</surname><order>3</order></author><author><firstname>Jennifer A</firstname><surname>Cooper</surname><order>4</order></author><author><firstname>Thomas</firstname><surname>Bolton</surname><order>5</order></author><author><firstname>Spencer</firstname><surname>Keene</surname><order>6</order></author><author><firstname>Rachel</firstname><surname>Denholm</surname><order>7</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>8</order></author><author><firstname>Hoda</firstname><surname>Abbasizanjani</surname><orcid>0000-0002-9575-4758</orcid><order>9</order></author><author><firstname>Fatemeh</firstname><surname>Torabi</surname><orcid>0000-0002-5853-4625</orcid><order>10</order></author><author><firstname>Efosa</firstname><surname>Omigie</surname><order>11</order></author><author><firstname>Sam</firstname><surname>Hollings</surname><order>12</order></author><author><firstname>Teri-Louise</firstname><surname>North</surname><order>13</order></author><author><firstname>Renin</firstname><surname>Toms</surname><order>14</order></author><author><firstname>Emanuele Di</firstname><surname>Angelantonio</surname><orcid>0000-0001-8776-6719</orcid><order>15</order></author><author><firstname>Spiros</firstname><surname>Denaxas</surname><orcid>0000-0001-9612-7791</orcid><order>16</order></author><author><firstname>Johan H</firstname><surname>Thygesen</surname><order>17</order></author><author><firstname>Christopher</firstname><surname>Tomlinson</surname><orcid>0000-0002-0903-5395</orcid><order>18</order></author><author><firstname>Ben</firstname><surname>Bray</surname><order>19</order></author><author><firstname>Craig J</firstname><surname>Smith</surname><order>20</order></author><author><firstname>Mark</firstname><surname>Barber</surname><order>21</order></author><author><firstname>George Davey</firstname><surname>Smith</surname><order>22</order></author><author><firstname>Nishi</firstname><surname>Chaturvedi</surname><order>23</order></author><author><firstname>Cathie</firstname><surname>Sudlow</surname><order>24</order></author><author><firstname>William N</firstname><surname>Whiteley</surname><orcid>0000-0002-4816-8991</orcid><order>25</order></author><author><firstname>Angela</firstname><surname>Wood</surname><order>26</order></author><author><firstname>Jonathan A C</firstname><surname>Sterne</surname><order>27</order></author><author><firstname>(for the CVD-COVID-UK/COVID-IMPACT consortium and the Longitudinal Health and Wellbeing COVID-19 National Core</firstname><surname>Study)</surname><order>28</order></author><author><firstname>Jonathan A.C.</firstname><surname>Sterne</surname><orcid>0000-0001-8496-6053</orcid><order>29</order></author><author><firstname>(for the CVD-COVID-UK/COVID-IMPACT Consortium and the Longitudinal Health and Wellbeing COVID-19 National Core</firstname><surname>Study)</surname><order>30</order></author></authors><documents><document><filename>58867__25501__591abb78b88846489c7472e003e7d48e.pdf</filename><originalFilename>58867_VoR.pdf</originalFilename><uploaded>2022-10-19T11:59:44.7499943</uploaded><type>Output</type><contentLength>833537</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807> |
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2022-10-19T12:03:00.0244459 v2 58867 2021-12-02 Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 93dd7e747f3118a99566c68592a3ddcc 0000-0002-9575-4758 Hoda Abbasizanjani Hoda Abbasizanjani true false f569591e1bfb0e405b8091f99fec45d3 0000-0002-5853-4625 Fatemeh Torabi Fatemeh Torabi true false 2021-12-02 HDAT Background: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.Methods: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.Results: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.Conclusions: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. Journal Article Circulation 146 12 892 906 Ovid Technologies (Wolters Kluwer Health) 0009-7322 1524-4539 20 9 2022 2022-09-20 10.1161/circulationaha.122.060785 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University This work was funded by the Longitudinal Health and Wellbeing COVID-19 National Core Study, which was established by the UK Chief Scientific Officer in October 2020 and funded by UK Research and Innovation (grant references MC_PC_20030 and MC_PC_20059); by the British Heart Foundation as part of the British Heart Foundation Data Science Center led by Health Data Research UK (British Heart Foundation grant number SP/19/3/34678); by the Data and Connectivity National Core Study led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant reference MC_PC_20058); by the CONVALESCENCE study of long COVID-19 funded by National Institute for Health and Care Research (NIHR)/UK Research and Innovation; by the Con-COV team funded by the Medical Research Council (grant number MR/V028367/1); by Health Data Research UK, which receives its funding from Health Data Research UK Ltd (HDR-9006) funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and the Wellcome Trust; by core funding from the British Heart Foundation (RG/13/13/30194; RG/18/13/33946), British Heart Foundation Cambridge CRE (RE/13/6/30180), and NIHR Cambridge Biomedical Research Center (BRC-1215-20014); by the ADR Wales program of work, which is aligned to the priority themes as identified in the Welsh Government’s national strategy: Prosperity for All (ADR Wales brings together data science experts at Swansea University Medical School, staff from the Wales Institute of Social and Economic Research, Data and Methods at Cardiff University, and specialist teams within the Welsh Government to develop new evidence that supports Prosperity for All by using the SAIL Databank at Swansea University to link and analyze anonymized data; ADR Wales is part of the Economic and Social Research Council [part of UK Research and Innovation] funded ADR UK [grant ES/S007393/1]); by the Wales COVID-19 Evidence Center, funded by Health and Care Research Wales; and by the BigData@Heart Consortium, funded by the Innovative Medicines Initiative-2 Joint Undertaking under grant agreement 116074. Dr Ip was funded by a British Heart Foundation–Turing Cardiovascular Data Science 419 Award (BCDSA/100005) and is funded by the International Alliance for Cancer Early Detection, a partnership among Cancer Research UK C18081/A31373, Canary Center at Stanford University, the University of Cambridge, OHSU Knight Cancer Institute, University College London, and the University of Manchester. R. Knight and Drs Cooper and Sterne were supported by the NIHR Bristol Biomedical Research Center. R. Knight and Drs Walker and Davey Smith were supported by the Medical Research Council Integrative Epidemiology Unit at the University of Bristol (MC_UU_00011/1). R. Knight was supported by NIHR ARC West. Drs Denholm and Sterne were supported by Health Data Research UK. S. Keene is funded by the NIHR Blood and Transplant Research Unit in Donor Health and Genomics (NIHR BTRU-2014-10024). X. Jiang was funded by the Health Data Research UK–Turing Wellcome PhD Programme in Health Data Science. Dr Wood was supported by the British Heart Foundation–Turing Cardiovascular Data Science Award (BCDSA/100005). Dr Whiteley is supported by the Chief Scientist’s Office (CAF/01/17). Drs Sudlow, Smith, Barber, Wood, and Whiteley are supported by the Stroke Association (SA CV 20/100018). C. Tomlinson is supported by a University College London UK Research and Innovation Center for Doctoral Training in AI-Enabled Healthcare studentship (EP/S021612/1), Medical Research Council Clinical Top-Up, and a studentship from the NIHR Biomedical Research Center at University College London Hospital National Health Service Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. 2022-10-19T12:03:00.0244459 2021-12-02T09:38:13.1674919 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Rochelle Knight 1 Venexia Walker 0000-0001-5064-446x 2 Samantha Ip 3 Jennifer A Cooper 4 Thomas Bolton 5 Spencer Keene 6 Rachel Denholm 7 Ashley Akbari 0000-0003-0814-0801 8 Hoda Abbasizanjani 0000-0002-9575-4758 9 Fatemeh Torabi 0000-0002-5853-4625 10 Efosa Omigie 11 Sam Hollings 12 Teri-Louise North 13 Renin Toms 14 Emanuele Di Angelantonio 0000-0001-8776-6719 15 Spiros Denaxas 0000-0001-9612-7791 16 Johan H Thygesen 17 Christopher Tomlinson 0000-0002-0903-5395 18 Ben Bray 19 Craig J Smith 20 Mark Barber 21 George Davey Smith 22 Nishi Chaturvedi 23 Cathie Sudlow 24 William N Whiteley 0000-0002-4816-8991 25 Angela Wood 26 Jonathan A C Sterne 27 (for the CVD-COVID-UK/COVID-IMPACT consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study) 28 Jonathan A.C. Sterne 0000-0001-8496-6053 29 (for the CVD-COVID-UK/COVID-IMPACT Consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study) 30 58867__25501__591abb78b88846489c7472e003e7d48e.pdf 58867_VoR.pdf 2022-10-19T11:59:44.7499943 Output 833537 application/pdf Version of Record true © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License true eng https://creativecommons.org/licenses/by/4.0/ |
| title |
Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales |
| spellingShingle |
Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales Ashley Akbari Hoda Abbasizanjani Fatemeh Torabi |
| title_short |
Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales |
| title_full |
Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales |
| title_fullStr |
Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales |
| title_full_unstemmed |
Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales |
| title_sort |
Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales |
| author_id_str_mv |
aa1b025ec0243f708bb5eb0a93d6fb52 93dd7e747f3118a99566c68592a3ddcc f569591e1bfb0e405b8091f99fec45d3 |
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aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari 93dd7e747f3118a99566c68592a3ddcc_***_Hoda Abbasizanjani f569591e1bfb0e405b8091f99fec45d3_***_Fatemeh Torabi |
| author |
Ashley Akbari Hoda Abbasizanjani Fatemeh Torabi |
| author2 |
Rochelle Knight Venexia Walker Samantha Ip Jennifer A Cooper Thomas Bolton Spencer Keene Rachel Denholm Ashley Akbari Hoda Abbasizanjani Fatemeh Torabi Efosa Omigie Sam Hollings Teri-Louise North Renin Toms Emanuele Di Angelantonio Spiros Denaxas Johan H Thygesen Christopher Tomlinson Ben Bray Craig J Smith Mark Barber George Davey Smith Nishi Chaturvedi Cathie Sudlow William N Whiteley Angela Wood Jonathan A C Sterne (for the CVD-COVID-UK/COVID-IMPACT consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study) Jonathan A.C. Sterne (for the CVD-COVID-UK/COVID-IMPACT Consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study) |
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Journal article |
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Circulation |
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146 |
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12 |
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2022 |
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0009-7322 1524-4539 |
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10.1161/circulationaha.122.060785 |
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Ovid Technologies (Wolters Kluwer Health) |
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Faculty of Medicine, Health and Life Sciences |
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| description |
Background: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.Methods: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.Results: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.Conclusions: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. |
| published_date |
2022-09-20T04:15:44Z |
| _version_ |
1763754056777465856 |
| score |
11.036684 |