Cardiovascular disease diagnoses remain high 3 months after COVID-19 infection

Among the most disturbing results of the COVID-19 pandemic are the thousands of reports of patients living with post-acute sequelae of SARS-CoV-2 infection or “COVID-long” weeks – even months – after testing positive for the virus.

These patients continue to experience a handful of lingering symptoms, ranging from fatigue, cognitive dysfunction, and loss of smell and taste to joint pain, shortness of breath, and even cardiovascular disease, as clinicians continue to experience. are working to learn more about the long-term health effects of Covid-related disease19.

A team of researchers from the Uniformed Services University of the Health Sciences / Henry M Jackson Foundation for the Advancement of Military Medicine (USU / HJF) sought to better understand these clinical findings and undertook a survey and longitudinal review of electronic medical records. (EMR) of a population within military health systems (MHS), including active duty and beneficiaries.

“Particularly for active duty, which must be ready and able to take on critical responsibilities that can be physically demanding, the threat of long-term sequelae from a highly transmissible and widespread respiratory pathogen is a significant concern,” Brian Agan , MD, senior scientific assistant and director of HIV research for the USU / HJF Infectious Diseases Clinical Research Program and presenting author, said Contagion®.

In research presented virtually at IDWeek 2021, investigators found that cardiovascular disease (CVD) diagnoses, in particular, remained elevated for 3 COVID-19 months of disease onset.

“Compared to the pre-COVID period, the odds ratio for CVD (ICD-10) encounters almost doubled in each post-COVID period from 31 to 90 days after onset,” Agan said. “Further analyzes are underway to assess case characteristics, risk factors and predictors of these outcomes.”

From March to December 2020, Agan and investigators analyzed MHS recipients who were enrolled in the Epidemiology, Immunology and Clinical Features of Emerging Infectious Diseases with Pandemic Potential (EPICC) cohort, which totaled 1015 participants positive for SARS-CoV-2, symptomatic and had 3-month follow-up data available in the EMR. Investigators conducted surveys in late 2020 to determine the severity and duration of symptoms of the COVID-19 disease. The EMR provided details of the health care history before and after the onset of the COVID-19 illness.

Using available data and generalized linear models, while also controlling for age, sex, and race, the investigators calculated the probabilities of clinical organ system diagnoses in the 3 months before and after the onset of the disease. symptoms.

Of the 1015 participants included in the analysis, investigators collected survey data more than 28 days after symptom onset from 625 people. A total of 17% and 6% of them reported persistent symptoms for 28 to 84 days and 85 days or more, respectively, and 9.6% said they had not resumed normal activities for 1 month.

After 28 days, dyspnea, loss of smell and / or taste, fatigue and exercise intolerance were the most frequently reported symptoms. The period of the first month after symptom onset, compared to the period 61 to 90 days before symptom onset, was associated with an increase in pulmonary diagnoses (adjusted odds ratio [aOR] = 57, 95% CI 28-112), renal (aOR = 29, 95% CI 10-84), cardiovascular (aOR = 7, 95% CI 5-11) and neurological (aOR = 3, CI at 95% 2-4). Investigators pointed out that cardiovascular disease diagnoses remained elevated for 3 months (aOR = 2, 95% CI 1-3).

“Persistent symptoms and increased post-COVID diagnoses can be very relevant to job tasks and daily functions given the pulmonary, cardiac and neurocognitive domains involved,” Agan concluded. “These findings underscore the long-term morbidity of COVID-19, even in a relatively young and healthy population, and reinforce the importance of mitigating SARS-CoV-2 infections, including through vaccination. We need additional studies to better understand the pathogenesis of long COVID and an investigation of measures to identify the risk and preventive measures against long COVID in people infected with SARS-CoV-2. “

The study, “Long-term clinical outcomes following SARS-CoV-2 infection include persistent symptoms and cardiovascular disease beyond 3 months after infection,” was presented virtually at IDWeek 2021 , which took place from September 29 to October 3, 2021.

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