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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 ,
Xiyun Jiang ,
Emanuele Di Angelantonio ,
Spiros Denaxas,
Johan H. Thygesen ,
Christopher Tomlinson ,
Ben Bray,
Craig J. Smith,
Mark Barber ,
Kamlesh Khunti,
George Davey Smith ,
Nishi Chaturvedi ,
Cathie Sudlow ,
William N. Whiteley ,
Angela M. Wood,
Jonathan A.C. Sterne ,
(for the CVD-COVID-UK/COVID-IMPACT Consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study)
,
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 ,
Xiyun Jiang ,
Emanuele Di Angelantonio ,
Spiros Denaxas,
Johan H. Thygesen ,
Christopher Tomlinson ,
Ben Bray,
Craig J. Smith,
Mark Barber ,
Kamlesh Khunti,
George Davey Smith ,
Nishi Chaturvedi ,
Cathie Sudlow ,
William N. Whiteley ,
Angela M. Wood,
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>2022-10-13T13:36:23.1688245</datestamp><bib-version>v2</bib-version><id>61291</id><entry>2022-09-20</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>2022-09-20</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>COVID-19; electronic health records; myocardial infarction; pulmonary embolism; stroke; thrombosis; venous thrombosis</keywords><publishedDay>19</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-09-19</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>2022-10-13T13:36:23.1688245</lastEdited><Created>2022-09-20T20:46:47.1287791</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><orcid>0000-0002-4128-6821</orcid><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><orcid>0000-0003-0622-6476</orcid><order>6</order></author><author><firstname>Rachel</firstname><surname>Denholm</surname><orcid>0000-0002-8067-5440</orcid><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><orcid>0000-0001-9022-7003</orcid><order>12</order></author><author><firstname>Teri-Louise</firstname><surname>North</surname><order>13</order></author><author><firstname>Renin</firstname><surname>Toms</surname><orcid>0000-0002-6922-1448</orcid><order>14</order></author><author><firstname>Xiyun</firstname><surname>Jiang</surname><orcid>0000-0003-0720-923x</orcid><order>15</order></author><author><firstname>Emanuele Di</firstname><surname>Angelantonio</surname><orcid>0000-0001-8776-6719</orcid><order>16</order></author><author><firstname>Spiros</firstname><surname>Denaxas</surname><order>17</order></author><author><firstname>Johan H.</firstname><surname>Thygesen</surname><orcid>0000-0002-7479-3459</orcid><order>18</order></author><author><firstname>Christopher</firstname><surname>Tomlinson</surname><orcid>0000-0002-0903-5395</orcid><order>19</order></author><author><firstname>Ben</firstname><surname>Bray</surname><order>20</order></author><author><firstname>Craig J.</firstname><surname>Smith</surname><order>21</order></author><author><firstname>Mark</firstname><surname>Barber</surname><orcid>0000-0002-2893-1566</orcid><order>22</order></author><author><firstname>Kamlesh</firstname><surname>Khunti</surname><order>23</order></author><author><firstname>George Davey</firstname><surname>Smith</surname><orcid>0000-0002-1407-8314</orcid><order>24</order></author><author><firstname>Nishi</firstname><surname>Chaturvedi</surname><orcid>0000-0002-6211-2775</orcid><order>25</order></author><author><firstname>Cathie</firstname><surname>Sudlow</surname><orcid>0000-0002-7725-7520</orcid><order>26</order></author><author><firstname>William N.</firstname><surname>Whiteley</surname><orcid>0000-0002-4816-8991</orcid><order>27</order></author><author><firstname>Angela M.</firstname><surname>Wood</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>61291__25448__526f185883d64d84b4a550f2b1153dd6.pdf</filename><originalFilename>61291_VoR.pdf</originalFilename><uploaded>2022-10-13T13:34:27.8943090</uploaded><type>Output</type><contentLength>833535</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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2022-10-13T13:36:23.1688245 v2 61291 2022-09-20 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 2022-09-20 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 COVID-19; electronic health records; myocardial infarction; pulmonary embolism; stroke; thrombosis; venous thrombosis 19 9 2022 2022-09-19 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. 2022-10-13T13:36:23.1688245 2022-09-20T20:46:47.1287791 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Rochelle Knight 0000-0002-4128-6821 1 Venexia Walker 0000-0001-5064-446x 2 Samantha Ip 3 Jennifer A. Cooper 4 Thomas Bolton 5 Spencer Keene 0000-0003-0622-6476 6 Rachel Denholm 0000-0002-8067-5440 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 0000-0001-9022-7003 12 Teri-Louise North 13 Renin Toms 0000-0002-6922-1448 14 Xiyun Jiang 0000-0003-0720-923x 15 Emanuele Di Angelantonio 0000-0001-8776-6719 16 Spiros Denaxas 17 Johan H. Thygesen 0000-0002-7479-3459 18 Christopher Tomlinson 0000-0002-0903-5395 19 Ben Bray 20 Craig J. Smith 21 Mark Barber 0000-0002-2893-1566 22 Kamlesh Khunti 23 George Davey Smith 0000-0002-1407-8314 24 Nishi Chaturvedi 0000-0002-6211-2775 25 Cathie Sudlow 0000-0002-7725-7520 26 William N. Whiteley 0000-0002-4816-8991 27 Angela M. Wood 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 61291__25448__526f185883d64d84b4a550f2b1153dd6.pdf 61291_VoR.pdf 2022-10-13T13:34:27.8943090 Output 833535 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 |
| author_id_fullname_str_mv |
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 Xiyun Jiang Emanuele Di Angelantonio Spiros Denaxas Johan H. Thygesen Christopher Tomlinson Ben Bray Craig J. Smith Mark Barber Kamlesh Khunti George Davey Smith Nishi Chaturvedi Cathie Sudlow William N. Whiteley Angela M. Wood Jonathan A.C. Sterne (for the CVD-COVID-UK/COVID-IMPACT Consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study) |
| format |
Journal article |
| container_title |
Circulation |
| container_volume |
146 |
| container_issue |
12 |
| container_start_page |
892 |
| publishDate |
2022 |
| institution |
Swansea University |
| issn |
0009-7322 1524-4539 |
| doi_str_mv |
10.1161/circulationaha.122.060785 |
| publisher |
Ovid Technologies (Wolters Kluwer Health) |
| college_str |
Faculty of Medicine, Health and Life Sciences |
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0 |
| 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 |
2022-09-19T04:20:02Z |
| _version_ |
1763754327083581440 |
| score |
11.016235 |