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Risk of cardiovascular events following COVID-19 in people with and without pre-existing chronic respiratory disease

Hannah Whittaker, Constantinos Kallis, Thomas Bolton, Angela Wood Orcid Logo, Samantha Walker, Aziz Sheikh, Alex Brownrigg, Ashley Akbari Orcid Logo, Kamil Sterniczuk, Jennifer K Quint, (CVD-COVID-UK/COVID-IMPACT Consortium)

International Journal of Epidemiology, Volume: 53, Issue: 3

Swansea University Author: Ashley Akbari Orcid Logo

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DOI (Published version): 10.1093/ije/dyae068

Abstract

BackgroundCOVID-19 is associated with cardiovascular outcomes in the general population, but it is unknown whether people with chronic respiratory disease (CRD) have a higher risk of cardiovascular events post-COVID-19 compared with the general population and, if so, what respiratory-related factors...

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Published in: International Journal of Epidemiology
ISSN: 0300-5771 1464-3685
Published: Oxford University Press (OUP) 2024
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa71178
Abstract: BackgroundCOVID-19 is associated with cardiovascular outcomes in the general population, but it is unknown whether people with chronic respiratory disease (CRD) have a higher risk of cardiovascular events post-COVID-19 compared with the general population and, if so, what respiratory-related factors may modify this risk in these people.MethodsPrimary and secondary care data from the National Health Service England were used to define a population of adults in England with COVID-19 (index date) between 1 January 2020 and 30 November 2021. Adjusted Cox proportional hazard regression was used to quantify the association between CRD, asthma-related factors, chronic obstructive pulmonary disease (COPD)-related factors, and risk of cardiovascular events. Asthma-specific factors included baseline asthma control, exacerbations, and inhaled corticosteroid (ICS) dose. COPD-specific risk factors included baseline ICS and exacerbations. Secondary objectives quantified the impact of COVID-19 hospitalisation and vaccine dose on cardiovascular outcomes.ResultsOf 3 670 455 people, those with CRD had a higher risk of cardiovascular events [adjusted hazard ratio (HRadj), 1.08; 95% confidence interval (CI) 1.06–1.11], heart failure (HRadj, 1.17; 95% CI, 1.12–1.22), angina (HRadj, 1.13; 95% CI, 1.06–1.20) and pulmonary emboli (HRadj, 1.24; 95% CI, 1.15–1.33) compared with people without CRD. In people with asthma or COPD, baseline exacerbations were associated with a higher risk of cardiovascular outcomes (HRadj, 1.36; 95% CI, 1.27–1.00 and HRadj, 1.35; 95% CI, 1.24–1.46, respectively). Regardless of CRD, the risk of cardiovascular events was lower with increasing COVID-19 vaccine dose.ConclusionsHigher risk of cardiovascular events post-COVID-19 might be explained by the underlying severity of the CRD, and COVID-19 vaccines were beneficial to both people with and those without CRD with regards to cardiovascualr events.
College: Faculty of Medicine, Health and Life Sciences
Funders: The British Heart Foundation Data Science Centre (grant No SP/19/3/34678), awarded to Health Data Research (HDR) UK funded co-development (with NHS England) of the Secure Data Environment service for England, provision of linked data sources, data access, user software licences, computational usage, data management and wrangling support, with additional contributions from the HDR UK Data and Connectivity component of the UK Government Chief Scientific Adviser’s National Core Studies programme to coordinate national COVID-19 priority research. Consortium partner organizations funded the time of contributing data analysts, biostatisticians, epidemiologists and clinicians. This research is part of 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 ref: MC_PC_20058).
Issue: 3

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