Risk factors for long-term cardiovascular post-acute sequelae of COVID-19 infection: A nested case-control study in Hong Kong

Yu, Qiuyan; Fan, Min; Lin, Celia Jiaxi; Lui, David Tak Wai; Tan, Kathryn Choon Beng; Yiu, Kai Hang; Akyea, Ralph Kwame; Qureshi, Nadeem; Lai, Francisco Tsz Tsun; Wan, Eric Yuk Fai; Li, Xue; Chan, Esther Wai Yin; Wong, Ian Chi Kei; Chui, Celine Sze Ling

Abstract

People with COVID-19 can experience post-acute sequelae of SARS-CoV-2 (PASC). Studies on risk factors of PASC outcomes are ongoing, especially for endocrine system-related diseases that may impact the cardiovascular system. Cardiac-related PASC is one of the burdens after COVID-19 infection. This study aimed to examine the risk factors of cardiac-related PASC. In this nested case-control study, we obtained electronic health records (EHRs) database from the Hong Kong Hospital Authority. We defined cases as patients with at least one cardiac-related PASC and controls as patients without any cardiac-related PASC. We applied the incidence density sampling and matched controls to cases on age and sex at a 1:10 ratio. Multivariable conditional logistic regression was used to determine the associations between risk factors and cardiac-related PASC. A total of 455 individuals with cardiac-related PASC and matched 3,423 controls were obtained in the underlying cohort. COVID-19-associated hospitalisation (aOR: 1.41, 95% CI: 1.03–1.93) and peripheral vascular disease (aOR: 2.98, 95% CI: 1.31–6.79) were associated with an increased likelihood of cardiac-related PASC. Higher doses of the COVID-19 vaccine (2 doses: 0.68 [0.52–0.89]; ≥3 doses: 0.56 [0.40–0.78]) and more frequent healthcare utilization visits (aOR: 0.95, 95% CI: 0.92–0.97) were associated with a lower likelihood of cardiac-related PASC. This is the first study to examine risk factors of cardiac-related PASC among the Chinese population. We identified peripheral vascular disease and COVID-19-associated hospitalisation as the risk factors for cardiac-related PASC. COVID-19 vaccination was protective against cardiac-related PASC, which should be prioritized for high-risk patients.

Citation

Yu, Q., Fan, M., Lin, C. J., Lui, D. T. W., Tan, K. C. B., Yiu, K. H., Akyea, R. K., Qureshi, N., Lai, F. T. T., Wan, E. Y. F., Li, X., Chan, E. W. Y., Wong, I. C. K., & Chui, C. S. L. (2024). Risk factors for long-term cardiovascular post-acute sequelae of COVID-19 infection: A nested case-control study in Hong Kong. npj Cardiovascular Health, 1(1), Article 10. https://doi.org/10.1038/s44325-024-00011-z

• Journal Article Type: Article
• Acceptance Date: Jun 26, 2024
• Online Publication Date: Aug 2, 2024
• Publication Date: Aug 2, 2024
• Deposit Date: Aug 6, 2024
• Publicly Available Date: Aug 6, 2024
• Journal: npj Cardiovascular Health
• Electronic ISSN: 2948-2836
• Publisher: Nature Research
• Peer Reviewed: Peer Reviewed
• Volume: 1
• Issue: 1
• Article Number: 10
• DOI: https://doi.org/10.1038/s44325-024-00011-z
• Public URL: https://nottingham-repository.worktribe.com/output/38100532
• Publisher URL: https://www.nature.com/articles/s44325-024-00011-z