TY - JOUR
T1 - International electronic health record-derived post-acute sequelae profiles of COVID-19 patients
AU - Zhang, Harrison G.
AU - Dagliati, Arianna
AU - Shakeri Hossein Abad, Zahra
AU - Xiong, Xin
AU - Bonzel, Clara Lea
AU - Xia, Zongqi
AU - Tan, Bryce W.Q.
AU - Avillach, Paul
AU - Brat, Gabriel A.
AU - Hong, Chuan
AU - Morris, Michele
AU - Visweswaran, Shyam
AU - Patel, Lav P.
AU - Gutiérrez-Sacristán, Alba
AU - Hanauer, David A.
AU - Holmes, John H.
AU - Samayamuthu, Malarkodi Jebathilagam
AU - Bourgeois, Florence T.
AU - L’Yi, Sehi
AU - Maidlow, Sarah E.
AU - Moal, Bertrand
AU - Murphy, Shawn N.
AU - Strasser, Zachary H.
AU - Neuraz, Antoine
AU - Ngiam, Kee Yuan
AU - Loh, Ne Hooi Will
AU - Omenn, Gilbert S.
AU - Prunotto, Andrea
AU - Dalvin, Lauren A.
AU - Klann, Jeffrey G.
AU - Schubert, Petra
AU - Vidorreta, Fernando J.Sanz
AU - Benoit, Vincent
AU - Verdy, Guillaume
AU - Kavuluru, Ramakanth
AU - Estiri, Hossein
AU - Luo, Yuan
AU - Malovini, Alberto
AU - Tibollo, Valentina
AU - Bellazzi, Riccardo
AU - Cho, Kelly
AU - Ho, Yuk Lam
AU - Tan, Amelia L.M.
AU - Tan, Byorn W.L.
AU - Gehlenborg, Nils
AU - Lozano-Zahonero, Sara
AU - Jouhet, Vianney
AU - Chiovato, Luca
AU - Aronow, Bruce J.
AU - Toh, Emma M.S.
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - The risk profiles of post-acute sequelae of COVID-19 (PASC) have not been well characterized in multi-national settings with appropriate controls. We leveraged electronic health record (EHR) data from 277 international hospitals representing 414,602 patients with COVID-19, 2.3 million control patients without COVID-19 in the inpatient and outpatient settings, and over 221 million diagnosis codes to systematically identify new-onset conditions enriched among patients with COVID-19 during the post-acute period. Compared to inpatient controls, inpatient COVID-19 cases were at significant risk for angina pectoris (RR 1.30, 95% CI 1.09–1.55), heart failure (RR 1.22, 95% CI 1.10–1.35), cognitive dysfunctions (RR 1.18, 95% CI 1.07–1.31), and fatigue (RR 1.18, 95% CI 1.07–1.30). Relative to outpatient controls, outpatient COVID-19 cases were at risk for pulmonary embolism (RR 2.10, 95% CI 1.58–2.76), venous embolism (RR 1.34, 95% CI 1.17–1.54), atrial fibrillation (RR 1.30, 95% CI 1.13–1.50), type 2 diabetes (RR 1.26, 95% CI 1.16–1.36) and vitamin D deficiency (RR 1.19, 95% CI 1.09–1.30). Outpatient COVID-19 cases were also at risk for loss of smell and taste (RR 2.42, 95% CI 1.90–3.06), inflammatory neuropathy (RR 1.66, 95% CI 1.21–2.27), and cognitive dysfunction (RR 1.18, 95% CI 1.04–1.33). The incidence of post-acute cardiovascular and pulmonary conditions decreased across time among inpatient cases while the incidence of cardiovascular, digestive, and metabolic conditions increased among outpatient cases. Our study, based on a federated international network, systematically identified robust conditions associated with PASC compared to control groups, underscoring the multifaceted cardiovascular and neurological phenotype profiles of PASC.
AB - The risk profiles of post-acute sequelae of COVID-19 (PASC) have not been well characterized in multi-national settings with appropriate controls. We leveraged electronic health record (EHR) data from 277 international hospitals representing 414,602 patients with COVID-19, 2.3 million control patients without COVID-19 in the inpatient and outpatient settings, and over 221 million diagnosis codes to systematically identify new-onset conditions enriched among patients with COVID-19 during the post-acute period. Compared to inpatient controls, inpatient COVID-19 cases were at significant risk for angina pectoris (RR 1.30, 95% CI 1.09–1.55), heart failure (RR 1.22, 95% CI 1.10–1.35), cognitive dysfunctions (RR 1.18, 95% CI 1.07–1.31), and fatigue (RR 1.18, 95% CI 1.07–1.30). Relative to outpatient controls, outpatient COVID-19 cases were at risk for pulmonary embolism (RR 2.10, 95% CI 1.58–2.76), venous embolism (RR 1.34, 95% CI 1.17–1.54), atrial fibrillation (RR 1.30, 95% CI 1.13–1.50), type 2 diabetes (RR 1.26, 95% CI 1.16–1.36) and vitamin D deficiency (RR 1.19, 95% CI 1.09–1.30). Outpatient COVID-19 cases were also at risk for loss of smell and taste (RR 2.42, 95% CI 1.90–3.06), inflammatory neuropathy (RR 1.66, 95% CI 1.21–2.27), and cognitive dysfunction (RR 1.18, 95% CI 1.04–1.33). The incidence of post-acute cardiovascular and pulmonary conditions decreased across time among inpatient cases while the incidence of cardiovascular, digestive, and metabolic conditions increased among outpatient cases. Our study, based on a federated international network, systematically identified robust conditions associated with PASC compared to control groups, underscoring the multifaceted cardiovascular and neurological phenotype profiles of PASC.
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U2 - 10.1038/s41746-022-00623-8
DO - 10.1038/s41746-022-00623-8
M3 - Article
AN - SCOPUS:85134068033
SN - 2398-6352
VL - 5
JO - npj Digital Medicine
JF - npj Digital Medicine
IS - 1
M1 - 81
ER -