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Odds of Developing Cardiovascular Disease Increased in Weeks Following COVID-19 Infection

An analysis of EHR data provides insight into the apparent increase in risk of developing cardiovascular disease or diabetes in the weeks immediately proceeding a COVID-19 infection.

This article was originally published on EndocrinologyNetwork.com.

An analysis of EHR data from general practices in the United Kingdom is shedding light on the potential increase in risk for developing cardiovascular disease and diabetes after contracting COVID-19.

An analysis of data from more than 1300 family practices with data from more than 850,000 patients, results of the study demonstrate contracting COVID-19 was associated with a 6-fold increase in cardiovascular disease diagnoses and an 81% increase in the net incidence of diabetes in the first 4 weeks after COVID-19.

“Use of a large, national database of electronic health records from primary care has enabled us to characterize the risk of cardiovascular disease and diabetes mellitus during the acute and longer-term phases following COVID-19 infection,” said lead investigator Emma Rezel-Potts, PhD, a research associate in Translational Epidemiology and Public Health at Kings College London, in a statement. “Whilst it is in the first 4 weeks that COVID-19 patients are most at risk of these outcomes, the risk of diabetes mellitus remains increased for at least 12 weeks. Clinical and public health interventions focusing on reducing diabetes risk among those recovering from COVID-19 over the longer term may be very beneficial.”

As the world has moved further along into the COVID-19 pandemic, research focuses have begun to shift from treatment of the disease in the acute phase to long-term sequelae. Recognized as major risk factors for severe COVID-19, the long-term risk of cardiometabolic comorbidities has become a chief concern among potential long-term risks associated with contracting COVID-19. With this in mind, Rezel-Potts and a team of colleagues launched the current study with an interest in conducting a matched cohort study assessing cardiometabolic outcomes up to 12 months after COVID-19 infection among patients in the UK.

With this in mind, investigators designed their study using data obtained from the e Clinical Practice Research Datalink (CPRD) Aurum, which is a database encompassing information from 1356 family practices in England with approximately 13.4 million registered patients in the March 2022 release. The database provided investigators with information related to 516,985 participants diagnosed with OCVID-19, including 431,193 participants without prevalent diabetes or cardiovascular disease, which were included in the current analyses.

Matching these individuals with controls based on age, sex, and family practice, investigators identified 428,650 matched pairs of controls and COVID-19 patients. The primary outcome of interest for the investigators’ analyses were first recorded diagnoses of cardiovascular disease and diabetes mellitus. For the purpose of analysis follow-up time was divided into 3 specific categories, with 4 weeks from index date, 5-12 weeks from index date, and 13-52 weeks from index date defined as acute COVID-19, post-acute COVID-19, and long COVID-19, respectively.

In adjusted analyses, acute COVID-19 was associated with net increased cardiovascular disease incidence (aRR, 5.82 [95% CI, 4.82-7.03]), including incidence of pulmonary embolism (aRR, 11.51 [95% CI, 7.07-18.73]), atrial arrhythmias (6.44, 4.17 to 9.96), and venous thrombosis (aRR, 5.43 [95% CI, 3.27-9.01]). Investigators pointed out cardiovascular disease incidence declined from weeks 5-12 (aRR, 1.49 [95% CI, 1.28-1.73]) and showed a net decrease from 13-52 weeks (aRR, 0.80 [95% CI, 0.73-0.88]).

Further analysis indicated the net incidence of diabetes mellitus was increased in the first 4 weeks following COVID-19 infection (aRR, 1.81 [95% CI, 1.51-2.19]) and remained elevated from 5 to 12 weeks (aRR 1.27, 1.11-1.46) but not from 13 to 52 weeks overall (aRR, 1.07 [95% CI, 0.99-1.16]).

“The information provided by this very large population-based study on the longer-term effects of COVID-19 on development of cardiovascular conditions and diabetes will be extremely valuable to doctors managing the millions of people who have had COVID-19 by now,” added study investigator Ajay Shah, MD, executive dean of the Faculty of Life Sciences and Medicine and the British Heart Foundation, in the aforementioned statement. “It is clear that particular vigilance is required for at least the first 3 months after COVID-19.”

This study, “Cardiometabolic outcomes up to 12 months after COVID-19 infection. A matched cohort study in the UK,” was published in PLOS Medicine.