An article recently published in eClinicalMedicine Journal assessed the threat of post-acute sequelae of coronavirus disease 2019 (COVID-19) in the United Kingdom (UK) and Hong Kong (HK).
Long COVID, also known as post-acute COVID-19 sequelae (PASC), is explained as a multitude of symptoms and symptoms involving organ systems that persist after a first episode of COVID-19.
Long COVID has a significant public health problem, with systematic reviews suggesting that up to 80% of survivors suffer at least one symptom after acute COVID-19. Despite efforts, the evidence from existing studies is inconsistent due to heterogeneous estimates.
In the existing study, researchers characterized long-term sequelae among COVID-19 survivors in Hong Kong and the United Kingdom. The researchers received the patients’ electronic medical records from the UK Biobank (UKB) and the Hong Kong Hospital Authority (HKHA). .
Patients over the age of 18 with a laboratory-confirmed diagnosis of COVID-19 were eligible for inclusion. COVID-19 patients were known between April 2020 and May 2022 with HKHA and between March 2020 and May 2021 with UKB.
People who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) served as controls. Controls were compared with COVID-19 cases by sex and year of birth.
All subjects were followed until outcome or death, whichever comes first. The index date is the date 21 days after the first diagnosis of COVID-19. In addition, the team has collected anonymous longitudinal knowledge about fitness care since 2016.
Outcomes included occurrence of primary cardiovascular events (defined as composite end outcomes of coronary heart center disease, stroke, and center failure), myocardial infarction (MI), deep vein thrombosis (DVT), coronary artery disease, Bell’s palsy, acute respiratory distension syndrome (ARDS), post-traumatic stress disorder (PTSD), encephalitis, anxiety, and mortality, among others. People who had been diagnosed with any of these end results in the past were excluded.
The authors implemented inverse probability remedy weighting through confounding propensity scores. Logistic regression models were used to estimate propensity scores. The rates of occurrence of the results were calculated.
Cox proportional hazard regressions were used to calculate proportions and confidence periods for 95% of the results.
In sensitivity analyses, the researchers redefined the index date as 30 or 90 days after diagnosis; adjusted for all-cause mortality and excluded subjects with COVID-19 diagnoses.
In subgroup analyses, subjects were stratified by age, sex, COVID-19 vaccination prior to indexing, Charlson comorbidity index (CHF), and disease severity.
The researchers knew of 535,186 COVID-19 patients from HKHA and 16,400 patients from the UK. Approximately 47% of patients were men. The mean age of HKHA and UKB subjects was 54. 1 and 68. 1 years, respectively.
The HKHA and UKB subjects followed for a median of 146 and 243 days, respectively. About 0. 8% of HKHA patients with COVID-19 and none from UKB were rediagnosed at least 30 days later.
COVID-19 cases, compared to controls, showed a primary threat of atrial fibrillation, DVT, central insufficiency, ARDS, chronic lung disease, anxiety disorder, PTSD, seizures, acute renal failure, end-stage renal disease, interstitial lung disease, pancreatitis, cardiovascular mortality, coronary heart disease, and all-cause mortality. The occurrence of primary cardiovascular events is higher in UKB and HKHA.
COVID-19 cases in HK showed a higher incidence of liver damage, while cases in the UK had a higher incidence of Bell’s palsy, myocardial infarction, and stroke. The effects of sensitivity analyses were consistent with the number one analyses.
Subgroup analyses indicated that severe COVID-19 patients, women, those who received less than two doses of vaccines, older patients (65 years of age or older), and patients with ICC aged four years and older had a higher risk of SCCP than others.
Researchers reported a peak incidence of SCAP affecting the cardiovascular, psychiatric, nephrological, respiratory, and hepatic systems in patients in the United Kingdom and Hong Kong.
Women, elderly patients, those with severe disease or multimorbidity, and those receiving less than two doses of the vaccine were at higher risk of switching to PASC.
The COVID-19 cases in HK were basically due to the Omicron variant of SARS-CoV-2. The threat of death for any reason decreased in the HK cohort than in the UK cohort. However, both cohorts had a similar threat of PASC.
Limitations of the coming with detection or indication bias and underdetection of asymptomatic cases of COVID-19, among others.
In addition, several unmeasured confounding factors would possibly have generated bias. In addition, the threat of mild symptoms and the potential advantages of the fourth dose of PASC vaccine were not addressed due to limitations in pattern duration.
Taken together, the study reported stable increases in sequelae and all-cause mortality after acute COVID-19 in the UK and Hong Kong.
Lam, ICH, et al. (2023) Long-term post-acute sequelae of COVID-19 infection: a multi-database retrospective cohort in Hong Kong and the United Kingdom. eClinicalMedicine, doi: 10. 1016/j. eclinm. 2023. 102000. https://www. thelancet. com/journals/eclim/article/PIIS2589-5370(23)00177-3/full text
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Tarun was founded in Hyderabad, India. He holds a master’s degree in Biotechnology from the University of Hyderabad and is passionate about clinical studies. She enjoys reading study articles and literature reviews and is passionate about writing.
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