International electronic health record-derived post-acute sequelae profiles of COVID-19 patients.
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Zhang Harrison G, Dagliati Arianna, Shakeri Hossein Abad Zahra, Xiong Xin, Bonzel Clara-Lea, Xia Zongqi, Tan Bryce W Q, Avillach Paul, Brat Gabriel A, Hong Chuan, Morris Michele, Visweswaran Shyam, Patel Lav P, Gutiérrez-Sacristán Alba, Hanauer David A, Holmes John H, Samayamuthu Malarkodi Jebathilagam, Bourgeois Florence T, L'Yi Sehi, Maidlow Sarah E, Moal Bertrand, Murphy Shawn N, Strasser Zachary H, Neuraz Antoine, Ngiam Kee Yuan, Loh Ne Hooi Will, Omenn Gilbert S, Prunotto Andrea, Dalvin Lauren A, Klann Jeffrey G, Schubert Petra, Vidorreta Fernando J Sanz, Benoit Vincent, Verdy Guillaume, Kavuluru Ramakanth, Estiri Hossein, Luo Yuan, Malovini Alberto, Tibollo Valentina, Bellazzi Riccardo, Cho Kelly, Ho Yuk-Lam, Tan Amelia L M, Tan Byorn W L, Gehlenborg Nils, Lozano-Zahonero Sara, Jouhet Vianney, Chiovato Luca, Aronow Bruce J, Toh Emma M S, Wong Wei Gen Scott, Pizzimenti Sara, Wagholikar Kavishwar B, Bucalo Mauro, Consortium for Clinical Characterization of COVID-19 by EHR (4CE), Cai Tianxi, South Andrew M, Kohane Isaac S, Weber Griffin M
Аннотация
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.