Contextualising adverse events of special interest to characterise the baseline incidence rates in 24 million patients with COVID-19 across 26 databases: a multinational retrospective cohort study.
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Voss Erica A, Shoaibi Azza, Yin Hui Lai Lana, Blacketer Clair, Alshammari Thamir, Makadia Rupa, Haynes Kevin, Sena Anthony G, Rao Gowtham, van Sandijk Sebastiaan, Fraboulet Clement, Boyer Laurent, Le Carrour Tanguy, Horban Scott, Morales Daniel R, Martínez Roldán Jordi, Ramírez-Anguita Juan Manuel, Mayer Miguel A, de Wilde Marcel, John Luis H, Duarte-Salles Talita, Roel Elena, Pistillo Andrea, Kolde Raivo, Maljković Filip, Denaxas Spiros, Papez Vaclav, Kahn Michael G, Natarajan Karthik, Reich Christian, Secora Alex, Minty Evan P, Shah Nigam H, Posada Jose D, Garcia Morales Maria Teresa, Bosca Diego, Cadenas Juanino Honorio, Diaz Holgado Antonio, Pedrera Jiménez Miguel, Serrano Balazote Pablo, García Barrio Noelia, Şen Selçuk, Üresin Ali Yağız, Erdogan Baris, Belmans Luc, Byttebier Geert, Malbrain Manu L N G, Dedman Daniel J, Cuccu Zara, Vashisht Rohit, Butte Atul J, Patel Ayan, Dahm Lisa, Han Cora, Bu Fan, Arshad Faaizah, Ostropolets Anna, Nyberg Fredrik, Hripcsak George, Suchard Marc A, Prieto-Alhambra Dani, Rijnbeek Peter R, Schuemie Martijn J, Ryan Patrick B
Аннотация
METHODS: A multi-national cohort study with data from primary care, electronic health records, and insurance claims mapped to a common data model. This study's evidence was collected between Jan 1, 2017 and the conclusion of each database (which ranged from Jul 2020 to May 2022). The 16 pre-specified prevalent AESIs were: acute myocardial infarction, anaphylaxis, appendicitis, Bell's palsy, deep vein thrombosis, disseminated intravascular coagulation, encephalomyelitis, Guillain- Barré syndrome, haemorrhagic stroke, non-haemorrhagic stroke, immune thrombocytopenia, myocarditis/pericarditis, narcolepsy, pulmonary embolism, transverse myelitis, and thrombosis with thrombocytopenia. Age-sex standardised incidence rate ratios (SIR) were estimated to compare post-COVID-19 to pre-pandemic rates in each of the databases.
FINDINGS: Substantial heterogeneity by age was seen for AESI rates, with some clearly increasing with age but others following the opposite trend. Similarly, differences were also observed across databases for same health outcome and age-sex strata. All studied AESIs appeared consistently more common in the post-COVID-19 compared to the historical cohorts, with related meta-analytic SIRs ranging from 1.32 (1.05 to 1.66) for narcolepsy to 11.70 (10.10 to 13.70) for pulmonary embolism.
INTERPRETATION: Our findings suggest all AESIs are more common after COVID-19 than in the general population. Thromboembolic events were particularly common, and over 10-fold more so. More research is needed to contextualise post-COVID-19 complications in the longer term.
FUNDING: None.