Dataset Information

International electronic health record-derived post-acute sequelae profiles of COVID-19 patients.

ABSTRACT: 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.

SUBMITTER: Zhang HG

PROVIDER: S-EPMC9242995 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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International electronic health record-derived post-acute sequelae profiles of COVID-19 patients.

Zhang Harrison G HG Dagliati Arianna A Shakeri Hossein Abad Zahra Z Xiong Xin X Bonzel Clara-Lea CL Xia Zongqi Z Tan Bryce W Q BWQ Avillach Paul P Brat Gabriel A GA Hong Chuan C Morris Michele M Visweswaran Shyam S Patel Lav P LP Gutiérrez-Sacristán Alba A Hanauer David A DA Holmes John H JH Samayamuthu Malarkodi Jebathilagam MJ Bourgeois Florence T FT L'Yi Sehi S Maidlow Sarah E SE Moal Bertrand B Murphy Shawn N SN Strasser Zachary H ZH Neuraz Antoine A Ngiam Kee Yuan KY Loh Ne Hooi Will NHW Omenn Gilbert S GS Prunotto Andrea A Dalvin Lauren A LA Klann Jeffrey G JG Schubert Petra P Vidorreta Fernando J Sanz FJS Benoit Vincent V Verdy Guillaume G Kavuluru Ramakanth R Estiri Hossein H Luo Yuan Y Malovini Alberto A Tibollo Valentina V Bellazzi Riccardo R Cho Kelly K Ho Yuk-Lam YL Tan Amelia L M ALM Tan Byorn W L BWL Gehlenborg Nils N Lozano-Zahonero Sara S Jouhet Vianney V Chiovato Luca L Aronow Bruce J BJ Toh Emma M S EMS Wong Wei Gen Scott WGS Pizzimenti Sara S Wagholikar Kavishwar B KB Bucalo Mauro M Cai Tianxi T South Andrew M AM Kohane Isaac S IS Weber Griffin M GM

NPJ digital medicine 20220629 1

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 ...[more]

PMID: 35768548

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Project description:BackgroundData on the post-acute and post-infectious complications of patients who have recovered from severe coronavirus disease 2019 (COVID-19) are limited. While studies report that approximately 5-15% of COVID-19 hospitalized patients require intensive care and mechanical ventilation, a substantially higher number need non-invasive ventilation and are subject to prolonged hospitalizations, with long periods of immobility and isolation. The purpose of this study is to describe the post-infectious sequelae of severe viral illness and the post-acute complications of intensive care treatments in critically ill patients who have recovered from severe COVID-19 infection.MethodsWe performed a retrospective chart review of adult patients initially hospitalized with confirmed COVID-19 infection, who recovered and were transferred to a general medical ward or discharged home between March 15, 2020 and May 15, 2020, dates inclusive, after an intensive care unit (ICU) or high dependency unit (HDU) admission in a designated COVID-19 hospital in the United Arab Emirates. Demographic data, underlying comorbidities, treatment, complications, and outcomes were collected. Descriptive statistical analyses were performed.ResultsOf 71 patients transferred out of ICU (n = 38, 54%) and HDU (n = 33, 46%), mean age was 48 years (SD, 9.95); 96% men; 54% under age 50. Mean ICU stay was 12.4 days (SD, 5.29), HDU stay was 13.4 days (SD, 4.53). Pre-existing conditions were not significantly associated with developing post-acute complications (Odds Ratio [OR] 1.1, 95% confidence interval [CI] 0.41, 2.93, p = 1.00). Fifty nine percent of patients had complications; myopathy, swallowing impairments, and pressure ulcers were most common. Delirium and confusion were diagnosed in 18% (n = 13); all were admitted to the ICU and required mechanical ventilation. Of note, of all patients studied, 59.2% (n = 42/71) had at least 1 complication, 32.4% (n = 23) had at least 2 complications, and 19.7% (n = 14) suffered 3 or more sequelae. Complications were significantly more common in ICU patients (n = 33/38, 87%), compared to HDU patients (n = 9/33, 27%) (OR 17.6, 95% CI 5.23, 59.21, p <0.05).ConclusionIn a subset of critically ill patients who recovered from severe COVID-19 infection, there was considerable short-term post-infectious and post-acute disability. Long-term follow-up of COVID-19 survivors is warranted.

Dataset Information

International electronic health record-derived post-acute sequelae profiles of COVID-19 patients.

Publications

International electronic health record-derived post-acute sequelae profiles of COVID-19 patients.

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