학술논문
International electronic health record-derived post-acute sequelae profiles of COVID-19 patients
Document Type
article
Author
Harrison G. Zhang; Arianna Dagliati; Zahra Shakeri Hossein Abad; Xin Xiong; Clara-Lea Bonzel; Zongqi Xia; Bryce W. Q. Tan; Paul Avillach; Gabriel A. Brat; Chuan Hong; Michele Morris; Shyam Visweswaran; Lav P. Patel; Alba Gutiérrez-Sacristán; David A. Hanauer; John H. Holmes; Malarkodi Jebathilagam Samayamuthu; Florence T. Bourgeois; Sehi L’Yi; Sarah E. Maidlow; Bertrand Moal; Shawn N. Murphy; Zachary H. Strasser; Antoine Neuraz; Kee Yuan Ngiam; Ne Hooi Will Loh; Gilbert S. Omenn; Andrea Prunotto; Lauren A. Dalvin; Jeffrey G. Klann; Petra Schubert; Fernando J. Sanz Vidorreta; Vincent Benoit; Guillaume Verdy; Ramakanth Kavuluru; Hossein Estiri; Yuan Luo; Alberto Malovini; Valentina Tibollo; Riccardo Bellazzi; Kelly Cho; Yuk-Lam Ho; Amelia L. M. Tan; Byorn W. L. Tan; Nils Gehlenborg; Sara Lozano-Zahonero; Vianney Jouhet; Luca Chiovato; Bruce J. Aronow; Emma M. S. Toh; Wei Gen Scott Wong; Sara Pizzimenti; Kavishwar B. Wagholikar; Mauro Bucalo; The Consortium for Clinical Characterization of COVID-19 by EHR (4CE); Tianxi Cai; Andrew M. South; Isaac S. Kohane; Griffin M. Weber
Source
npj Digital Medicine, Vol 5, Iss 1, Pp 1-11 (2022)
Subject
Language
English
ISSN
2398-6352
Abstract
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.