Cardiometabolic outcomes up to 12 months after COVID-19 infection. A matched cohort study in the UK, 2022, Rezel-Potts et al

Abstract

Background
Acute Coronavirus Disease 2019 (COVID-19) has been associated with new-onset cardiovascular disease (CVD) and diabetes mellitus (DM), but it is not known whether COVID-19 has long-term impacts on cardiometabolic outcomes. This study aimed to determine whether the incidence of new DM and CVDs are increased over 12 months after COVID-19 compared with matched controls.

Methods and findings
We conducted a cohort study from 2020 to 2021 analysing electronic records for 1,356 United Kingdom family practices with a population of 13.4 million. Participants were 428,650 COVID-19 patients without DM or CVD who were individually matched with 428,650 control patients on age, sex, and family practice and followed up to January 2022.

Outcomes were incidence of DM and CVD. A difference-in-difference analysis estimated the net effect of COVID-19 allowing for baseline differences, age, ethnicity, smoking, body mass index (BMI), systolic blood pressure, Charlson score, index month, and matched set. Follow-up time was divided into 4 weeks from index date (“acute COVID-19”), 5 to 12 weeks from index date (“post-acute COVID-19”), and 13 to 52 weeks from index date (“long COVID-19”).

Net incidence of DM increased in the first 4 weeks after COVID-19 (adjusted rate ratio, RR 1.81, 95% confidence interval (CI) 1.51 to 2.19) and remained elevated from 5 to 12 weeks (RR 1.27, 1.11 to 1.46) but not from 13 to 52 weeks overall (1.07, 0.99 to 1.16).

Acute COVID-19 was associated with net increased CVD incidence (5.82, 4.82 to 7.03) including pulmonary embolism (RR 11.51, 7.07 to 18.73), atrial arrythmias (6.44, 4.17 to 9.96), and venous thromboses (5.43, 3.27 to 9.01). CVD incidence declined from 5 to 12 weeks (RR 1.49, 1.28 to 1.73) and showed a net decrease from 13 to 52 weeks (0.80, 0.73 to 0.88). The analyses were based on health records data and participants’ exposure and outcome status might have been misclassified.

Conclusions
In this study, we found that CVD was increased early after COVID-19 mainly from pulmonary embolism, atrial arrhythmias, and venous thromboses. DM incidence remained elevated for at least 12 weeks following COVID-19 before declining. People without preexisting CVD or DM who suffer from COVID-19 do not appear to have a long-term increase in incidence of these conditions.

Open access, https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004052

 

All sorts of autoimmune diagnoses are elevated following a Covid infection, true of many other infectious diseases. The general idea behind autoimmune diseases seems to be: "it's immune alright, but we don't know how, the body attacks itself, somehow". Seems logical that there would almost always be an initial immune trigger.

The more I look at all this and it really seems like medicine is staring the most significant revelation in the history of the profession in the face and is just unable to make eye contact: almost all disease is caused by pathogens or the immune system reacting to them, or at the very least particles/molecules that the immune system sees as a threat, probably applies to all sorts of pollutants and particles we happen to ingest or breathe on a regular basis. This idea that the immune system is just border defense, rather than embedded in the basic function of every cell, organ and process in the body is not doing well lately, especially with all the nonsense about how reinfections protect against... reinfections.

The general disinterest over the MS-EBV breakthrough says a lot about how uncomfortable medicine is with this, a very difficult pill to swallow.