One-Year Adverse Outcomes Among US Adults With Post–COVID Condition vs Those Without COVID in a Large Commercial Insurance Database, 2023

[Mij]

Key Points

Question Do postacute sequelae of SARS-CoV-2 increase risks of 1-year adverse outcomes?

Findings In this case-control study of 13 435 US adults with post–COVID-19 condition (PCC) and 26 870 matched adults without COVID-19, the adults with PCC experienced increased risks for a number of cardiovascular outcomes, such as ischemic stroke. During the 12-month follow-up period, 2.8% of the individuals with PCC vs 1.2% of the individuals without COVID-19 died, implying an excess death rate of 16.4 per 1000 individuals.

Meaning Individuals with PCC may be at increased risk for adverse outcomes in the year following initial infection.

Abstract

Importance Many individuals experience ongoing symptoms following the onset of COVID-19, characterized as postacute sequelae of SARS-CoV-2 or post–COVID-19 condition (PCC). Less is known about the long-term outcomes for these individuals.

Objective To quantify 1-year outcomes among individuals meeting a PCC definition compared with a control group of individuals without COVID-19.

Design, Setting, and Participants This case-control study with a propensity score–matched control group included members of commercial health plans and used national insurance claims data enhanced with laboratory results and mortality data from the Social Security Administration’s Death Master File and Datavant Flatiron data. The study sample consisted of adults meeting a claims-based definition for PCC with a 2:1 matched control cohort of individuals with no evidence of COVID-19 during the time period of April 1, 2020, to July 31, 2021.

Exposures Individuals experiencing postacute sequelae of SARS-CoV-2 using a Centers for Disease Control and Prevention–based definition.

Main Outcomes and Measures Adverse outcomes, including cardiovascular and respiratory outcomes and mortality, for individuals with PCC and controls assessed over a 12-month period.

Results The study population included 13 435 individuals with PCC and 26 870 individuals with no evidence of COVID-19 (mean [SD] age, 51 [15.1] years; 58.4% female). During follow-up, the PCC cohort experienced increased health care utilization for a wide range of adverse outcomes: cardiac arrhythmias (relative risk [RR], 2.35; 95% CI, 2.26-2.45), pulmonary embolism (RR, 3.64; 95% CI, 3.23-3.92), ischemic stroke (RR, 2.17; 95% CI, 1.98-2.52), coronary artery disease (RR, 1.78; 95% CI, 1.70-1.88), heart failure (RR, 1.97; 95% CI, 1.84-2.10), chronic obstructive pulmonary disease (RR, 1.94; 95% CI, 1.88-2.00), and asthma (RR, 1.95; 95% CI, 1.86-2.03). The PCC cohort also experienced increased mortality, as 2.8% of individuals with PCC vs 1.2% of controls died, implying an excess death rate of 16.4 per 1000 individuals.

Conclusions and Relevance This case-control study leveraged a large commercial insurance database and found increased rates of adverse outcomes over a 1-year period for a PCC cohort surviving the acute phase of illness. The results indicate a need for continued monitoring for at-risk individuals, particularly in the area of cardiovascular and pulmonary management.

https://jamanetwork.com/journals/jama-health-forum/fullarticle/2802095

 

[John Mac]

News article on the study


Long COVID linked to increased risk of death and other cardiovascular issues in new study
EVAN ROSEN, NEW YORK DAILY NEWS
Sat, Mar 4, 2023, 10:20 PM GMT2 min read

Individuals who experience long COVID-19 are at a higher risk for cardiovascular and other health issues, according to a new study.

The findings showed that the chance of patients dying was doubled in those who experienced lingering symptoms from the disease.

The report, published Friday by the Journal of the American Medical Association, studied over 13,000 adults with post-COVID-19 condition — also known as PCC — and compared them to over 26,000 adults without COVID over a one-year period.

https://sports.yahoo.com/long-covid-linked-increased-risk-222000408.html

 

[Mij]

Impact of Vaccination on Major Adverse Cardiovascular Events in Patients With COVID-19 Infection

SARS-CoV-2 infection increases the risk of major adverse cardiac events (MACE) and long-term cardiovascular sequelae after recovery.1 However, the association of vaccination on cardiovascular outcomes following infection has not been elucidated in the United States. We investigate association between vaccination and MACE among patients with prior SARS-CoV-2 infection.

https://www.sciencedirect.com/science/article/pii/S073510972207601X

 

[Mij]

 

[rvallee]

Honestly, a lot of this feels like someone forgot the #1 rule of warfare: it's all logistics. Militaries are about logistics even more than they are about fighting, because it's through logistics that they get the most out of their soldiers. For every boot on the ground you have 5-10 doing support, elevating their skills and supplies.

Supply lines are especially important. You may have all the ammunition and equipment in the world, if it doesn't get where it's needed, when it's needed, in the right quantity and state, then it's useless. You will lose.

Our immune systems can do a lot, can fight diseases and restore damage. But they are fighting. It's like medicine forgets all about the fact that it's violent at the cellular level. Or assumes that it all gets repaired good as new if they can't see the damage. Which they almost never can, technology isn't anywhere near that level.

And they forget that with any fighting, there is logistics, supply-lines, and the cold, harsh reality of the linear passage of time. This system isn't unlimited. It's not free. It comes at a cost, every time. It uses energy, but that supply is mostly fixed, so it takes it from somewhere else. And sometimes it gets what it needs a bit too late, and that changes the whole battlefield. Nothing worse than siege warfare, it just drags on and on.

There's some movie or video game logic to all of this. Or superhero logic. Never runs out of supplies. Can defeat wave after wave of enemies without even breaking a sweat. Becomes immune to harm by simply learning how to easily bat any threat out. It's all that freaking hopium. It disabled reasoning. Medicine without reasoning, well, that's the hopium-based psychosomatic ideology in all its gory. No typo.