Risk Factors Associated With Post−COVID-19: A Condition Systematic Review and Meta-analysis

Discussion in 'Long Covid research' started by Mij, Mar 23, 2023.

  1. Mij

    Mij Senior Member (Voting Rights)

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    Key Points

    Question Which individuals are at risk of developing post−COVID-19 condition (PCC)?

    Findings This systematic review and meta-analysis of 41 studies including 860 783 patients found that female sex, older age, higher body mass index, smoking, preexisting comorbidities, and previous hospitalization or ICU admission were risk factors significantly associated with developing PCC, and that SARS-CoV-2 vaccination with 2 doses was associated with lower risk of PCC.

    Meanings The findings of this systematic review and meta-analysis provide a profile of the characteristics associated with increased risk of developing PCC and suggest that vaccination may be protective against PCC.

    Abstract
    Importance Post−COVID-19 condition (PCC) is a complex heterogeneous disorder that has affected the lives of millions of people globally. Identification of potential risk factors to better understand who is at risk of developing PCC is important because it would allow for early and appropriate clinical support.

    Objective To evaluate the demographic characteristics and comorbidities that have been found to be associated with an increased risk of developing PCC.

    Data sources Medline and Embase databases were systematically searched from inception to December 5, 2022.

    Study Selection The meta-analysis included all published studies that investigated the risk factors and/or predictors of PCC in adult (≥18 years) patients.

    Data Extraction and Synthesis Odds ratios (ORs) for each risk factor were pooled from the selected studies. For each potential risk factor, the random-effects model was used to compare the risk of developing PCC between individuals with and without the risk factor. Data analyses were performed from December 5, 2022, to February 10, 2023.

    Main Outcomes and Measures The risk factors for PCC included patient age; sex; body mass index, calculated as weight in kilograms divided by height in meters squared; smoking status; comorbidities, including anxiety and/or depression, asthma, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, immunosuppression, and ischemic heart disease; previous hospitalization or ICU (intensive care unit) admission with COVID-19; and previous vaccination against COVID-19.

    Results The initial search yielded 5334 records of which 255 articles underwent full-text evaluation, which identified 41 articles and a total of 860 783 patients that were included. The findings of the meta-analysis showed that female sex (OR, 1.56; 95% CI, 1.41-1.73), age (OR, 1.21; 95% CI, 1.11-1.33), high BMI (OR, 1.15; 95% CI, 1.08-1.23), and smoking (OR, 1.10; 95% CI, 1.07-1.13) were associated with an increased risk of developing PCC. In addition, the presence of comorbidities and previous hospitalization or ICU admission were found to be associated with high risk of PCC (OR, 2.48; 95% CI, 1.97-3.13 and OR, 2.37; 95% CI, 2.18-2.56, respectively). Patients who had been vaccinated against COVID-19 with 2 doses had a significantly lower risk of developing PCC compared with patients who were not vaccinated (OR, 0.57; 95% CI, 0.43-0.76).

    Conclusions and Relevance This systematic review and meta-analysis demonstrated that certain demographic characteristics (eg, age and sex), comorbidities, and severe COVID-19 were associated with an increased risk of PCC, whereas vaccination had a protective role against developing PCC sequelae. These findings may enable a better understanding of who may develop PCC and provide additional evidence for the benefits of vaccination.

    https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2802877
     
  2. rvallee

    rvallee Senior Member (Voting Rights)

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    Canada
    All dependent on how each study defined LC, usually poorly. This approach has yielded nothing and most professionals don't believe in prevalence numbers because they're all over the place, and the rest is generic, or as they like to say when convenient: non-specific.

    I can't believe how much money has been wasted on studies that add zero useful knowledge while nothing is done about the existing knowledge. Even their conclusion here is basically "hey, someone should figure this out, I guess".

    Because really we're still at the same place we were on day 1 in terms of risk factor: COVID. It's the risk factor. And it's not just everywhere, I still see MDs praising reinfections because they give people immunity... from being reinfected.
     

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