Distinguishing between direct and indirect consequences of covid-19

Figueroa, Jonine D.; Brennan, Paul M.; Τheodoratou, Evropi; Poon, Michael T C; Purshouse, Karin; Din, Farhat V N; Jin, Kai; Mesa‐Eguiagaray, Ines; Dunlop, Malcolm; Hall, Peter; Cameron, David; Sudlow, Cathie

doi:10.1136/bmj.m2377

Cited by 19 publications

(20 citation statements)

References 5 publications

(2 reference statements)

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“…nancial distress due to complete loss or reduced income), and behavioral conditions (e.g. changes in dietary habits and physical activity), lived experiences of trauma and grief (from pandemic related happenings) that may be differentially experienced by people with COVID-19 may also shape health outcomes in COVID-19 survivors [14][15][16][17][18][19] . A better understanding of the biologic mechanisms and pathophysiology of PASC will facilitate the development of treatment strategies to lessen the burden of chronic illness and reduce permanent health loss and mortality among people with PASC.…”

Section: Resultsmentioning

confidence: 99%

Burdens of Post-acute Sequelae of COVID-19 by Age, Race, Sex, and Health Status

Al‐Aly¹,

Bowe

2021

Preprint

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The Post-Acute Sequelae of SARS-CoV-2 infection (PASC) have been characterized; however, the burden of PASC remains unknown. And whether the burden of individual sequela varies in different population groups is also not clear. Here we estimate that PASC — defined as the presence of at least one sequela in excess of non-infected controls — was 73.43 (72.10, 74.72) per 1000 persons at 6 months. The burden of PASC was 44.51 (43.09, 45.85), 217.08 (212.43, 222.23), and 360.16 (350.53, 369.38) among non-hospitalized, hospitalized, and those who required intensive care during the first 30-days of infection. Burdens of some sequelae were more pronounced in younger individuals, and some were more pronounced in older adults; the same picture was evident in analyses across race, and sex groups. The burden of individual sequela was consistently higher in people with poorer baseline health and increased in a graded fashion according to care setting of the acute infection. In sum, the burden of PASC is substantial; however, PASC is non-monolithic with sequelae that are differentially expressed in various population groups. Collectively, our results may be useful in informing health systems capacity planning and care strategies of people with PASC.

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Section: Resultsmentioning

confidence: 99%

Burdens of Post-acute Sequelae of COVID-19 by Age, Race, Sex, and Health Status

Al‐Aly¹,

Bowe

2021

Preprint

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“…loss of employment), and behavioral conditions (e.g. changes in diet and exercise) that may be differentially experienced by people with COVID-19 may also shape health outcomes in COVID-19 survivors and may be responsible drivers of some of the clinical manifestations reported here [9][10][11][12][13] . Some of the burden reported here may not be related to COVID-19 but may be diagnosed during the course of receiving care for COVID-19 -this may represent a previously unrealized disease that was brought to prominence (and realized) as a consequence of the higher frequency of interaction with the health care system that is experienced by COVID-19 survivors.…”

Section: Discussionmentioning

confidence: 97%

High Dimensional Characterization of Post-acute Sequalae of COVID-19: analysis of health outcomes and clinical manifestations at 6 months

Al‐Aly¹,

Xie

Bowe

2021

Preprint

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The coronavirus disease 2019 (COVID-19) is a viral illness caused by the severe acute respiratory syndrome coronavirus 2. The acute clinical manifestations of COVID-19 are well characterized. The post-acute sequalae of COVID-19 have not been comprehensively described. Here, we use the national healthcare databases of the US Department of Veterans Affairs to undertake a high dimensional approach to comprehensively identify 6-months outcomes of incident clinical manifestations including diagnoses, medication use, and laboratory abnormalities in people who survived the first 30 days of COVID-19. We first describe the clinical manifestations in people with COVID-19 compared to users of the Veterans Affairs healthcare system. We then provide a comparative evaluation of the post-acute sequalae in 30-day survivors who were hospitalized for COVID-19 vs. seasonal influenza. We show that beyond the first 30 days of illness, people with COVID-19 are at higher risk of death and health resource utilization. Our approach identifies incident clinical manifestations in the respiratory system and several other manifestations including the nervous system and neurocognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, and signs and symptoms related to poor generalized wellbeing including malaise, fatigue, musculoskeletal pain, and anemia. There was increased incident use of pain medications (opioids and non-opioids), antidepressants, anxiolytics, antihypertensives, antihyperlipidemic, insulin, and several other medication classes. The findings show that beyond the first 30 days of illness, substantial burden of health loss — spanning pulmonary and several extrapulmonary organ systems — is experienced by COVID-19 survivors. The results provide a roadmap to inform health system planning and development of multidisciplinary care strategies aimed at reducing chronic health loss and optimizing wellness among COVID-19 survivors.

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“…ej., pérdida de empleo) y en el comportamiento (p. ej., cambios en la dieta y el ejercicio) que pueden experimentar los sobrevivientes de COVID-19 3 .…”

Section: Comentariounclassified

Padecer COVID-19 se asocia a un mayor riesgo para la salud a mediano plazo

Ciapponi

2021

Evid actual pract ambul

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Distinguishing between direct and indirect consequences of covid-19

Cited by 19 publications

References 5 publications

Burdens of Post-acute Sequelae of COVID-19 by Age, Race, Sex, and Health Status

Burdens of Post-acute Sequelae of COVID-19 by Age, Race, Sex, and Health Status

High Dimensional Characterization of Post-acute Sequalae of COVID-19: analysis of health outcomes and clinical manifestations at 6 months

Padecer COVID-19 se asocia a un mayor riesgo para la salud a mediano plazo

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