Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks

Wang, Weijie; Wang, Chi-Yen; Wang, Shiow-Ing; Wei, James Cheng‐Chung

doi:10.1016/j.eclinm.2022.101619

Cited by 165 publications

(211 citation statements)

References 29 publications

(29 reference statements)

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“…Pre-existing AF also exacerbates symptoms as well as the risk of death in patients with COVID-19 ( 26 , 27 ). In addition, the incidence of AF is significantly higher in survivors of COVID-19 ( 28 ). This predicts a link between COVID-19 and the development of AF.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive bioinformatics analysis reveals common potential mechanisms, progression markers, and immune cells of coronary virus disease 2019 and atrial fibrillation

Yang

Zhao

2022

Front. Cardiovasc. Med.

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ObjectivesAtrial fibrillation (AF) is the most common arrhythmia in coronary virus disease 2019 (COVID-19) patients, especially in severe patients. A history of AF can exacerbate COVID-19 symptoms. COVID-19 Patients with new-onset AF have prolonged hospital stays and increased death risk. However, the mechanisms and targets of the interaction between COVID-19 and AF have not been elucidated.Materials and methodsWe used a series of bioinformatics analyses to understand biological pathways, protein-protein interaction (PPI) networks, gene regulatory networks (GRNs), and protein-chemical interactions between COVID-19 and AF and constructed an AF-related gene signature to assess COVID-19 severity and prognosis.ResultsWe found folate and one-carbon metabolism, calcium regulation, and TFG-β signaling pathway as potential mechanisms linking COVID-19 and AF, which may be involved in alterations in neutrophil metabolism, inflammation, and endothelial cell function. We identified hug genes and found that NF-κb, hsa-miR-1-3p, hsa-miR-124-3p, valproic acid, and quercetin may be key regulatory molecules. We constructed a 3-gene signature consisting of ARG1, GIMAP7, and RFX2 models for the assessment of COVID-19 severity and prognosis, and found that they are associated with neutrophils, T cells, and hematopoietic stem cells, respectively.ConclusionOur study reveals a dysregulation of metabolism, inflammation, and immunity between COVID-19 and AF, and identified several therapeutic targets and progression markers. We hope that the results will reveal important insights into the complex interactions between COVID-19 and AF that will drive novel drug development and help in severity assessment.

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Section: Discussionmentioning

confidence: 99%

Comprehensive bioinformatics analysis reveals common potential mechanisms, progression markers, and immune cells of coronary virus disease 2019 and atrial fibrillation

Yang

Zhao

2022

Front. Cardiovasc. Med.

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“…A recent study of eClinicalMedicine found that COVID-19 survivors, compared with non-COVID-19 controls, had a significantly higher risk of cardiovascular events within 12-month follow-up. 1 This study offered timely information to readers. However, we have several concerns.…”

mentioning

confidence: 89%

“…Although vaccination and antiviral therapy have produced positive results, 4 further research is needed to prevent sequelae such as long-term cardiovascular events among COVID-19 survivors. 1 …”

mentioning

confidence: 99%

Concerns about Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks

Chang

Sun²,

Hung³

2022

eClinicalMedicine

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“…Studies suggest that 20 to 40% of COVID-19 survivors may be affected by Post-Acute Sequelae of COVID-19 (PASC) [2][3][4] also termed Post COVID conditions (PCC), [5,6], Long COVID [7], Post-Acute COVID-19 Syndrome (PACS) [8], Chronic COVID-19 Syndrome [9], and Long Haul COVID-19 [10]. PASC is an aggregate term for a highly heterogeneous group of post-COVID-19 problems, including persistent symptoms of acute infection (e.g., cough, fatigue, loss of smell [11][12][13]), new chronic disorders, (e.g., chronic lung or neurologic disease [3,[14][15][16][17][18][19][20][21]), and late post-COVID complications (e.g., autoimmune complications). COVID-19 vaccinations might decrease the risk for PASC by 13% -22% [22,23]; however, with a massive number of breakthrough infections and a relaxation of mitigation measures across the world, the high prevalence of PASC during an ongoing pandemic might present a tremendous burden for healthcare systems worldwide.…”

Section: Introductionmentioning

confidence: 99%

Characterizing and Predicting Post-Acute Sequelae of SARS CoV-2 infection (PASC) in a Large Academic Medical Center in the US

Fritsche

Jin

Admon

et al. 2022

Preprint

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ObjectiveThe growing number of Coronavirus Disease-2019 (COVID-19) survivors who are affected by Post-Acute Sequelae of SARS CoV-2 infection (PACS) represent a worldwide public health challenge. Yet, the novelty of this condition and the resulting limited data on underlying pathomechanisms so far hampered the advancement of effective therapies. Using electronic health records (EHR) data, we aimed to characterize PASC-associated diagnoses and to develop risk prediction models.MethodsIn our cohort of 63,675 COVID-19 positive patients seen at Michigan Medicine, 1,724 (2.7 %) had a recorded PASC diagnosis. We used a case control study design comparing PASC cases with 17,205 matched controls and performed phenome-wide association studies (PheWASs) to characterize enriched phenotypes of the post-COVID-19 period and potential PASC pre-disposing phenotypes of the pre-, and acute-COVID-19 periods. We also integrated PASC-associated phenotypes into Phenotype Risk Scores (PheRSs) and evaluated their predictive performance.ResultsIn the post-COVID-19 period, cases were significantly enriched for known PASC symptoms (e.g., shortness of breath, malaise/fatigue, and cardiac dysrhythmias) but also many musculoskeletal, infectious, and digestive disorders. We found seven phenotypes in the pre-COVID-19 period (irritable bowel syndrome, concussion, nausea/vomiting, shortness of breath, respiratory abnormalities, allergic reaction to food, and circulatory disease) and 69 phenotypes in the acute-COVID-19 period (predominantly respiratory, circulatory, neurological, digestive, and mental health phenotypes) that were significantly associated with PASC. The derived pre-COVID-19 PheRS and acute-COVID-19 PheRS had low accuracy to differentiate cases from controls; however, they stratified risk well, e.g., a combination of the two PheRSs identified a quarter of the COVID-19 positive cohort at a 3.5-fold increased risk for PASC compared to the bottom 50% of their distributions.ConclusionsOur agnostic screen of time stamped EHR data uncovered a plethora of PASC-associated diagnoses across many categories and highlighted a complex arrangement of presenting and likely pre-disposing features – the latter with a potential for risk stratification approaches. Yet, considerably more work will need to be done to better characterize PASC and its subtypes, especially long-term consequences, and to consider more comprehensive risk models.

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Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks

Cited by 165 publications

References 29 publications

Comprehensive bioinformatics analysis reveals common potential mechanisms, progression markers, and immune cells of coronary virus disease 2019 and atrial fibrillation

Comprehensive bioinformatics analysis reveals common potential mechanisms, progression markers, and immune cells of coronary virus disease 2019 and atrial fibrillation

Concerns about Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks

Characterizing and Predicting Post-Acute Sequelae of SARS CoV-2 infection (PASC) in a Large Academic Medical Center in the US

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