Study: Elevated Risk of New Medical Condition After COVID-19

A retrospective cohort study reveals that COVID-19 patients have an increased risk of developing a new health problem after the initial phase of the underlying infection.

A retrospective study examined 193,113 participants who had tested positive for COVID-19 between January 1, 2020, and October 31, 2020. The age range of the participants varied between 18 to 65 years. To monitor the participants, information from a national claims database, a laboratory testing database, and an inpatient hospital admissions database was obtained.

The participants' records were tracked to see how many had developed new clinical sequelae within 6 months of the post-acute phase of COVID-19, defined as a period beginning 3 weeks after the initial SARS-CoV-2 infection diagnosis. This data was compared with data from other patients who had been admitted to the hospital and included those that were not diagnosed with SARS-CoV-2 infection.

The study results indicated that 14% of participants with SARS-CoV-2 infection had developed at least one new medical condition that required treatment following COVID-19. And, the risk of developing new clinical sequelae was 5% higher in the SARS-CoV-2 infected group compared to those who did not have a COVID-19 diagnosis.

Of particular interest is the fact that although individuals who were older, had pre-existing conditions, and were admitted to the hospital because of COVID-19 were at greatest excess risk, younger adults (below 50), those with no pre-existing conditions, or those not admitted to the hospital for COVID-19 also had an increased risk of developing new medical conditions.

New Medical Diagnoses Post COVID-19

According to the study, the excess risk of developing new clinical sequelae after COVID-19 includes diagnoses that are less commonly seen in other viral illnesses:

• chronic respiratory failure
• cardiac arrythmia
• hypercoagulability
• encephalopathy
• peripheral neuropathy
• amnesia (memory difficulty)
• diabetes
• liver test abnormalities
• myocarditis
• anxiety
• fatigue

Differentiating Long Haul COVID-19 from New Medical Diagnosis

According to the CDC, post-COVID conditions are being referred to by a wide range of names, including post-acute COVID-19, long-term effects of COVID, long COVID, post-acute COVID syndrome, chronic COVID, long-haul COVID, long haulers, late sequelae, and others.

The broad research term for these patients is "post-acute sequalae of SARS-COV-2 infection (PASC)" and encompasses those who have developed a new medical diagnosis. PASC patients have been infected with SARS-CoV-2 and have either: 1.) new symptoms/diagnoses; 2.) recurring symptoms, or 3.) ongoing symptoms.

Implications for Healthcare Providers

According to the National Institute of Health, PASC effects can continue months after recovery and can involve multiple organs and systems. Therefore, it is important to consider the long-term impact on healthcare providers as patients will continue to require medical care over a period of time. Considerations should be made to facilitate adequate resources including planning for staffing and supply needs.

In February 2021, the National Institutes of Health announced a $1.15 billion initiative to support research into the causes and ultimately the prevention and treatment of long-haul COVID. One aim of the initiative includes identifying how the SARS-CoV-2 infection triggers changes in the body that increases the risk of developing new conditions.

The research cohort will include both children and adults who have SARS-CoV-2 infection and PASC, as well as those who may not have been infected by SARS-CoV-2, for comparison. Researchers will collect data from these participants over time.

To learn more about this research initiative, visit: SARS-CoV-2 Recovery Cohort Studies

References:

1. BMJ 2021;373:n1098.
2. Centers for Disease Control and Prevention (CDC): Post-COVID Conditions: Information for Healthcare Providers retrieved May 26, 2021.
3. National Institutes of Health: When COVID-19 Symptoms Linger retrieved May 26, 2021.