The Perfect Enemy | First-wave COVID patients had much higher risk of death for 18 months
January 29, 2023

First-wave COVID patients had much higher risk of death for 18 months

Within the first 21 days after diagnosis, the risk of all-cause death was 68 to 81 times times higher in COVID-19 patients.

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In the first wave of the COVID-19 pandemic, infected UK patients had a significantly elevated risk of cardiovascular disease (CVD) for at least 18 months, suggests a study of nearly 160,000 people published today in Cardiovascular Research.

University of Hong Kong researchers followed 7,584 patients listed in the UK Biobank who tested positive for COVID-19 from Mar 16 to Nov 30, 2020, before vaccines were available, for up to 18 months. Their outcomes were compared with those of randomly matched, uninfected controls from two groups: a contemporary cohort from Mar 16 to Nov 30, 2020, and a historical cohort from the same period in 2018.

The average age in all three groups was 66 years, and the proportions of men and women were nearly equal.

As much as 81 times more likely to die

In the acute phase (first 21 days after diagnosis), compared with the 75,790 contemporary and 75,774 historical controls, COVID-19 was tied to four to five times the risk of CVD (hazard ratios [HRs], 4.3 and 5.0, respectively). In the same period, the risk of all-cause death was 81 times and nearly 68 times higher in COVID-19 patients (HRs, 81.1 and 67.5, respectively).

In the post-acute phase (up to 18 months), COVID-19 patients remained at a significantly higher risk of CVD (HRs, 1.4 and 1.3 relative to the 71,296 contemporary and 71,314 historical controls, respectively) and of all-cause death (HRs, 5.0 and 4.5, respectively). COVID-19 patients with severe disease were more likely to experience major CVD or die than those with milder illness.

“The findings indicate that patients with COVID-19 should be monitored for at least a year after recovering from the acute illness to diagnose cardiovascular complications of the infection, which form part of long COVID,” senior author Ian C. K. Wong, PhD, said in a European Society of Cardiology press release.

Wong added that the historical control group was included to rule out the consequences of disrupted healthcare services after the pandemic began, which led to poorer health and higher death rates even in uninfected people.