Risk factors associated with post-COVID-19 condition: A systematic review and meta-analysis

Tsampasian, Vasiliki, Elghazaly, Hussein, Chattopadhyay, Rahul, Debski, Maciej ORCID: https://orcid.org/0000-0002-3669-3916, Naing, Thin Kyi Phyu, Garg, Pankaj ORCID: https://orcid.org/0000-0002-5483-169X, Clark, Allan ORCID: https://orcid.org/0000-0003-2965-8941, Ntatsaki, Eleana and Vassiliou, Vassilios S. ORCID: https://orcid.org/0000-0002-4005-7752 (2023) Risk factors associated with post-COVID-19 condition: A systematic review and meta-analysis. JAMA Internal Medicine, 183 (6). ISSN 2168-6106

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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.

Item Type: Article
Additional Information: Conflict of Interest Disclosures: Drs Chattopadhyay, Debski, and Tsampasian reported being academic clinical fellows funded by the UK National Institute of Health (NIHR) and Research. Dr Clark reported funding from Brainomix, National Institute of Health Research UK, Stroke Association, and Versus Arthritis outside the submitted work. Dr Ntatsaki reported partial funding from an NIHR Clinical Research Network East of England Greenshoot scheme, outside the submitted work. No other disclosures were reported.
Uncontrolled Keywords: internal medicine,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2724
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
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Depositing User: LivePure Connector
Date Deposited: 23 Jan 2024 01:39
Last Modified: 23 Jan 2024 01:39
URI: https://ueaeprints.uea.ac.uk/id/eprint/94211
DOI: 10.1001/jamainternmed.2023.0750

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