An increase in the risk of clinical consequences after SARS-CoV-2 infection

Scientists have observed that the general postviral recovery time varies for patients with viral disease and severe respiratory coronavirus 2 (SARS-CoV-2). Epidemiological studies have shown that morbidity is increasing in COVID-19 patients. During the acute phase of infection, the lung, liver, cardiovascular, cognitive, kidney and neurological functions are often affected. In addition, people who have already recovered from SARS-CoV-2 often complain of a variety of persistent symptoms that adversely affect mental, social, and physical well-being. However, researchers have yet to determine whether these complications are related to the severity of COVID-19 disease, as some people who have recovered from diseases such as pneumonia and influenza also experience cerebrovascular, cardiovascular, and neurological complications.

Previous research related to longitudinal studies on patients who had recovered from other coronavirus infections (MERS and SARS-CoV) found a higher incidence of prolonged physical and mental sequelae. So far, the majority of studies have focused on clinical outcomes in hospital patients, that is, a small sample size. Because of this limitation, the outcome of these results cannot be generalized to a larger population affected by COVID-19.

Not much work has been done on the prevalence of clinical sequelae during the post-acute COVID-19 infection period for the age group between 18 and 65 years of age. This age group also has a lower risk of severe SARS-CoV-2 infection. In addition, the roles of gender, age, hospitalization, and pre-existing conditions in increasing the risk of clinical consequences in the post-acute phase of the disease have not been studied extensively.

A new study published on the medRxiv * preprint server focused on the role of factors such as gender, age, hospitalization, etc. in understanding the risks of clinical consequences in the post-acute phase of COVID-19 in adults between 18 and 65 Years. This study analyzed a larger dataset that included commercially insured adults in the United States using ICD-10 (International Classification of Diseases Tenth Revision) codes. The analysis helped identify rare diseases and also determined whether there was an association between subgroups.

In this study, researchers performed a retrospective cohort analysis using three sets of data taken from the UnitedHealth Group’s Clinical Discovery Database. They examined the administrative data of outpatient and inpatient claims and analyzed the laboratory results for SARS-CoV-2 from outpatients. This included the hospital admission database, which is regularly updated for patients with a primary, secondary, or tertiary diagnosis of COVID-19.

The current study reported that 14% of people younger than 65 years of age diagnosed with COVID-19 developed at least one new clinical sequel that requires immediate medical care in the post-acute stage of SARS-CoV required. 2 infection. This research has confirmed the increased risks associated with certain types of episodes that occur up to 4 months after the onset of the post-acute phase. In general, researchers have indicated that the risks from COVID-19 increase with age, pre-existing health complications, and hospitalization. However, this study shows that younger adults (≤ 50 years), people without pre-existing health conditions and asymptomatic SARS-CoV-2 patients are also at risk of developing new clinical consequences in the post-acute phase.

Research has also shown the possibility of developing clinical outcomes related to mental health problems. For example, researchers have seen an increase in anxiety regardless of age or pre-existing conditions. Regarding the possibility of health complications due to SARS-CoV-2 infection, the likelihood of numerous clinical consequences remains high during the post-acute phase.

During the post-acute phase of COVID-19, patients can develop various diseases such as chronic respiratory failure, heart irregularities such as tachycardia and hypercoagulability in the form of a pulmonary embolism. Apart from these, there is a high likelihood of developing amnesia, anxiety, encephalopathy, diabetes, peripheral neuropathy, liver disease, myocarditis, and fatigue. The current study is the first to quantify the potential for health risks in the younger age group affected by COVID-19.

One limitation of this study is that it did not take into account race and ethnicity at the individual level. Therefore, more research is needed to understand the influence of ethnicity and race on the risk of long-term clinical consequences. Another limitation of the study is related to several misclassifications, e.g. B. the consideration of clinical diagnoses and comorbidities in previous years, which lead to biased data. However, the scientists believe that the result of this research has given clinicians a full understanding of the potential risks in younger people during the post-acute phase of SARS-CoV-2.

* Important NOTE

medRxiv publishes preliminary scientific reports that are not peer-reviewed and therefore should not be considered conclusive, guide clinical practice / health-related behavior, or treated as established information.

Journal reference:

  • SARS-CoV-2 infection and risk of clinical consequences during the post-acute phase: a retrospective cohort study, Sarah E. Daugherty, Yinglong Guo, Kevin Heath, Micah C. Dasmarinas, Karol G. Jubilo, Jirapat Samranvedhya, Marc Lipsitch, Ken Cohen, medRxiv 2021.03.12.21253448; doi: https://doi.org/10.1101/2021.03.12.21253448, https://www.medrxiv.org/content/10.1101/2021.03.12.21253448v1

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