Tsampasian V, Elghazaly H, Chattopadhyay R, Debski M, Naing TKP, Garg P, Clark A, Ntatsaki E, Vassiliou VS, et al.
JAMA internal medicine. Date of publication 2023 Jun 1;volume 183(6):566-580.
1. JAMA Intern Med. 2023 Jun 1;183(6):566-580. doi:
10.1001/jamainternmed.2023.0750.
Risk Factors Associated With Post-COVID-19 Condition: A Systematic Review and
Meta-analysis.
Tsampasian V(1)(2), Elghazaly H(3), Chattopadhyay R(1)(4), Debski M(1)(2), Naing
TKP(1)(2), Garg P(1)(2), Clark A(2), Ntatsaki E(5)(6), Vassiliou VS(1)(2).
Author information:
(1)Department of Cardiology, Norfolk and Norwich University Hospital, Norwich,
UK.
(2)Norwich Medical School, University of East Anglia, Norwich, UK.
(3)Imperial College London and Imperial College National Health Service Trust,
London, UK.
(4)Department of Cardiology, Cambridge University Hospitals, Cambridge, UK.
(5)Department of Rheumatology, Ipswich Hospital, East Suffolk and North Essex
National Health Service Foundation Trust, Ipswich, UK.
(6)Department of Medicine, University College London, London, UK.
Comment in
JAMA Intern Med. 2023 Jun 1;183(6):565. doi:
10.1001/jamainternmed.2023.0760.
Eur J Intern Med. 2023 Oct;116:137-140. doi: 10.1016/j.ejim.2023.07.002.
JAMA Intern Med. 2023 Sep 1;183(9):1036. doi:
10.1001/jamainternmed.2023.3036.
JAMA Intern Med. 2023 Sep 1;183(9):1035-1036. doi:
10.1001/jamainternmed.2023.3033.
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.
TRIAL REGISTRATION: PROSPERO Identifier: CRD42022381002.
DOI: 10.1001/jamainternmed.2023.0750
PMCID: PMC10037203
PMID: 36951832 [Indexed for MEDLINE]
Conflict of interest statement: 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.
