ArticleBMJ open2021
Severity of COVID-19 and adverse long-term outcomes: a retrospective cohort study based on a US electronic health record database.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Incidence of long COVID-19 in people with previous SARS-Cov2 infection: a systematic review and meta-analysis of 120,970 patients.Internal and emergency medicine · 2023Pooled it
- Virtual pulmonary rehabilitation approaches in patients with post COVID syndrome: a pilot study.BMC pulmonary medicine · 2024Trial
- Airway epithelial SARS-CoV-2 infectious and repair responses: relationships to age, sex, and post-COVID pulmonary syndromes.bioRxiv : the preprint server for biology · 2025Article
- Long-Term Clinical Outcomes of Adults Hospitalized for COVID-19 Pneumonia.Emerging infectious diseases · 2025Observational
- Mitochondrial metabolic rescue in post-COVID-19 syndrome: MR spectroscopy insights and precision nutritional therapeutics.Frontiers in immunology · 2025Review
- Health diagnosis associated with COVID-19 death in the United States: A retrospective cohort study using electronic health records.PloS one · 2025Article
- Did aetiology matter in illness duration and complications in patients presenting in primary care with acute respiratory tract infections early in the COVID-19 pandemic: An observational study in nine countries.The European journal of general practice · 2024Observational
- Lights and Shadows of Long COVID: Are Latent Infections the Real Hidden Enemy?Journal of clinical medicine · 2024Review
- Impact of Long COVID-19 on Health Outcomes Among Adults With Preexisting Cardiovascular Disease and Hypertension: A Systematic Review.CJC open · 2024Review
- COVID-19 in the Initiation and Progression of Atherosclerosis: Pathophysiology During and Beyond the Acute Phase.JACC. Advances · 2024Review
- Burden of Neurologic Health Care and Incident Neurologic Diagnoses in the Year After COVID-19 or Influenza Hospitalization.Neurology · 2024Article
- Post-COVID-19 conditions in children and adolescents diagnosed with COVID-19.Pediatric research · 2024Article
- Extracellular vesicles in COVID-19 convalescence can regulate T cell metabolism and function.iScience · 2023Article
- Article
- Coronavirus Disease 2019 Severity and Risk of Subsequent Cardiovascular Events.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- A Case-Crossover Phenome-wide association study (PheWAS) for understanding Post-COVID-19 diagnosis patterns.Journal of biomedical informatics · 2022Article
- Observational
- Determinants of Cause-Specific Mortality and Loss of Independence in Older Patients following Hospitalization for COVID-19: The GeroCovid Outcomes Study.Journal of clinical medicine · 2022Article
- Behavioral problems of pediatric patients recovered from COVID-19 in Wuhan, China.Acta psychologica · 2022Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify potential risk factors for adverse long-term outcomes (LTOs) associated with COVID-19, using a large electronic health record (EHR) database.
designRetrospective cohort study. Patients with COVID-19 were assigned into subcohorts according to most intensive treatment setting experienced. Newly diagnosed conditions were classified as respiratory, cardiovascular or mental health LTOs at >30-≤90 or >90-≤180 days after COVID-19 diagnosis or hospital discharge. Multivariate regression analysis was performed to identify any association of treatment setting (as a proxy for disease severity) with LTO incidence.
settingOptum deidentified COVID-19 EHR dataset drawn from hospitals and clinics across the USA.
participantsIndividuals diagnosed with COVID-19 (N=57 748) from 20 February to 4 July 2020. MAIN OUTCOMES: Incidence of new clinical conditions after COVID-19 diagnosis or hospital discharge and the association of treatment setting (as a proxy for disease severity) with their risk of occurrence.
resultsPatients were assigned into one of six subcohorts: outpatient (n=22 788), emergency room (ER) with same-day COVID-19 diagnosis (n=11 633), ER with COVID-19 diagnosis≤21 days before ER visit (n=2877), hospitalisation without intensive care unit (ICU; n=16 653), ICU without ventilation (n=1837) and ICU with ventilation (n=1960). Respiratory LTOs were more common than cardiovascular or mental health LTOs across subcohorts and LTO incidence was higher in hospitalised versus non-hospitalised subcohorts. Patients with the most severe disease were at increased risk of respiratory (risk ratio (RR) 1.86, 95% CI 1.56 to 2.21), cardiovascular (RR 2.65, 95% CI 1.49 to 4.43) and mental health outcomes (RR 1.52, 95% CI 1.20 to 1.91) up to 6 months after hospital discharge compared with outpatients.
conclusionsPatients with severe COVID-19 had increased risk of new clinical conditions up to 6 months after hospital discharge. The extent that treatment setting (eg, ICU) contributed to these conditions is unknown, but strategies to prevent COVID-19 progression may nonetheless minimise their occurrence.
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