Evidence map›Paper›PMID 36121907›Full record

ArticleCirculation2022

Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales.

Rochelle Knight, Venexia Walker, Samantha Ip, Jennifer A Cooper, Thomas Bolton, Spencer Keene, Rachel Denholm, Ashley Akbari, Hoda Abbasizanjani, Fatemeh Torabi and 20 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 162 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
162citing papers in PubMed, 3 pooled it
56.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

162 citing papers in PubMed, 3 syntheses or guidelines pooled it, 282 citations in OpenAlex.

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102 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors at 13 institutions in 2 countries.

Rochelle Knight *Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK (R.K., V.W., J.A.C., R.D., T.-L.N., R.T., G.D.S., J.A.C.S.).ORCID 0000-0002-4128-6821
Venexia Walker *Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK (R.K., V.W., J.A.C., R.D., T.-L.N., R.T., G.D.S., J.A.C.S.).ORCID 0000-0001-5064-446X
Samantha Ip *British Heart Foundation Cardiovascular Epidemiology Unit (S.I., T.B., S.K., X.J., E.D.A., A.M.W.), University of Cambridge, UK.
Jennifer A CooperDepartment of Population Health Sciences, Bristol Medical School, University of Bristol, UK (R.K., V.W., J.A.C., R.D., T.-L.N., R.T., G.D.S., J.A.C.S.).
Thomas BoltonBritish Heart Foundation Cardiovascular Epidemiology Unit (S.I., T.B., S.K., X.J., E.D.A., A.M.W.), University of Cambridge, UK.
Spencer KeeneBritish Heart Foundation Cardiovascular Epidemiology Unit (S.I., T.B., S.K., X.J., E.D.A., A.M.W.), University of Cambridge, UK.ORCID 0000-0003-0622-6476
Rachel DenholmDepartment of Population Health Sciences, Bristol Medical School, University of Bristol, UK (R.K., V.W., J.A.C., R.D., T.-L.N., R.T., G.D.S., J.A.C.S.).ORCID 0000-0002-8067-5440
Ashley AkbariPopulation Data Science, Swansea University Medical School, Swansea University, Wales, UK (A.A., H.A., F.T.).ORCID 0000-0003-0814-0801
Hoda AbbasizanjaniPopulation Data Science, Swansea University Medical School, Swansea University, Wales, UK (A.A., H.A., F.T.).ORCID 0000-0002-9575-4758
Fatemeh TorabiPopulation Data Science, Swansea University Medical School, Swansea University, Wales, UK (A.A., H.A., F.T.).ORCID 0000-0002-5853-4625
Efosa OmigieNational Health Service Digital, Leeds, UK (E.O., S.H.).
Sam HollingsNational Health Service Digital, Leeds, UK (E.O., S.H.).ORCID 0000-0001-9022-7003
Teri-Louise NorthDepartment of Population Health Sciences, Bristol Medical School, University of Bristol, UK (R.K., V.W., J.A.C., R.D., T.-L.N., R.T., G.D.S., J.A.C.S.).
Renin TomsDepartment of Population Health Sciences, Bristol Medical School, University of Bristol, UK (R.K., V.W., J.A.C., R.D., T.-L.N., R.T., G.D.S., J.A.C.S.).ORCID 0000-0002-6922-1448
Xiyun JiangBritish Heart Foundation Cardiovascular Epidemiology Unit (S.I., T.B., S.K., X.J., E.D.A., A.M.W.), University of Cambridge, UK.ORCID 0000-0003-0720-923X
Emanuele Di AngelantonioBritish Heart Foundation Cardiovascular Epidemiology Unit (S.I., T.B., S.K., X.J., E.D.A., A.M.W.), University of Cambridge, UK.ORCID 0000-0001-8776-6719
Spiros DenaxasHealth Data Research UK (S.D.), London.
Johan H ThygesenInstitute of Health Informatics (S.D., J.H.T., C.T.), University College London, UK.ORCID 0000-0002-7479-3459
Christopher TomlinsonInstitute of Health Informatics (S.D., J.H.T., C.T.), University College London, UK.ORCID 0000-0002-0903-5395
Ben BraySchool of Population Health and Environmental Sciences, King's College London, UK (B.B.).
Craig J SmithGeoffrey Jefferson Brain Research Centre, Manchester Centre for Clinical Neurosciences, Northern Care Alliance National Health Service Foundation Trust, Salford Royal Hospital, UK (C.J.S.).
Mark BarberGlasgow Caledonian University, UK (M.B.).ORCID 0000-0002-2893-1566
Kamlesh KhuntiDiabetes Research Centre, University of Leicester, UK (K.K.).
George Davey SmithDepartment of Population Health Sciences, Bristol Medical School, University of Bristol, UK (R.K., V.W., J.A.C., R.D., T.-L.N., R.T., G.D.S., J.A.C.S.).ORCID 0000-0002-1407-8314
Nishi ChaturvediMRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science (N.C.), University College London, UK.ORCID 0000-0002-6211-2775
Cathie SudlowBritish Heart Foundation Data Science Centre (T.B., C.S.), London.ORCID 0000-0002-7725-7520
William N Whiteley *Centre for Clinical Brain Sciences, University of Edinburgh, UK (W.N.W.).ORCID 0000-0002-4816-8991
Angela M Wood *British Heart Foundation Cardiovascular Epidemiology Unit (S.I., T.B., S.K., X.J., E.D.A., A.M.W.), University of Cambridge, UK.
Jonathan A C Sterne *Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK (R.K., V.W., J.A.C., R.D., T.-L.N., R.T., G.D.S., J.A.C.S.).ORCID 0000-0001-8496-6053
CVD-COVID-UK/COVID-IMPACT Consortium and the Longitudinal Health and Wellbeing COVID-19 National Core Study
University of Bristol · GBBritish Heart Foundation · GBSwansea University · GBNHS Digital · GBUniversity College Hospital · GBCancer Research UK · GBGlasgow Caledonian University · GBHealth Data Research UK · GBKing's College London · GBManchester Academic Health Science Centre · GBMRC Unit for Lifelong Health and Ageing · GBNuffield Health · GBUniversity of Leicester · GB

Funding

British Heart Foundation CH/12/2/29428British Heart Foundation RG/13/13/30194British Heart Foundation RG/18/13/33946Medical Research Council MC_PC_20030Medical Research Council MC_PC_20051Medical Research Council MC_PC_20058Medical Research Council MC_PC_20059Medical Research Council MC_UU_00011/1
6 · The paper itself

Abstract

backgroundInfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces a prothrombotic state, but long-term effects of COVID-19 on incidence of vascular diseases are unclear.

methodsWe studied vascular diseases after COVID-19 diagnosis in population-wide anonymized linked English and Welsh electronic health records from January 1 to December 7, 2020. We estimated adjusted hazard ratios comparing the incidence of arterial thromboses and venous thromboembolic events (VTEs) after diagnosis of COVID-19 with the incidence in people without a COVID-19 diagnosis. We conducted subgroup analyses by COVID-19 severity, demographic characteristics, and previous history.

resultsAmong 48 million adults, 125 985 were hospitalized and 1 319 789 were not hospitalized within 28 days of COVID-19 diagnosis. In England, there were 260 279 first arterial thromboses and 59 421 first VTEs during 41.6 million person-years of follow-up. Adjusted hazard ratios for first arterial thrombosis after COVID-19 diagnosis compared with no COVID-19 diagnosis declined from 21.7 (95% CI, 21.0-22.4) in week 1 after COVID-19 diagnosis to 1.34 (95% CI, 1.21-1.48) during weeks 27 to 49. Adjusted hazard ratios for first VTE after COVID-19 diagnosis declined from 33.2 (95% CI, 31.3-35.2) in week 1 to 1.80 (95% CI, 1.50-2.17) during weeks 27 to 49. Adjusted hazard ratios were higher, for longer after diagnosis, after hospitalized versus nonhospitalized COVID-19, among Black or Asian versus White people, and among people without versus with a previous event. The estimated whole-population increases in risk of arterial thromboses and VTEs 49 weeks after COVID-19 diagnosis were 0.5% and 0.25%, respectively, corresponding to 7200 and 3500 additional events, respectively, after 1.4 million COVID-19 diagnoses.

conclusionsHigh relative incidence of vascular events soon after COVID-19 diagnosis declines more rapidly for arterial thromboses than VTEs. However, incidence remains elevated up to 49 weeks after COVID-19 diagnosis. These results support policies to prevent severe COVID-19 by means of COVID-19 vaccines, early review after discharge, risk factor control, and use of secondary preventive agents in high-risk patients.

Indexed as

COVID-19ThrombosisVascular DiseasesVenous ThromboembolismVenous ThrombosisAdultCohort StudiesCOVID-19 VaccinesHumansSARS-CoV-2WalesCOVID-19 VaccinesCOVID-19electronic health recordsmyocardial infarctionpulmonary embolismstrokethrombosisvenous thrombosis

Identifiers

PMID36121907
PMCPMC9484653
OpenAlexW4296299144

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.