Nature Communications (Mar 2024)
Impact of vaccination on the association of COVID-19 with cardiovascular diseases: An OpenSAFELY cohort study
- Genevieve I. Cezard,
- Rachel E. Denholm,
- Rochelle Knight,
- Yinghui Wei,
- Lucy Teece,
- Renin Toms,
- Harriet J. Forbes,
- Alex J. Walker,
- Louis Fisher,
- Jon Massey,
- Lisa E. M. Hopcroft,
- Elsie M. F. Horne,
- Kurt Taylor,
- Tom Palmer,
- Marwa Al Arab,
- Jose Ignacio Cuitun Coronado,
- Samantha H. Y. Ip,
- Simon Davy,
- Iain Dillingham,
- Sebastian Bacon,
- Amir Mehrkar,
- Caroline E. Morton,
- Felix Greaves,
- Catherine Hyams,
- George Davey Smith,
- John Macleod,
- Nishi Chaturvedi,
- Ben Goldacre,
- William N. Whiteley,
- Angela M. Wood,
- Jonathan A. C. Sterne,
- Venexia Walker,
- On behalf of the Longitudinal Health and Wellbeing and Data and Connectivity UK COVID-19 National Core Studies, CONVALESCENCE study and the OpenSAFELY collaborative
Affiliations
- Genevieve I. Cezard
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge
- Rachel E. Denholm
- Population Health Sciences, University of Bristol
- Rochelle Knight
- Population Health Sciences, University of Bristol
- Yinghui Wei
- Centre for Mathematical Sciences, School of Engineering, Computing and Mathematics, University of Plymouth
- Lucy Teece
- Department of Population Health Sciences, University of Leicester
- Renin Toms
- Population Health Sciences, University of Bristol
- Harriet J. Forbes
- Faculty of Epidemiology and Population Health, London School of Hygiene & tropical Medicine
- Alex J. Walker
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford
- Louis Fisher
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford
- Jon Massey
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford
- Lisa E. M. Hopcroft
- NHS National Services Scotland
- Elsie M. F. Horne
- Population Health Sciences, University of Bristol
- Kurt Taylor
- Population Health Sciences, University of Bristol
- Tom Palmer
- Population Health Sciences, University of Bristol
- Marwa Al Arab
- Population Health Sciences, University of Bristol
- Jose Ignacio Cuitun Coronado
- Population Health Sciences, University of Bristol
- Samantha H. Y. Ip
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge
- Simon Davy
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford
- Iain Dillingham
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford
- Sebastian Bacon
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford
- Amir Mehrkar
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford
- Caroline E. Morton
- Digital Environment Research Institute, Queen Mary University of London
- Felix Greaves
- National Institute for Health and Care Excellence
- Catherine Hyams
- Population Health Sciences, University of Bristol
- George Davey Smith
- Population Health Sciences, University of Bristol
- John Macleod
- Population Health Sciences, University of Bristol
- Nishi Chaturvedi
- MRC Unit for Lifelong Health and Ageing, University College London
- Ben Goldacre
- The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford
- William N. Whiteley
- Centre for Clinical Brain Sciences, University of Edinburgh
- Angela M. Wood
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge
- Jonathan A. C. Sterne
- Population Health Sciences, University of Bristol
- Venexia Walker
- Population Health Sciences, University of Bristol
- On behalf of the Longitudinal Health and Wellbeing and Data and Connectivity UK COVID-19 National Core Studies, CONVALESCENCE study and the OpenSAFELY collaborative
- DOI
- https://doi.org/10.1038/s41467-024-46497-0
- Journal volume & issue
-
Vol. 15,
no. 1
pp. 1 – 14
Abstract
Abstract Infection with SARS-CoV-2 is associated with an increased risk of arterial and venous thrombotic events, but the implications of vaccination for this increased risk are uncertain. With the approval of NHS England, we quantified associations between COVID-19 diagnosis and cardiovascular diseases in different vaccination and variant eras using linked electronic health records for ~40% of the English population. We defined a ‘pre-vaccination’ cohort (18,210,937 people) in the wild-type/Alpha variant eras (January 2020-June 2021), and ‘vaccinated’ and ‘unvaccinated’ cohorts (13,572,399 and 3,161,485 people respectively) in the Delta variant era (June-December 2021). We showed that the incidence of each arterial thrombotic, venous thrombotic and other cardiovascular outcomes was substantially elevated during weeks 1-4 after COVID-19, compared with before or without COVID-19, but less markedly elevated in time periods beyond week 4. Hazard ratios were higher after hospitalised than non-hospitalised COVID-19 and higher in the pre-vaccination and unvaccinated cohorts than the vaccinated cohort. COVID-19 vaccination reduces the risk of cardiovascular events after COVID-19 infection. People who had COVID-19 before or without being vaccinated are at higher risk of cardiovascular events for at least two years.
