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德国初级保健患者中 COVID-19 与后续血管事件的关联。

Association between COVID-19 and subsequent vascular events in primary care patients in Germany.

机构信息

Real World Solutions, IQVIA, Basel, Switzerland; University of Paris Cité, Comparative Effectiveness Research, Paris, France.

Real World Solutions, IQVIA, Barcelona, Spain.

出版信息

Public Health. 2022 Dec;213:107-113. doi: 10.1016/j.puhe.2022.10.005. Epub 2022 Oct 17.

Abstract

OBJECTIVES

The aim of this study was to investigate the relationship between COVID-19 diagnosis and the risk of developing a first-ever vascular event (VE) compared with the same risk in those with respiratory tract infection (RTI).

STUDY DESIGN

This was a retrospective cohort study.

METHODS

This study using data from Disease Analyzer Database (IQVIA) included patients aged ≥18 years with at least one visit to a German practice during the index period. VEs were defined as cardiovascular or cerebrovascular events. Two cohorts were created: patients with a diagnosis of COVID-19 and those diagnosed with RTI. These were matched using propensity scores. Kaplan-Meier curves were created for the purposes of time to event analysis. A Poisson model was used to calculate incidence rates and derive incidence rate ratios (IRRs).

RESULTS

A total of 58,904 patients were matched. There was no significant association between COVID-19 diagnosis and increased incidence of VE events among females (IRR [95% confidence interval (CI)]: 0.96 [0.82-1.11] and 1.30 [0.88-1.81]) or males (IRR, 95% CI: 0.91 [0.78-1.05] and 1.13 [0.80-1.62]). Overall, no significant association between COVID-19 diagnosis and incidence of VE was observed across age categories except for cardiovascular vascular events in the age category ≥70 years (IRR [95% CI]: 0.78 [0.67-0.94]).

CONCLUSIONS

Overall, our study suggests that COVID-19 diagnosis was not associated with an increased risk of developing VE compared with RTI diagnosis. However, further research in a variety of healthcare settings and regions is needed to confirm these preliminary findings from our cohort, which is a good reflection of routine clinical practice in Germany.

摘要

目的

本研究旨在探讨与呼吸道感染(RTI)相比,COVID-19 诊断与首次发生血管事件(VE)风险之间的关系。

研究设计

这是一项回顾性队列研究。

方法

本研究使用来自 IQVIA 的 Disease Analyzer 数据库的数据,纳入了在指数期内至少有一次德国就诊记录的年龄≥18 岁的患者。VE 定义为心血管或脑血管事件。创建了两个队列:COVID-19 诊断患者和 RTI 诊断患者。使用倾向评分进行匹配。为了进行事件时间分析,创建了 Kaplan-Meier 曲线。使用泊松模型计算发病率和得出发病率比(IRR)。

结果

共匹配了 58904 名患者。COVID-19 诊断与女性(IRR [95%置信区间(CI)]:0.96 [0.82-1.11] 和 1.30 [0.88-1.81])或男性(IRR,95%CI:0.91 [0.78-1.05] 和 1.13 [0.80-1.62])VE 事件发生率增加之间无显著关联。总体而言,除≥70 岁年龄组的心血管血管事件外,COVID-19 诊断与 VE 发生率之间无显著关联(IRR [95%CI]:0.78 [0.67-0.94])。

结论

总体而言,我们的研究表明,与 RTI 诊断相比,COVID-19 诊断与 VE 风险增加无关。然而,需要在各种医疗保健环境和地区进行进一步研究,以证实我们的队列研究中的这些初步发现,该队列研究很好地反映了德国的常规临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a7d/9574461/9d3ca49e85bc/gr1_lrg.jpg

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