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Not to be sneezed at: cardiovascular disease after COVID-19 infection
  1. Anda Bularga,
  2. David E Newby,
  3. Andrew R Chapman
  1. Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr David E Newby, Centre for Cardiovascular Sciences, The University of Edinburgh, Edinburgh EH16 4SU, UK; d.e.newby{at}

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COVID-19 has changed our way of life since it was first identified in December of 2019. While our understanding of the manifestations and outcomes of the immediate acute illness has improved, we are still learning about the medium to long-term impact of this diagnosis on patients’ health. For some time, it has been suggested that COVID-19 may be associated with incident cardiovascular events such as venous thromboembolism, stroke and myocardial infarction.1 However, the absolute risk of these events and whether an excess risk is present are challenging to determine without a contemporary reference population. This is particularly problematic in the midst of a global pandemic.

The UK Biobank is a large robust contemporary cohort of middle-aged volunteers who were prospectively recruited between 2006 and 2010.2 In this cohort, half a million participants aged between 40 and 69 years provided informed consent for detailed clinical assessment, with data linkage to routine data sources including primary care and death register data. Raisi-Estabragh and colleagues3 identified 20 505 participants from the UK Biobank study who had recorded COVID-19 infection status, defined based on disease coding in primary care or hospital episode statistics using a positive antibody test or a positive reverse transcriptase PCR based test. The authors included participants from the first two waves of the COVID-19 pandemic and were able to perform matched analysis in 17 871 participants. The authors used 1-to-2 propensity score matching to link to a reference population of 35 742 patients without evidence of COVID-19 infection using nearest neighbour matching and tying with the date of COVID-19 infection. Several relevant variables were included for matching including age, sex, deprivation, body mass index, ethnicity, diabetes mellitus, …

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  • Contributors All authors contributed to the drafting and revision of the manuscript.

  • Funding The authors are funded by Wellcome Trust (WT103782AIA); Medical Research Council (MR/V007254/1); British Heart Foundation (CH/09/002, RG/16/10/32375, RE/18/5/34216).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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