Nearly a third (32 in 100) of older adults infected with Covid-19 in 2020 developed at least one new condition requiring medical attention in the months after initial infection, 11 more than those who did not have Covid-19, find an American study published by The BMJ .
The conditions involved a variety of major organs and systems, including the heart, kidneys, lungs and liver, as well as mental health complications.
Studies have begun to emerge examining the frequency and severity of new conditions (sequelae) after Covid-19 infection, but few have described the excess risk of new conditions caused by Covid-19 infection in older adults ( of at least 65 years).
To address this, US researchers used health insurance plan records to identify 133,366 people aged 65 and older in 2020 who were diagnosed with Covid-19 before April 1, 2020.
These individuals were matched with three comparison groups (non-Covid) from 2020, 2019 and a group diagnosed with viral lower respiratory tract disease.
The researchers then recorded any persistent or new conditions starting 21 days after a Covid-19 diagnosis (the post-acute period) and calculated the excess risk of conditions caused by Covid-19 over several months based on the age, race, sex and whether the patients were admitted to the hospital for Covid-19.
The results show that among people diagnosed with Covid-19 in 2020, 32% sought medical care in the post-acute period for one or more new or ongoing conditions, which was 11% higher than the 2020 comparison group.
Compared to the 2020 comparison group, Covid-19 patients had a higher risk of developing a range of conditions including respiratory failure (an additional 7.55 per 100 people), fatigue (an additional 5.66 per per 100 people), high blood pressure (an extra 4.43 per 100 people) and mental health diagnoses (an extra 2.5 per 100 people).
Similar findings were found for the 2019 comparison group.
However, compared to the group with viral lower respiratory tract disease, only respiratory failure, dementia and fatigue showed larger risk differences of 2.39, 0.71 and 0.18 per 100 people with Covid-19. 19, respectively.
People admitted to hospital with Covid-19 were at markedly increased risk for most conditions, but not all. The risk of several conditions also increased for men, blacks, and those over 75 years of age.
This is an observational study, so it cannot establish cause, and the researchers acknowledge some limitations, including the fact that some diagnoses may not actually represent a new condition caused by Covid-19 infection.
However, they warn that with more than 357 million people infected by coronavirus around the world, “the number of survivors with sequelae after acute infection will continue to grow.”
“These findings further highlight the wide range of important sequelae following acute infection with the SARS-CoV-2 virus,” they write. "Understanding the magnitude of the risk of major clinical sequelae could improve the diagnosis and treatment of people with sequelae after acute SARS-CoV-2 infection."
“In addition, our results can help providers and other key stakeholders anticipate the scale of future health complications and improve planning for the use of healthcare resources,” they conclude.
Conclusions The results confirm an excess risk of persistent and new sequelae in adults ≥ 65 years of age after acute SARS-CoV-2 infection. Aside from respiratory failure, dementia, and postviral fatigue, the sequelae resembled those of viral lower respiratory tract disease in older adults. These findings further highlight the wide range of important sequelae following acute SARS-CoV-2 virus infection. |
