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Impact of vaccination on the association of COVID-19 with cardiovascular diseases

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.

Nature Communications, 2024

Paper information

Authors
  • Genevieve Cezard,
  • Rachel Denholm,
  • Rochelle Knight,
  • Yinghui Wei,
  • Lucy Teece,
  • Renin Toms,
  • Harriet Forbes,
  • Alex Walker,
  • Louis Fisher,
  • Jon Massey,
  • Lisa Hopcroft,
  • Elsie Horne,
  • Kurt Taylor,
  • Tom Palmer,
  • Marwa Al Arab,
  • Jose Ignacio Cuitun Coronado,
  • Samantha Ip,
  • Simon Davy,
  • Iain Dillingham,
  • Seb Bacon,
  • Amir Mehrkar,
  • Caroline Morton,
  • Felix Greaves,
  • Catherine Hyams,
  • George Davey Smith,
  • John Macleod,
  • Nishi Chaturvedi,
  • Ben Goldacre,
  • William Whiteley,
  • Angela Wood,
  • Jonathan Sterne,
  • Venexia Walker
Citation
Cezard GI, Denholm RE, Knight R, et al. Impact of vaccination on the association of COVID-19 with cardiovascular diseases: An OpenSAFELY cohort study. Nat Commun. 2024;15(1):2173. doi:10.1038/s41467-024-46497-0
Categories

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.