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Risk factors associated with post-acute sequelae of SARS-CoV-2: An N3C and NIH RECOVER study

Hill, EL; Mehta, HB; Sharma, S; et. al., BMC Public Health

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Published

October 2023

Journal

BMC Public Health

Abstract

More than one-third of individuals experience post-acute sequelae of SARS-CoV-2 infection (PASC, which includes long-COVID). The objective is to identify risk factors associated with PASC/long-COVID diagnosis. This was a retrospective case-control study including 31 health systems in the United States from the National COVID Cohort Collaborative (N3C). 8,325 individuals with PASC (defined by the presence of the International Classification of Diseases, version 10 code U09.9 or a long-COVID clinic visit) matched to 41,625 controls within the same health system and COVID index date within ± 45 days of the corresponding case's earliest COVID index date. Measurements of risk factors included demographics, comorbidities, treatment and acute characteristics related to COVID-19. Multivariable logistic regression, random forest, and XGBoost were used to determine the associations between risk factors and PASC.

Authors

Elaine L Hill, Hemalkumar B Mehta, Suchetha Sharma, Klint Mane, Sharad Kumar Singh, Catherine Xie, Emily Cathey, Johanna Loomba, Seth Russell, Heidi Spratt, Peter E DeWitt, Nariman Ammar, Charisse Madlock-Brown, Donald Brown, Julie A McMurry, Christopher G Chute, Melissa A Haendel, Richard Moffitt, Emily R Pfaff, Tellen D Bennett; N3C Consortium; RECOVER Consortium

Keywords

COVID-19; Long-COVID; PASC; Post-acute sequelae of SARS-CoV-2; Risk factors

Short Summary

An electronic health record, or EHR, is a digital file that contains information about a person’s healthcare. In this study, researchers studied anonymous EHR data from the National COVID Cohort Collaborative (N3C), a group of medical systems located across the United States. They compared a group of 8,325 people who had a Long COVID diagnosis or received healthcare at a Long COVID clinic to a group of 41,625 people who did not have Long COVID. The researchers found key differences between these 2 groups. They also identified risk factors that could make someone more likely to develop Long COVID, including being middle-aged (40 to 69 years old), being female, and having certain chronic (long-term) health conditions before they got COVID. Examples of these chronic health conditions were obesity and lung disease. More research is needed to better understand why and how the risk factors found in this study make someone more likely to develop Long COVID.

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