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. 2024 Feb 26;15(1):1716.
doi: 10.1038/s41467-024-45953-1.

Persistence in risk and effect of COVID-19 vaccination on long-term health consequences after SARS-CoV-2 infection

Ivan Chun Hang Lam #  1 , Ran Zhang #  2 , Kenneth Keng Cheung Man  1   3   4   5 , Carlos King Ho Wong  1   2   3   6 , Celine Sze Ling Chui  3   7   8   9 , Francisco Tsz Tsun Lai  1   2   3   9 , Xue Li  1   3   9   10 , Esther Wai Yin Chan  1   3   11   12 , Chak Sing Lau  13 , Ian Chi Kei Wong  14   15   16   17 , Eric Yuk Fai Wan  18   19   20   21
Affiliations

Persistence in risk and effect of COVID-19 vaccination on long-term health consequences after SARS-CoV-2 infection

Ivan Chun Hang Lam et al. Nat Commun. .

Abstract

The persisting risk of long-term health consequences of SARS-CoV-2 infection and the protection against such risk conferred by COVID-19 vaccination remains unclear. Here we conducted a retrospective territory-wide cohort study on 1,175,277 patients with SARS-CoV-2 infection stratified by their vaccination status and non-infected controls to evaluate the risk of clinical sequelae, cardiovascular and all-cause mortality using a territory-wide public healthcare database with population-based vaccination records in Hong Kong. A progressive reduction in risk of all-cause mortality was observed over one year between patients with SARS-CoV-2 infection and controls. Patients with complete vaccination or have received booster dose incurred a lower risk of health consequences including major cardiovascular diseases, and all-cause mortality than unvaccinated or patients with incomplete vaccination 30-90 days after infection. Completely vaccinated and patients with booster dose of vaccines did not incur significant higher risk of health consequences from 271 and 91 days of infection onwards, respectively, whilst un-vaccinated and incompletely vaccinated patients continued to incur a greater risk of clinical sequelae for up to a year following SARS-CoV-2 infection. This study provided real-world evidence supporting the effectiveness of COVID-19 vaccines in reducing the risk of long-term health consequences of SARS-CoV-2 infection and its persistence following infection.

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Conflict of interest statement

K.K.C.M. reported grants from the Hong Kong Research Grant Council, the CW Maplethorpe Fellowship, UK National Institute for Health and Care Research, European Commission Framework Horizon 2020, Innovation and Technology Commission of the Government of the Hong Kong Special Administrative Region, and personal fees from IQVIA Ltd outside the submitted work. CKHW. reports the receipt of General Research Fund, Research Grant Council, Government of Hong Kong SAR; EuroQol Research Foundation; AstraZeneca and Boehringer Ingelheim, all outside the submitted work. C.S.L.C. has received grants from the Health Bureau of the Hong Kong Government, Hong Kong Research Grant Council, Hong Kong Innovation and Technology Commission, Pfizer, IQVIA, and Amgen; and personal fees from PrimeVigilance; outside the submitted work. F.T.T.L. has been supported by the RGC Postdoctoral Fellowship under the Hong Kong Research Grants Council and has received research grants from the Health Bureau of the Government of the Hong Kong Special Administrative Region, outside the submitted work. X.L. has received research grants from Hong Kong Health and Medical Research Fund (HMRF, HMRF Fellowship Scheme, HKSAR), Research Grants Council Early Career Scheme (RGC/ECS, HKSAR), Janssen and Pfizer; internal funding from the University of Hong Kong; consultancy fees from Merck Sharp & Dohme and Pfizer, unrelated to this work. E.W.C. reports grants from Research Grants Council (RGC, Hong Kong), Research Fund Secretariat of the Food and Health Bureau, National Natural Science Fund of China, Wellcome Trust, Bayer, Bristol-Myers Squibb, Pfizer, Janssen, Amgen, Takeda, and Narcotics Division of the Security Bureau of the Hong Kong Special Administrative Region; honorarium from Hospital Authority; outside the submitted work. ICKW reports grants from Amgen, Bristol-Myers Squibb, Pfizer, Janssen, Bayer, GSK and Novartis, the Hong Kong RGC, and the Hong Kong Health and Medical Research Fund in Hong Kong, National Institute for Health Research in England, European Commission, National Health and Medical Research Council in Australia, consulting fees from IQVIA and World Health Organization, payment for expert testimony for Appeal Court of Hong Kong and is a non-executive director of Jacobson Medical in Hong Kong and Therakind in England, outside of the submitted work; no other relationships or activities that could appear to have influenced the submitted work. EYFW has received research grants from the Health Bureau of the Government of the Hong Kong Special Administrative Region, and the Hong Kong Research Grants Council, outside the submitted work. The remaining authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart for identifying study population.
Fig. 2
Fig. 2. Hazard ratio (and 95% confidence interval) of clinical sequelae compared to the control groups between 0 and 30, 31 and 90, 91 and 180, 181 and 270, 271 and 365 days of SARS-CoV-2 infection.
Note: Major CVD major cardiovascular disease, Composite outcome of stroke, heart failure and coronary artery disease, ARDS acute respiratory distress syndrome, CAD coronary artery disease, ESRD end-stage renal disease. Hazard ratio (HR) and 95% confidence interval (95% CI) were estimated by Cox regression, HR > 1 (or <1) indicates patients with COVID-19 had higher (lower) risk of sequelae compared to the non-COVID-19 control cohort. Dose 0, 1, 2, 3 refers to study population who have received 0 dose, 1 dose, 2 doses, and ≥3 doses of BioNtech or CoronaVac COVID-19 vaccines, respectively.
See this image and copyright information in PMC

References

    1. Daugherty SE, et al. Risk of clinical sequelae after the acute phase of SARS-CoV-2 infection: retrospective cohort study. BMJ. 2021;373:n1098. - PMC - PubMed
    1. Al-Aly Z, Xie Y, Bowe B. High-dimensional characterization of post-acute sequelae of COVID-19. Nature. 2021;594:259–264. - PubMed
    1. Lam ICH, et al. Long-term post-acute sequelae of COVID-19 infection: a retrospective, multi-database cohort study in Hong Kong and the UK. eClinicalMedicine. 2023;60:102000. - PMC - PubMed
    1. Chaichana U, et al. Definition of post-COVID-19 condition among published research studies. JAMA Netw. Open. 2023;6:e235856–e235856. - PMC - PubMed
    1. Thaweethai T, et al. Development of a definition of postacute sequelae of SARS-CoV-2 infection. JAMA. 2023;329:1934–1946. - PMC - PubMed

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