If further proof was needed that SARS-CoV-2 infection has long-term sequelae for the human body, research conducted by Monash University has provided it, highlighting the need for general practitioners and other frontline physicians to be aware of their patients’ COVID-19. 19 story.
The research, led by epidemiologist and PhD candidate Stacey Rowe, and co-authored by Professor Brett Sutton, Victoria’s Chief Health Officer, and renowned infectious disease epidemiologist Professor Allen Cheng, is published by the SERVANT.
“Essentially what we wanted to do was see what kind of hospitalizations might have been associated with COVID-19 – did it cause any complications other than respiratory, for example,” Ms Rowe said. . Preview+.
Rowe and colleagues analyzed population-level surveillance and administrative data for all laboratory-confirmed COVID-19 cases reported to Victoria’s Department of Health from January 23, 2020 to May 31, 2021 – before deployment. of vaccination and the appearance of the Omicron variant – and related data on hospital admissions (dates of admission as of September 30, 2021).
“A total of 20,594 cases of COVID-19 have been notified and 2,992 people (14.5%) have been hospitalized with COVID-19,” Rowe and colleagues reported in the SERVANT.
“The incidence of hospitalizations within 89 days of COVID-19 onset was higher than during the baseline period for several conditions, including myocarditis and pericarditis (IRR, 14.8; 95% CI, 3.2 to 68.3), thrombocytopenia (IRR, 7.4; 95% CI, 4.4–12.5), pulmonary embolism (IRR, 6.4; 95% CI, 3.6–11, 4), acute myocardial infarction (IRR, 3.9; 95% CI, 2.6–5.8) and cerebral infarction (IRR, 2.3; 95% CI, 1.4–3.9).
In other words, says Rowe, “there are considerable risks associated with SARS-CoV-2 infection” beyond the initial COVID-19 illness.
“You are 15 times more likely to get myocarditis requiring hospitalizations after COVID-19 compared to before,” she said.
“Things like heart attacks or acute myocardial infarction occur quite close to COVID infection, but other conditions such as coagulation conditions – pulmonary embolism, for example – this risk was the most high later in COVID illness, highest around 14-60 days post COVID illness.
Other results were also revealing.
“The incidence of cerebral infarction hospitalizations was twice as high after the onset of COVID-19 as during the baseline period,” Rowe and colleagues wrote. “Other researchers (here, here, and here) have estimated the risk of stroke to be 2 to 13 times higher for people with COVID-19.”
Professor Cheng, speaking with Preview+said that with testing and tracing of positive COVID-19 cases now non-compulsory in Australia, it was more difficult to know exactly who had had COVID.
“What this study suggests is that [the possibility of a previous COVID illness] should be on the radar because there is a high risk window,” he said.
“If someone has, for example, chest pain, within two months of COVID, we really need to be mindful of that, because the pain is probably a bit more likely to represent myocardial infarction than it is to other times.
“You can’t say that every heart attack that happens after COVID is due to COVID. But there is a period of high risk, and it seems to be close to when you contracted COVID.
Rowe and his colleagues recommend vaccination and “other mitigation strategies.”
“Our results indicate the need for ongoing COVID-19 mitigation measures, including vaccination, and support early diagnosis and management of complications in people with a history of SARS-CoV-2 infection” , they wrote.
“The pathophysiological mechanisms underlying the persistence of symptoms and the development of major complications have yet to be elucidated, the prevalence of the post-COVID-19 state (by vaccination status) established and the risks of complications following vaccination quantified. .”
Professor Cheng said Preview+:
“What [this study] shows that it’s better not to get COVID and whichever way you do it’s probably a good thing.
“Vaccination is the easiest way to protect against COVID, but it’s not perfect. Not going out when there’s a lot of COVID out there, wearing masks, improving ventilation and all those other things , are also important.
At some point in the SERVANT article the authors wrote:
“Some COVID-19 complications clinically resemble those reported after SARS-CoV-2 vaccination, which is important when evaluating suspected post-vaccination adverse events. Additionally, we found that the incidence of hospitalization with serious cardiac and thromboembolic events after SARS-CoV-2 infection was higher than the reported risk of these events after vaccination.
Mrs Rowe said Preview+:
“What we found with this study, and what other studies have found internationally, is that the risk of myocarditis is higher after SARS-CoV-2 infection than after vaccination.
“While people [who feel they have been injured by the vaccine] could grasp this, there are many studies now showing that the risk is higher after infection than it is after vaccination.
Professor Cheng agreed.
“It’s important to recognize that people experience side effects after vaccination – myocarditis occurs, often after the second dose, usually within a day or two,” he said. “It is very clearly due to vaccination.
“But the question, from a public health perspective, is whether the benefits outweigh the risks. COVID itself can cause myocarditis at a higher rate [than vaccination]. And that means you’d always better get vaccinated.
Ms Rowe said the study showed that COVID-19 was not just a respiratory illness.
“These results truly demonstrate that COVID-19 is a multi-organ disease, it is not a respiratory infection. If more research can be conducted to understand these pathophysiological mechanisms, then we can begin to think about how best to warn them.
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