Impact of vaccination on the association of COVID-19 with cardiovascular diseases: an OpenSAFELY cohort study

Genevieve I Cezard, Rachel E Denholm, Rochelle O C Knight, Yinghui Wei, Lucy Teece, Renin M B S Toms, Harriet J Forbes, Alex J Walker, Louis Fisher, Jon Massey, Lisa EM Hopcroft, Elsie M F Horne, Kurt R Taylor, Tom M Palmer, Marwa M AL Arab, Jose Ignacio Cuitun Coronado, Samantha Ip, Simon Davy, Iain Dillingham, Sebastian BaconAmir Mehrkar, Caroline E Morton, Felix Greaves, Catherine Hyams, George Davey Smith, John MacLeod, Nishi Chaturvedi, Ben Goldacre , William Whiteley, Angela M. Wood, Jonathan A C Sterne*, Venexia M Walker

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

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
Original languageEnglish
Article number2173
Number of pages14
JournalNature Communications
Volume15
Issue number1
DOIs
Publication statusPublished - 11 Mar 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.

Structured keywords

  • Bristol Population Health Science Institute

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