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Diagnosis-wide analysis of COVID-19 complications: an exposure-crossover study.
Murk, William; Gierada, Monica; Fralick, Michael; Weckstein, Andrew; Klesh, Reyna; Rassen, Jeremy A.
  • Murk W; Jacobs School of Medicine & Biological Sciences (Murk), University at Buffalo, Buffalo, NY; Aetion Inc. (Murk, Gierada, Weckstein, Rassen), New York, NY; Department of Medicine (Fralick), University of Toronto, Toronto, Ont.; HealthVerity Inc. (Klesh) Philadelphia, Penn. wmurk@buffalo.edu.
  • Gierada M; Jacobs School of Medicine & Biological Sciences (Murk), University at Buffalo, Buffalo, NY; Aetion Inc. (Murk, Gierada, Weckstein, Rassen), New York, NY; Department of Medicine (Fralick), University of Toronto, Toronto, Ont.; HealthVerity Inc. (Klesh) Philadelphia, Penn.
  • Fralick M; Jacobs School of Medicine & Biological Sciences (Murk), University at Buffalo, Buffalo, NY; Aetion Inc. (Murk, Gierada, Weckstein, Rassen), New York, NY; Department of Medicine (Fralick), University of Toronto, Toronto, Ont.; HealthVerity Inc. (Klesh) Philadelphia, Penn.
  • Weckstein A; Jacobs School of Medicine & Biological Sciences (Murk), University at Buffalo, Buffalo, NY; Aetion Inc. (Murk, Gierada, Weckstein, Rassen), New York, NY; Department of Medicine (Fralick), University of Toronto, Toronto, Ont.; HealthVerity Inc. (Klesh) Philadelphia, Penn.
  • Klesh R; Jacobs School of Medicine & Biological Sciences (Murk), University at Buffalo, Buffalo, NY; Aetion Inc. (Murk, Gierada, Weckstein, Rassen), New York, NY; Department of Medicine (Fralick), University of Toronto, Toronto, Ont.; HealthVerity Inc. (Klesh) Philadelphia, Penn.
  • Rassen JA; Jacobs School of Medicine & Biological Sciences (Murk), University at Buffalo, Buffalo, NY; Aetion Inc. (Murk, Gierada, Weckstein, Rassen), New York, NY; Department of Medicine (Fralick), University of Toronto, Toronto, Ont.; HealthVerity Inc. (Klesh) Philadelphia, Penn.
CMAJ ; 193(1): E10-E18, 2021 01 04.
Article in English | MEDLINE | ID: covidwho-1021693
ABSTRACT

BACKGROUND:

Many studies reporting coronavirus disease 2019 (COVID-19) complications have involved case series or small cohorts that could not establish a causal association with COVID-19 or provide risk estimates in different care settings. We sought to study all possible complications of COVID-19 to confirm previously reported complications and to identify potential complications not yet known.

METHODS:

Using United States health claims data, we compared the frequency of all International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis codes occurring before and after the onset of the COVID-19 pandemic in an exposure-crossover design. We included patients who received a diagnosis of COVID-19 between Mar. 1, 2020, and Apr. 30, 2020, and computed risk estimates and odds ratios (ORs) of association with COVID-19 for every ICD-10-CM diagnosis code.

RESULTS:

Among 70 288 patients with COVID-19, 69 of 1724 analyzed ICD-10-CM diagnosis codes were significantly associated with COVID-19. Disorders showing both strong association with COVID-19 and high absolute risk included viral pneumonia (OR 177.63, 95% confidence interval [CI] 147.19-214.37, absolute risk 27.6%), respiratory failure (OR 11.36, 95% CI 10.74-12.02, absolute risk 22.6%), acute kidney failure (OR 3.50, 95% CI 3.34-3.68, absolute risk 11.8%) and sepsis (OR 4.23, 95% CI 4.01-4.46, absolute risk 10.4%). Disorders showing strong associations with COVID-19 but low absolute risk included myocarditis (OR 8.17, 95% CI 3.58-18.62, absolute risk 0.1%), disseminated intravascular coagulation (OR 11.83, 95% CI 5.26-26.62, absolute risk 0.1%) and pneumothorax (OR 3.38, 95% CI 2.68-4.26, absolute risk 0.4%).

INTERPRETATION:

We confirmed and provided risk estimates for numerous complications of COVID-19. These results may guide prognosis, treatment decisions and patient counselling.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Risk Assessment / Pandemics / COVID-19 Testing / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Female / Humans / Male Country/Region as subject: North America Language: English Journal: CMAJ Journal subject: Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Risk Assessment / Pandemics / COVID-19 Testing / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Female / Humans / Male Country/Region as subject: North America Language: English Journal: CMAJ Journal subject: Medicine Year: 2021 Document Type: Article