{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:39:21Z","timestamp":1791434361073,"version":"4.3.3"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002701","name":"Ministry of Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002701","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Growing evidence suggests that some coronavirus disease 2019 (COVID-19) survivors experience a wide range of long-term postacute sequelae. We examined the postacute risk and burden of new-incident cardiovascular, cerebrovascular, and other thrombotic complications after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a highly vaccinated multiethnic Southeast Asian population, during Delta predominance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This cohort study used national testing and healthcare claims databases in Singapore to build a cohort of individuals who had a positive SARS-CoV-2 test between 1 September and 30 November 2021 when Delta predominated community transmission. Concurrently, we constructed a test-negative control group by enrolling individuals between 13 April 2020 and 31 December 2022 with no evidence of SARS-CoV-2 infection. Participants in both groups were followed up for a median of 300 days. We estimated risks of new-incident cardiovascular, cerebrovascular, and other thrombotic complications using doubly robust competing-risks survival analysis. Risks were reported using 2 measures: hazard ratio (HR) and excess burden (EB) with 95% confidence intervals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We included 106 012 infected cases and 1 684 085 test-negative controls. Compared with the control group, individuals with COVID-19 exhibited increased risk (HR, 1.157 [1.069\u20131.252]) and excess burden (EB, 0.70 [.53\u2013.88]) of new-incident cardiovascular and cerebrovascular complications. Risks decreased in a graded fashion for fully vaccinated (HR, 1.11 [1.02\u20131.22]) and boosted (HR, 1.10 [.92\u20131.32]) individuals. Conversely, risks and burdens of subsequent cardiovascular\/cerebrovascular complications increased for hospitalized and severe COVID-19 cases (compared to nonhospitalized cases).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Increased risks and excess burdens of new-incident cardiovascular\/cerebrovascular complications were reported among infected individuals; risks can be attenuated with vaccination and boosting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad469","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T09:56:09Z","timestamp":1695635769000},"page":"70-79","source":"Crossref","is-referenced-by-count":62,"title":["Long-term Cardiovascular, Cerebrovascular, and Other Thrombotic Complications in COVID-19 Survivors: A Retrospective Cohort Study"],"prefix":"10.1093","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2245-0331","authenticated-orcid":false,"given":"Jue Tao","family":"Lim","sequence":"first","affiliation":[{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University"},{"name":"National Centre for Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wee","family":"Liang En","sequence":"additional","affiliation":[{"name":"National Centre for Infectious Diseases"},{"name":"Duke-NUS Graduate Medical School, National University of Singapore"},{"name":"Department of Infectious Diseases, Singapore General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"An Ting","family":"Tay","sequence":"additional","affiliation":[{"name":"Singapore Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanette","family":"Pang","sequence":"additional","affiliation":[{"name":"Singapore Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin J","family":"Chiew","sequence":"additional","affiliation":[{"name":"National Centre for Infectious Diseases"},{"name":"Singapore Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Ong","sequence":"additional","affiliation":[{"name":"Singapore Ministry of Health"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Chien Boon","family":"Lye","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University"},{"name":"National Centre for Infectious Diseases"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore"},{"name":"Department of Infectious Diseases, Tan Tock Seng Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelvin Bryan","family":"Tan","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine, Nanyang Technological University"},{"name":"Singapore Ministry of Health"},{"name":"Saw Swee Hock School of Public Health, National University of Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"key":"2024021012295557300_ciad469-B1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat Med"},{"key":"2024021012295557300_ciad469-B2","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1093\/eurheartj\/ehac031","article-title":"Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus","volume":"43","author":"Raman","year":"2022","journal-title":"Eur Heart J"},{"key":"2024021012295557300_ciad469-B3","doi-asserted-by":"crossref","first-page":"e2269","DOI":"10.1212\/WNL.0000000000012930","article-title":"Frequency of neurologic manifestations in COVID-19: a systematic review and meta-analysis","volume":"97","author":"Misra","year":"2021","journal-title":"Neurology"},{"key":"2024021012295557300_ciad469-B4","doi-asserted-by":"crossref","first-page":"n693","DOI":"10.1136\/bmj.n693","article-title":"Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study","volume":"372","author":"Ayoubkhani","year":"2021","journal-title":"BMJ"},{"key":"2024021012295557300_ciad469-B5","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1038\/s41591-022-01689-3","article-title":"Long-term cardiovascular outcomes of COVID-19","volume":"28","author":"Xie","year":"2022","journal-title":"Nat Med"},{"key":"2024021012295557300_ciad469-B6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1004052","article-title":"Cardiometabolic outcomes up to 12 months after COVID-19 infection. 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