(126) Risk Factors for Long-Term Cardiovascular Post-Acute Sequelae of COVID-19 Infection: a Nested Case-Control Study

Background: People with COVID-19 can experience post-acute sequelae of SARS-CoV-2 (PASC). Studies on risk factors of PASC are ongoing, especially for endocrine system-related diseases which may impact the cardiovascular system. Cardiac-related PASC is one of the burdens after COVID-19 infection.

Objectives: This study aimed to examine the risk factors of cardiac-related PASC.

Methods: In this nested case-control study, we obtained electronic health records (EHRs) from the Hong Kong Hospital Authority. We defined cases as patients with at least one cardiac-related PASC and controls as patients without any cardiac-related PASC. We applied the incidence density sampling and matched controls to cases on age and sex at a 1:10 ratio. Multivariable logistic regression was used to determine the associations between risk factors and cardiac-related PASC.

Results: A total of 455 individuals with cardiac-related PASC and matched 3,423 controls were obtained in the underlying cohort. COVID-19 associated hospitalisation (aOR: 1.41, 95% CI: 1.03-1.93) and peripheral vascular disease (aOR: 2.98, 95% CI: 1.31-6.79) were associated with an increased likelihood of cardiac-related PASC. Higher doses of the COVID-19 vaccine (2 doses: 0.68 [0.52-0.89]; ≥3 doses: 0.56 [0.40-0.78]) and more frequent healthcare utilisation visits (aOR: 0.95, 95% CI: 0.92-0.97) were associated with a lower likelihood of cardiac-related PASC.

Conclusions: This is the first study to examine risk factors of cardiac-related PASC among the Chinese population. We identified peripheral vascular disease and COVID-19 associated hospitalisation as the risk factors for cardiac-related PASC. COVID-19 vaccination was protective against cardiac-related PASC, which should be prioritised for high-risk patients.