Journal article
Cardiovascular, Renal, and Pulmonary Risks of Long COVID: A Retrospective Cohort Study Stratified by Age and Sex
Journal of the American Heart Association, Vol.15(17), e049226
08/20/2026
DOI: 10.1161/JAHA.126.049226
PMID: 42622238
Appears in UI Libraries Support Open Access
Abstract
A substantial proportion of patients with acute COVID-19 develop postacute sequelae of SARS-CoV-2 infection (Long COVID). The risk of adverse cardiovascular and related outcomes in Long COVID remains elusive. We hypothesized that individuals with Long COVID are at elevated risk for adverse cardiovascular, renal, and pulmonary (CRP) outcomes compared with those who recovered from COVID-19 without developing Long COVID.
We performed a retrospective cohort study using the global TriNetX network (>150 million patients). Adults with documented COVID-19 were classified by the presence/absence of clinically recognized Long COVID. We analyzed absolute risks and relative risks for 15 CRP outcomes, stratified by age (18-50, 51-64, ≥65 years). After excluding patients with preexisting outcomes of interest, propensity score matching was applied for age, sex, and common confounders.
Among 2 613 432 adults identified with COVID-19 within TriNetX network, 315 612 matched individuals were included in the study. Long COVID was associated with higher risk of most CRP outcomes across all ages regardless of sex. Relative risks were disproportionately higher in younger adults, especially in young women for cardiovascular and renal outcomes and in young men for pulmonary outcomes. Findings remained directionally consistent across sensitivity analyses. Prior SARS-CoV-2 vaccination was not consistently associated with reduced CRP risk.
Clinically recognized Long COVID was associated with increased risk of CRP outcomes, with relatively higher relative risks observed in younger adults. These findings support the need for continuing surveillance and risk-reduction strategies for cardiovascular and related disorders in Long COVID.
Details
- Title: Subtitle
- Cardiovascular, Renal, and Pulmonary Risks of Long COVID: A Retrospective Cohort Study Stratified by Age and Sex
- Creators
- Akash Pradeep - University of IowaIzola Ramalho - University of Iowa, Internal MedicineMartha L Carvour - University of IowaSrija M Sivamurugan - University of IowaUpinder Singh - University of IowaAlejandro P Comellas - University of IowaSanjana Dayal - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of the American Heart Association, Vol.15(17), e049226
- DOI
- 10.1161/JAHA.126.049226
- PMID
- 42622238
- NLM abbreviation
- J Am Heart Assoc
- ISSN
- 2047-9980
- eISSN
- 2047-9980
- Publisher
- Wiley
- Grant note
- National Institutes of Health: AI162778, HL168630, T32HL007734 Office of Research and Development and Department of Veterans Affairs: 2I01BX007087 Institute for Clinical and Translational Science at the University of Iowa, National Institutes of Health Clinical and Translational Science Awards: UM1TR004403
This work was possible through fundings from National Institutes of Health AI162778, and HL168630, and Office of Research and Development and Department of Veterans Affairs 2I01BX007087 to Sanjana Dayal. Izola Ramalho is supported by the National Institutes of Health under award T32HL007734. TriNetX training and access provided by the Institute for Clinical and Translational Science at the University of Iowa, National Institutes of Health Clinical and Translational Science Awards program grant UM1TR004403.
- Language
- English
- Date published
- 08/20/2026
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Infectious Diseases; ICTS; Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Iowa Neuroscience Institute; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9985219921702771
Metrics
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