Long-term effects of COVID-19 on the risk of ischemic heart disease in asthma: A nationwide, population-based cohort study

<bold>Background:</bold> Little information is available on the impact of coronavirus disease 2019 (COVID-19) on the long-term risk of ischemic heart disease (IHD) in asthma. We aimed to investigate the long-term effect of COVID-19 on the risk of IHD in individuals with asthma, especially relative to COVID-19 severity. <bold>Methods:</bold> Using the Korean National Health Insurance Service claims-based database, we identified individuals with asthma who experienced COVID-19 between Oct 8, 2020, and Dec 16, 2021 (COVID-19 cohort, n=8,011), along with 1:1 propensity score (PS)-matched individuals with asthma who did not experience COVID-19 (matched controls, n=8,011). The incidence and risk of IHD were compared between the two groups. <bold>Results:</bold> During the follow-up period (range, 1–434 d), 0.7% of the severe COVID-19 cohort and 0.2% of the non-severe COVID-19 cohort developed IHD, while only 0.12% of the matched controls developed IHD. The severe COVID-19 cohort exhibited a higher risk of IHD (adjusted hazard ratio [aHR]=4.89; 95% confidence interval [CI]=1.86–12.84) compared to matched controls, whereas the non-severe COVID-19 cohort did not show a significantly increased risk of IHD (aHR=1.64; 95% CI=0.73–3.70). <bold>Conclusion:</bold> Our results show a significant increase in the occurrence and risk of IHD in asthmatics, especially in those who experienced severe COVID-19. Table 1. Impact of COVID-19 on risk of IHD <table-wrap><object-id>erj;64/suppl_68/PA3988/T1</object-id><object-id>T1</object-id><object-id>t1</object-id><table><colgroup><col></col><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td>N at risk</td><td>IHD (n)</td><td>Incidence/10,000PY</td><td> Hazard ratio (95% CI) </td></tr><tr><td>Matched controls</td><td>8,011</td><td>10</td><td>37.4</td><td>Reference</td></tr><tr><td>COVID-19 cohort</td><td>8,011</td><td>21</td><td>78.8</td><td>2.12 (0.99-4.53)</td></tr><tr><td> Non-severe COVID-19</td><td>7,012</td><td>14</td><td>61.5</td><td>1.77 (0.78-4.02)</td></tr><tr><td> Severe COVID-19</td><td>999</td><td>7</td><td>179.6</td><td>3.45 (1.29-9.25)</td></tr></tbody></table></table-wrap>