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Acute and post-acute respiratory complications of SARS-CoV-2 infection: population-based cohort study in South Korea and Japan

Author

Listed:
  • Yujin Choi

    (Kyung Hee University College of Medicine
    Kyung Hee University College of Korean Medicine)

  • Hyeon Jin Kim

    (Kyung Hee University College of Medicine
    Kyung Hee University)

  • Jaeyu Park

    (Kyung Hee University College of Medicine
    Kyung Hee University)

  • Myeongcheol Lee

    (Kyung Hee University College of Medicine
    Kyung Hee University)

  • Sunyoung Kim

    (Kyung Hee University Medical Center, Kyung Hee University College of Medicine)

  • Ai Koyanagi

    (Parc Sanitari Sant Joan de Deu)

  • Lee Smith

    (Anglia Ruskin University)

  • Min Seo Kim

    (Broad Institute of MIT and Harvard)

  • Masoud Rahmati

    (Aix-Marseille University
    Vali-E-Asr University of Rafsanjan
    Lorestan University)

  • Hayeon Lee

    (Kyung Hee University College of Medicine)

  • Jiseung Kang

    (Harvard Medical School
    Massachusetts General Hospital)

  • Dong Keon Yon

    (Kyung Hee University College of Medicine
    Kyung Hee University
    Kyung Hee University Medical Center, Kyung Hee University College of Medicine)

Abstract

Considering the significant burden of post-acute COVID-19 conditions among patients infected with SARS-CoV-2, we aimed to identify the risk of acute respiratory complications or post-acute respiratory sequelae. A binational population-based cohort study was conducted to analyze the risk of acute respiratory complications or post-acute respiratory sequelae after SARS-CoV-2 infection. We used a Korean nationwide claim-based cohort (K-COV-N; n = 2,312,748; main cohort) and a Japanese claim-based cohort (JMDC; n = 3,115,606; replication cohort) after multi-to-one propensity score matching. Among 2,312,748 Korean participants (mean age, 47.2 years [SD, 15.6]; 1,109,708 [48.0%] female), 17.1% (394,598/2,312,748) were infected with SARS-CoV-2. The risk of acute respiratory complications or post-acute respiratory sequelae is significantly increased in people with SARS-CoV-2 infection compared to the general population (acute respiratory complications: HR, 8.06 [95% CI, 6.92-9.38]; post-acute respiratory sequelae: 1.68 [1.62-1.75]), and the risk increased with increasing COVID-19 severity. We identified COVID-19 vaccination as an attenuating factor, showing a protective association against acute or post-acute respiratory conditions. Furthermore, while the excess post-acute risk diminished with time following SARS-CoV-2 infection, it persisted beyond 6 months post-infection. The replication cohort showed a similar pattern in the association. Our study comprehensively evaluates respiratory complications in post-COVID-19 conditions, considering attenuating factors such as vaccination status, post-infection duration, COVID-19 severity, and specific respiratory conditions.

Suggested Citation

  • Yujin Choi & Hyeon Jin Kim & Jaeyu Park & Myeongcheol Lee & Sunyoung Kim & Ai Koyanagi & Lee Smith & Min Seo Kim & Masoud Rahmati & Hayeon Lee & Jiseung Kang & Dong Keon Yon, 2024. "Acute and post-acute respiratory complications of SARS-CoV-2 infection: population-based cohort study in South Korea and Japan," Nature Communications, Nature, vol. 15(1), pages 1-12, December.
    • Handle: RePEc:nat:natcom:v:15:y:2024:i:1:d:10.1038_s41467-024-48825-w
    DOI: 10.1038/s41467-024-48825-w
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    as
    1. Jeong-Seon Lee & Jae Il Shin & Sunyeup Kim & Yong-Sung Choi & Youn Ho Shin & Jimin Hwang & Jung U Shin & Ai Koyanagi & Louis Jacob & Lee Smith & Han Eol Jeong & Yunha Noh & In-Sun Oh & Sang Youl Rhee , 2023. "Breastfeeding and impact on childhood hospital admissions: a nationwide birth cohort in South Korea," Nature Communications, Nature, vol. 14(1), pages 1-10, December.
    2. Roxane Dumont & Viviane Richard & Elsa Lorthe & Andrea Loizeau & Francesco Pennacchio & María-Eugenia Zaballa & Hélène Baysson & Mayssam Nehme & Anne Perrin & Arnaud G. L’Huillier & Laurent Kaiser & R, 2022. "A population-based serological study of post-COVID syndrome prevalence and risk factors in children and adolescents," Nature Communications, Nature, vol. 13(1), pages 1-8, December.
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