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• W4306962885 abstract "A recent study of eClinicalMedicine found that COVID-19 survivors, compared with non-COVID-19 controls, had a significantly higher risk of cardiovascular events within 12-month follow-up.1Wang W Wang CY Wang SI Wei JC. Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: a retrospective cohort study from the TriNetX US collaborative networks.EClin Med. 2022; 53101619Google Scholar This study offered timely information to readers. However, we have several concerns. First, this study excluded patients who died within 30 days of the index date, a method that could lead to a Neyman bias that tends to distort survival analyses.2Hill G Connelly J Hébert R Lindsay J Millar W. Neyman's bias re-visited.J Clin Epidemiol. 2003; 56: 293-296Summary Full Text Full Text PDF PubMed Scopus (47) Google Scholar Thus, critically ill patients who had new cardiovascular events within 30 days of the diagnosis of COVID-19 were intentionally excluded, which may lead to an underestimation or overestimation of the true risk of cardiovascular events. Second, this study conducted by the TriNetX EHR database is retrospective and observational, and the authors have mentioned the possibility of residual unmeasured confounders such as smoking, exercise, or family history of cardiovascular disease. We recommend a self-matched study design, which may reduce the interference caused by unmeasured confounders.3Katsoularis I Fonseca-Rodríguez O Farrington P Lindmark K Fors Connolly AM Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study.Lancet. 2021; 398: 599-607Summary Full Text Full Text PDF PubMed Scopus (97) Google Scholar Third, as the investigators recognized, there may be inaccuracies in this study caused by the diagnosis and coding of myocardial injury or myocarditis into myocardial infarction and vice versa. Here, we would like to emphasize the importance of reporting case ascertainment, providing positive predictive rates or performing sensitivity analyses (using a rigorous definition of cardiovascular outcomes rather than just ICD-10) to make study results more reliable. Although vaccination and antiviral therapy have produced positive results,4Kim YE Huh K Park YJ Peck KR Jung J. Association between vaccination and acute myocardial infarction and ischemic stroke after COVID-19 infection.Jama. 2022; Crossref Scopus (10) Google Scholar further research is needed to prevent sequelae such as long-term cardiovascular events among COVID-19 survivors.1Wang W Wang CY Wang SI Wei JC. Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: a retrospective cohort study from the TriNetX US collaborative networks.EClin Med. 2022; 53101619Google Scholar Literature search: Chang, Sun and Hung; writing – original draft: Chang and Sun; writing – review and editing: Hung None reported. Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networksThe 12-month risk of incidental cardiovascular diseases is substantially higher in the COVID-19 survivors than the non-COVID-19 controls. Clinicians and patients with a history of COVID-19 should pay attention to their cardiovascular health in long term. Full-Text PDF Open AccessResponse to: ‘Concerns about ‘Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks’ by Renin Chang et alWe would like to thank Renin Chang and his collegues for the interest they have expressed in our recently published article ‘Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks’1 and the eClinicalMedicine editorial team to give us the opportunity to address their comments. Full-Text PDF Open Access" @default.
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• W4306962885 title "Concerns about Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks" @default.
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• W4306962885 doi "https://doi.org/10.1016/j.eclinm.2022.101701" @default.
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