Abstract 15405: Changes in Cardiometabolic Risk Factors Following SARS-CoV-2 Infection

Abstract

Introduction: Post-acute sequelae of SARS-CoV-2 infection consist of pulmonary and extrapulmonary conditions, including a higher incidence of type 2 diabetes, but it remains unknown whether other cardiometabolic pathways are impacted by infection. Research Question: Does SARS-CoV-2 infection predict worsening cardiometabolic risk factors? Methods: Using data from OneFlorida+ (a PCORnet CRN), we compared changes over time in body mass index (BMI), systolic blood pressure (SBP) and low-density lipoprotein (LDL). We compared an Exposed cohort with a positive SARS-CoV-2 test or COVID-19 diagnosis code between March 2020 - January 2022 (n = 75,217; age: 48.5 y, 64% female), relative to a contemporary Unexposed cohort of adult patients with negative SARS-CoV-2 tests (n = 240,575; age: 52.7 y, 61% female), and an age/sex-matched Historical control cohort (March 2018 - January 2020; n = 75,217; age: 48.5 y, 64% female). We used multiple imputation for missingness in demographic and clinical factors and inverse probability weighting for confounding and loss to follow-up. We used doubly robust marginal structural models to estimate baseline and longitudinal differences in cardiometabolic indicators by cohort. Results: At the start of the follow-up period, adjusted for covariates and relative to the Exposed, the Unexposed (BMI: -0.5 [-0.6,-0.4] kg/m 2 , SBP: -0.5 [-0.8,-0.2] mmHg, LDL: -7.7 [-14.5, -1.0] mg/dL) and Historical control (BMI: -0.4 [-0.5,-0.3] kg/m 2 , SBP: -1.0 [-1.5,-0.6] mmHg, LDL: 12.5 [-58.3, 83.3] mg/dL) cohorts had better cardiometabolic profiles ( Figure ). Relative to changes in the Exposed, control cohorts displayed faster decreases in BMI (Unexposed only), slower increases in SBP, and no changes in LDL during the follow-up period. Conclusions: SARS-CoV-2 infection was associated with weight retention and a rise in blood pressure. Longer follow-up can help identify stability and impacts of these cardio-metabolic indices on events and mortality.