Cardiac Arrhythmias Associated with Coronavirus Disease and Post-COVID Vaccinations: A Target Trial Emulation Using Real-World Data

Author(s)

Shreosi Sanyal, PhD1, Solomon Sundaram, MBA2, Ankita Gupta, MSc2, Deepak Aswal, B.Tech.2, Vikash Kumar Verma, MBA, PharmD2, Abhinav Nayyar, MBBS, MBA2, Ina Kukreja, MBA, PT2, Abhimanyu Roy, MBA2, Arunima Sachdev, MA2, Rahul Goyal, BS Tech3, Marissa Seligman, BS Pharma4, Louis Brooks Jr, MA5, Dawn Webster, PA-C, MPAS6.
1Optum, Hyderabad, India, 2Optum, Gurgaon, India, 3Optum, Phoenix, AZ, USA, 4Optum, Boston, MA, USA, 5Optum, Bloomsbury, NJ, USA, 6Optum, Pittsburgh, PA, USA.
OBJECTIVES: The assessment of cardiac arrhythmias in patients who had coronavirus disease (COVID-19) has emerged as a critical area of research, given the significant cardiovascular complications associated with COVID-19. Additionally, there has been a growing focus on the association of COVID-19 vaccinations and arrhythmic events. This target trial emulation, utilizing real-world data, aims to evaluate occurrences of cardiac arrhythmias in COVID-19 patients, and in sub-cohorts of patients who had first and second doses of COVID-19 vaccines.
METHODS: The study utilized Optum® de-identified Market Clarity database, identifying patients diagnosed with COVID-19 through both claims and electronic health records data from January 1, 2020, to December 31, 2022. After applying a 12-month pre- and an 18-month post-eligibility period and excluding patients with cardiovascular conditions during the baseline period, a total of 3,253,789 patients aged ≥18 years were accrued from the database. Patients with at least one incidence of cardiac arrhythmia were examined in the follow-up period. In addition, incidence rates of cardiac arrhythmias after first dose and second dose of COVID-19 vaccines were examined.
RESULTS: 7.37% patients had at least one incidence of cardiac arrhythmia in the follow-up period. However, this percentage significantly decreased to 3.59% (OR: 0.47; p<0.001) after receiving at least one dose of any COVID-19 vaccine in the US. The incidence of cardiac arrhythmias dropped even further to 1.90% (OR: 0.24; p<0.001) among patients who received at least two doses of the vaccine.
CONCLUSIONS: These findings suggest that COVID-19 vaccination may be associated with a reduced risk of cardiac arrhythmias in patients who were diagnosed with COVID-19, highlighting the potential protective effects of vaccination against such complications. While this study provides valuable insights into the incidence of cardiac arrhythmias in relation to COVID-19 and its vaccinations, further analysis will be carried out by adjusting other risk factors and increasing follow-up period duration.

Conference/Value in Health Info

2025-05, ISPOR 2025, Montréal, Quebec, CA

Value in Health, Volume 28, Issue S1

Code

CO102

Topic

Clinical Outcomes

Topic Subcategory

Clinical Outcomes Assessment

Disease

SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), STA: Vaccines

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