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COVID-19 hasn't gone away1Severe COVID-19 can increase the likelihood of new-onset medical conditions, worsened acute clinical outcomes, and exacerbation of existing conditions2,3New-onset conditions associated with severe COVID-19 Heart Failure

Severe COVID-19 was associated with a 45% higher likelihood of post-discharge incident heart failure caused by myocardial inflammation and damage4,5*

 Hypertension
  • 20.6% of patients with severe COVID-19 had new-onset, persistent hypertension at 6‑month follow-up6†
  • Patients with severe COVID-19 were 2.23x more likely to develop persistent hypertension than patients hospitalized with influenza6
 Diabetes

Severe COVID-19 was associated with increased risk for developing new-onset diabetes mellitus 4 weeks after infection, in multiple studies7-9

 Mental Health ConditionsSignificantly higher rates of new-onset mental health conditions occurred in US veterans hospitalized with severe COVID-19 compared with matched hospitalized COVID‑19–negative US veterans10‡
  • Depression (6.6% vs 4.3%, P<0.001)
  • Insomnia (4.9% vs 3.2%, P<0.001)
  • Dementia (3.0% vs 1.9%, P<0.001)
 Kidney DiseaseAcute kidney injury (AKI) that developed in patients with severe COVID-19 was associated with11
  • 43% lower likelihood of kidney recovery in the 6 months following discharge (P<0.05)
  • Significantly greater dialysis requirements (3.8% vs 1.2%, P<0.05)
 compared with AKI that developed in patients hospitalized due to other causes
 
Lack of kidney recovery and a greater need for dialysis following severe AKI are both indicators of new-onset chronic kidney disease (CKD)12 Venous Thromboembolism (VTE)

In a large national study (n=546,656), the VTE event rate was significantly higher (4.4% vs 2.7%, P<0.0001) among patients hospitalized with COVID-19 compared with matched historic controls without COVID-1913§

Interim Care Rx
If a delay or coverage denial occurs during the prior authorization or appeals process, eligible, commercially insured patients enrolled in Pfizer Dermatology Patient Access™ may receive LITFULO for up to 2 years at no cost shipped to them through Interim Care Rx.†Severe COVID-19 can worsen acute outcomes and exacerbate existing medical conditions3 Cardiovascular Disease
  • Patients with heart failure hospitalized for COVID-19 were at increased risk compared to patients without a history of heart failure hospitalized for COVID-1914||
    • Needing mechanical ventilation 3.6x (P<0.001)
    • Longer hospital stays +2 days (P<0.001)
    • In-hospital mortality 1.9x (P=0.002)
  • Patients hospitalized with COVID-19 who had pre-existing cardiovascular disease were 3.3x more likely to develop myocardial injury compared to patients hospitalized with COVID-19 who did not have pre-existing cardiovascular disease (P<0.001)15¶
 Diabetes
  • Persistent diabetes developed in 14.8% of prediabetic patients hospitalized with COVID‑19 (P<0.001), which is 3.5x higher than the rate observed in prediabetic patients without severe COVID-19 (4.2%, P<0.05) at 5-month follow-up16
  • Patients with pre-existing type 1 diabetes and severe COVID-19 were 12x more likely to develop diabetic ketoacidosis compared to their non–COVID-19 counterparts (P<0.001)17#
 Respiratory Disease

Patients with pre-existing asthma and severe COVID-19 had a 5.1x higher risk of severe asthma exacerbation and a 7.3x higher risk of death compared to patients without COVID‑1918**

 Autoimmune Disease
  • In patients with systemic lupus erythematosus (SLE), severe COVID-19 was associated with a 3.8x increased risk of an SLE flare compared with patients without COVID-1919††
  • Severe COVID-19 was associated with neurologic worsening in patients with multiple sclerosis and related disorders (P=0.001)20‡‡
 Resources

Access COVID-19-related resources for you and your patients.

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Watch COVID-19 experts debunk myths about risk factors and treatment.

 Explore LoadingSevere COVID-19: the study methods clearly demonstrate that patients were hospitalized because of/due to COVID-19.
Hospitalized with COVID-19: the study methods indicate that patients were hospitalized and tested positive for COVID-19, however it is unclear whether COVID-19 was the primary diagnosis.Compared with hospitalized patients without COVID-19 after accounting for age, race/ethnicity, sex, heart failure risk factors, and cardiovascular medications.4New-onset hypertension was also observed in 10.85% of nonhospitalized patients with COVID-19.6During a follow-up period of 7 days to 3 months after COVID-19 diagnosis.10COVID-19 inpatients (n=515,132) who were admitted on April 1, 2020, or later and discharged between April 1, 2020, and March 31, 2021, were matched 1:1 with historical controls who were admitted on April 1, 2018, or later and discharged by March 31, 2019.13Based on a multivariable logistic regression that adjusted for relevant demographic variables, comorbidities, previous treatment with renin-angiotensin-aldosterone system inhibitors, and markers of clinical severity on admission.14Defined as a composite of a history of coronary artery disease, heart failure or cardiomyopathy, atrial fibrillation or flutter, severe valvular disease, peripheral arterial disease, and stroke or transient ischemic attack. Sritharan et al. conducted an observational cohort study conducted in Australia with a total study population of N=1567.15Nonhospitalized patients with COVID-19 were 13× more likely to develop DKA compared with their non-COVID‑19 counterparts (P<0.001).17Severe asthma exacerbation defined as emergency department visits or hospitalizations related to asthma and the simultaneous presence of oral or intravenous corticosteroid use. Death due to all causes. Lee et al. conducted a study conducted in Korea with a total study population of N=21,888.18Hazard ratio adjusted for hydroxychloroquine use at index date and history of lupus nephritis. Mageau et al. conducted a matched cohort study in France with a total study population of N=158.19Conway et al. define moderate COVID-19 as patients requiring hospitalization but not ICU-level care and severe COVID-19 as patients requiring ICU-level care.20 In alignment with the CDC definition of severe outcomes of COVID-19 (hospitalization, admission to the ICU, intubation or mechanical ventilation, or death), these groups are collectively referred to as having severe COVID-19 within this piece.3,20 Neurologic worsening was defined as relapse, pseudorelapse, worsening of pre-existing multiple sclerosis and related disease symptoms, development of other neurologic symptoms, or new gadolinium-enhancing or T2 lesions on brain MRI.20CDC=Centers for Disease Control and Prevention; DKA=diabetic ketoacidosis; ICU=intensive care unit; MRI=magnetic resonance imaging.References:CDC National Wastewater Surveillance System. Wastewater COVID-19 National and Regional Trends. Centers for Disease Control and Prevention. Accessed April 3, 2025. https://www.cdc.gov/nwss/rv/COVID19-nationaltrend.htmlSigns and symptoms of long COVID. Centers for Disease Control and Prevention. Updated July 11, 2024. Accessed April 3, 2025. https://www.cdc.gov/covid/long-term-effects/long-covid-signs-symptoms.htmlUnderlying conditions and the higher risk for severe COVID-19. Centers for Disease Control and Prevention. Updated February 5, 2025. Accessed April 3, 2025. https://www.cdc.gov/covid/hcp/clinical-care/underlying-conditions.htmlSalah HM, Fudim M, O'Neil ST, et al. Post-recovery COVID-19 and incident heart failure in the National COVID Cohort Collaborative (N3C) study. Nat Commun. 2022;13(1):4117.Bashir H, Yildiz M, Cafardi J, et al. A review of heart failure in patients with COVID-19. Heart Fail Clin. 2023;19(2S):e1-e8.Zhang V, Fisher M, Hou W, et al. Incidence of new-onset hypertension post-COVID-19: comparison with influenza. Hypertension. 2023;80(10):2135-2148.Chourasia P, Goyal L, Kansal D, et al. Risk of new-onset diabetes mellitus as a post-COVID-19 condition and possible mechanisms: a scoping review. J Clin Med. 2023;12(3):1159.Zhang J, Shu T, Zhu R, et al. The long-term effect of COVID-19 disease severity on risk of diabetes incidence and the near 1-year follow-up outcomes among postdischarge patients in Wuhan. J Clin Med. 2022;11(11):3094.Xie Y, Al-Aly Z. Risks and burdens of incident diabetes in long COVID: a cohort study. Lancet Diabetes Endocrinol. 2022;10(5):311-321.Patel N, Dahman B, Bajaj SB. Development of new mental and physical health sequelae among US veterans after COVID-19. J Clin Med. 2022;11(12):3390.Nugent J, Aklilu A, Yamamoto Y, et al. Assessment of acute kidney injury and longitudinal kidney function after hospital discharge among patients with and without COVID-19. JAMA Netw Open. 2021;4(3):e211095.Vaidya SR, Aeddula NR. Chronic Kidney Disease. In: StatPearls. StatPearls Publishing; 2024. Accessed September 16, 2024. https://www.ncbi.nlm.nih.gov/books/NBK535404/Deitelzweig S, Luo X, Nguyen JL, et al. Thrombotic and bleeding events, mortality, and anticoagulant use among 546,656 hospitalized patients with COVID-19 in the United States: a retrospective cohort study. J Thromb Thrombolysis. 2022;53(4):766-776.Alvarez-Garcia J, Lee S, Gupta A, et al. Prognostic impact of prior heart failure in patients hospitalized with COVID-19. J Am Coll Cardiol. 2020;76(20):2334-2348.Sritharan HP, Bhatia KS, van Gaal W, et al. Association between pre-existing cardiovascular disease, mortality and cardiovascular outcomes in hospitalised patients with COVID-19. Front Cardiovasc Med. 2023;10:1224886.Xu AY, Wang SH, Duong TQ. Patients with prediabetes are at greater risk of developing diabetes 5 months postacute SARS-CoV-2 infection: a retrospective cohort study. BMJ Open Diabetes Res Care. 2023;11(3):e003257.Mehrotra-Varma S, Lu JY, Boparai MS, et al. Patients with type 1 diabetes are at elevated risk of developing new hypertension, chronic kidney disease and diabetic ketoacidosis after COVID-19: up to 40 months’ follow-up. Diabetes Obes Metab. 2024;26(11):5368-5375.Lee H, Kim BG, Jeong CY, et al. Long-term impacts of COVID-19 on severe exacerbation and mortality in adult asthma: A nationwide population-based cohort study. J Allergy Clin Immunol Pract. 2024;12(7):1783-1793.e4.Mageau A, Géradin C, Sallah K, et al. Risk of systemic lupus erythematosus flare after COVID-19 hospitalization: A matched cohort study. PLoS One. 2024;19(10):e0309316.Conway SE, Healy BC, Zurawski J, et al. COVID-19 severity is associated with worsened neurological outcomes in multiple sclerosis and related disorders. Mult Scler Relat Disord. 2022;63:103946.

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