Publication date: Jul 29, 2025
The COVID-19 pandemic presents significant health challenges, including increased risk of mortality and long-term complications. While vaccination has proven remarkably effective in mitigating severe disease and mortality associated with acute COVID-19 infection, the long-term implications of vaccination, particularly its influence on post-COVID cardiovascular events and the temporal dynamics of such effects, remain poorly understood. This target trial emulation study utilizes real-world electronic medical record data from April 2021 to March 2023 to address this gap. We evaluate the effect of pre-infection COVID-19 vaccination on the risk of major acute cardiovascular events (MACE) and all-cause mortality in individuals aged 40-85 years during one year after SARS-CoV-2 infection. Among individuals with COVID-19 (n = 18,223 vaccinated, n = 15,331 not vaccinated), vaccination provided a significant protective effect against MACE (weighted incidence rate ratio [wIRR] 0. 71, 95% CI 0. 58-0. 84) and all-cause mortality (wIRR 0. 32, 95% CI 0. 28-0. 36). This effect persisted for approximately three months after the acute infection. These findings underscore the importance of COVID-19 vaccination in reducing both short-term and long-term health risks associated with the infection.
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| Concepts | Keywords |
|---|---|
| April | Cardiac events |
| Mace | COVID-19 |
| Pandemic | DAG. |
| Vaccination | Death |
| Directed acyclic graph | |
| Long COVID | |
| MACE | |
| Mortality | |
| PACS | |
| Post-acute COVID syndrome | |
| Target trial emulation | |
| Vaccination |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| pathway | REACTOME | SARS-CoV-2 Infection |
| disease | MESH | complications |
| disease | MESH | infection |
| disease | IDO | acute infection |
| disease | MESH | Long Covid |
| disease | MESH | Death |
| disease | MESH | syndrome |
| disease | MESH | Cardiac events |
| disease | IDO | antibiotic resistance |
| disease | MESH | symptom burden |
| drug | DRUGBANK | Coenzyme M |
| disease | MESH | breakthrough infections |
| disease | MESH | atherosclerosis |
| disease | MESH | frailty |
| disease | MESH | myocardial infarction |
| disease | MESH | ischemic stroke |
| disease | MESH | fatal outcomes |
| disease | MESH | viral load |
| disease | MESH | influenza |
| disease | MESH | inflammation |
| disease | IDO | immune response |
| disease | MESH | arterial stiffness |
| drug | DRUGBANK | Isoxaflutole |
| disease | MESH | stroke |
| disease | MESH | reinfections |
| drug | DRUGBANK | Azelaic acid |
| disease | MESH | premature death |
| disease | MESH | pulmonary diseases |
| disease | MESH | respiratory failure |
| disease | MESH | education level |