Post-infection increases in Cardiometabolic Disease Staging (CMDS) scores are associated with increased odds of long COVID in a longitudinal retrospective cohort.

AIMS: We applied a validated Cardiometabolic Disease Staging (CMDS) model, which quantitatively measures CMD severity, to assess whether changes in cardiometabolic risk surrounding COVID-19 infection were associated with the risk of developing Long COVID. METHODS: CMDS scores (range 0.01 - 0.99) were calculated using body mass index, glucose, blood pressure, cholesterol, and triglycerides, collected up to three years before and after COVID-19 infection. Long COVID was defined using ICD-10 codes or self-reported symptom interference. Changes in CMDS scores and the odds of Long COVID were examined using logistic regression. RESULTS: A total of 6,364 patients [mean age: 57 years (SD 15); 58% female; 67.1% White] had available clinical data and Long COVID outcomes; 6.9% met criteria for Long COVID. Patients with Long COVID had significantly higher CMDS scores than those without Long COVID both before (0.21 vs. 0.19; p = 0.013) and after (0.24 vs. 0.19; p < 0.0001) COVID infection. Those whose CMDS score increased after COVID-19 infection had a 1.36-fold (OR 1.36; 95% CI: 1.08-1.71) increased odds of having Long COVID, remaining significant after adjusting for SDoH and comorbidities. CONCLUSIONS: Patients who increased in cardiometabolic disease severity after COVID-19 infection had increased odds of developing Long COVID.