Elevated amputation rates in COVID‐19 survivors: Insights from a large‐scale Japanese cohort study
ABSTRACT Objective COVID‐19 has been linked to increased vascular complications, but its long‐term impact on amputation rates is unclear. This study evaluated amputation risk post‐COVID‐19 using a nationwide insurance claims database in Japan. Methods We conducted a retrospective cohort study using...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-08-01
|
| Series: | Journal of Diabetes Investigation |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jdi.70078 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849705841519755264 |
|---|---|
| author | Daisuke Miyamori Shuhei Yoshida Masanori Ito |
| author_facet | Daisuke Miyamori Shuhei Yoshida Masanori Ito |
| author_sort | Daisuke Miyamori |
| collection | DOAJ |
| description | ABSTRACT Objective COVID‐19 has been linked to increased vascular complications, but its long‐term impact on amputation rates is unclear. This study evaluated amputation risk post‐COVID‐19 using a nationwide insurance claims database in Japan. Methods We conducted a retrospective cohort study using data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. COVID‐19 cases were identified via insurance payment waivers, and amputations were defined by procedure codes. Propensity score matching created balanced cohorts of COVID‐19 exposed and unexposed individuals. Matched cohorts were compared for amputation incidence, calculating incidence rate ratios (IRRs), and differences (IRDs). Sensitivity analyses examined outcomes at different time points, and subgroup analyses stratified results by key characteristics. Results This study included 3,098,948 matched pairs. Over a median follow‐up of 7 months, 286 amputations occurred in the COVID‐19 group vs 123 in controls (IRR 2.33, 95% CI 1.88–2.90; IRD 5.57 per 1,000,000 person‐months, 95% CI 4.22–6.92). The elevated risk persisted beyond 2 years post infection (IRR 2.03, 95% CI 1.31–3.20). Subgroup analyses showed higher risks in individuals with higher comorbidity burden (Charlson Comorbidity Index [CCI] ≥2; IRR 2.45 95% CI 1.92, 2.79) vs lower comorbidity burden (CCI 0–1; IRR 0.71 95%CI 0.29, 1.71) with significant interaction (P = 0.04). Conclusions Amputation rates increased among COVID‐19 survivors, persisting for over 2 years post infection. The interaction between COVID‐19 and comorbidity burden highlights the need for vigilant long‐term monitoring and management of vascular complications in COVID‐19 survivors, particularly those with multiple comorbidities. |
| format | Article |
| id | doaj-art-70450c8ea98d4124aa616adad93f39ac |
| institution | DOAJ |
| issn | 2040-1116 2040-1124 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj-art-70450c8ea98d4124aa616adad93f39ac2025-08-20T03:16:22ZengWileyJournal of Diabetes Investigation2040-11162040-11242025-08-011681551156010.1111/jdi.70078Elevated amputation rates in COVID‐19 survivors: Insights from a large‐scale Japanese cohort studyDaisuke Miyamori0Shuhei Yoshida1Masanori Ito2Department of General Internal Medicine Hiroshima University Hospital Hiroshima JapanDepartment of General Internal Medicine Hiroshima University Hospital Hiroshima JapanDepartment of General Internal Medicine Hiroshima University Hospital Hiroshima JapanABSTRACT Objective COVID‐19 has been linked to increased vascular complications, but its long‐term impact on amputation rates is unclear. This study evaluated amputation risk post‐COVID‐19 using a nationwide insurance claims database in Japan. Methods We conducted a retrospective cohort study using data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. COVID‐19 cases were identified via insurance payment waivers, and amputations were defined by procedure codes. Propensity score matching created balanced cohorts of COVID‐19 exposed and unexposed individuals. Matched cohorts were compared for amputation incidence, calculating incidence rate ratios (IRRs), and differences (IRDs). Sensitivity analyses examined outcomes at different time points, and subgroup analyses stratified results by key characteristics. Results This study included 3,098,948 matched pairs. Over a median follow‐up of 7 months, 286 amputations occurred in the COVID‐19 group vs 123 in controls (IRR 2.33, 95% CI 1.88–2.90; IRD 5.57 per 1,000,000 person‐months, 95% CI 4.22–6.92). The elevated risk persisted beyond 2 years post infection (IRR 2.03, 95% CI 1.31–3.20). Subgroup analyses showed higher risks in individuals with higher comorbidity burden (Charlson Comorbidity Index [CCI] ≥2; IRR 2.45 95% CI 1.92, 2.79) vs lower comorbidity burden (CCI 0–1; IRR 0.71 95%CI 0.29, 1.71) with significant interaction (P = 0.04). Conclusions Amputation rates increased among COVID‐19 survivors, persisting for over 2 years post infection. The interaction between COVID‐19 and comorbidity burden highlights the need for vigilant long‐term monitoring and management of vascular complications in COVID‐19 survivors, particularly those with multiple comorbidities.https://doi.org/10.1111/jdi.70078AmputationCOVID‐19National Insurance Claims Database |
| spellingShingle | Daisuke Miyamori Shuhei Yoshida Masanori Ito Elevated amputation rates in COVID‐19 survivors: Insights from a large‐scale Japanese cohort study Journal of Diabetes Investigation Amputation COVID‐19 National Insurance Claims Database |
| title | Elevated amputation rates in COVID‐19 survivors: Insights from a large‐scale Japanese cohort study |
| title_full | Elevated amputation rates in COVID‐19 survivors: Insights from a large‐scale Japanese cohort study |
| title_fullStr | Elevated amputation rates in COVID‐19 survivors: Insights from a large‐scale Japanese cohort study |
| title_full_unstemmed | Elevated amputation rates in COVID‐19 survivors: Insights from a large‐scale Japanese cohort study |
| title_short | Elevated amputation rates in COVID‐19 survivors: Insights from a large‐scale Japanese cohort study |
| title_sort | elevated amputation rates in covid 19 survivors insights from a large scale japanese cohort study |
| topic | Amputation COVID‐19 National Insurance Claims Database |
| url | https://doi.org/10.1111/jdi.70078 |
| work_keys_str_mv | AT daisukemiyamori elevatedamputationratesincovid19survivorsinsightsfromalargescalejapanesecohortstudy AT shuheiyoshida elevatedamputationratesincovid19survivorsinsightsfromalargescalejapanesecohortstudy AT masanoriito elevatedamputationratesincovid19survivorsinsightsfromalargescalejapanesecohortstudy |