ArticleJournal of diabetes investigation2025
Elevated amputation rates in COVID-19 survivors: Insights from a large-scale Japanese cohort study.
Article in Journal of diabetes investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Uncommon Combination of Low Alanine Aminotransferase and High Fatty Liver Index Associated With High Charlson Comorbidity Index: Insights From the K7Ps-Study-7.Journal of clinical medicine research · 2026Article
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3 authors.
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Abstract
objectiveCOVID-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.
methodsWe 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.
resultsThis 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).
conclusionsAmputation 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.
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