Medical research gets plenty of media attention. Unfortunately, the attention is often problematic, frequently failing to provide readers with information needed to understand findings or decide whether to believe them.1 Unless journalists highlight study cautions and limitations, avoid spin2 and overinterpretation of findings, the public may draw erroneous conclusions about the reliability and actionability of the research. Coverage of observational research may be especially challenging given inherent difficulty in inferring causation, a limitation that is rarely mentioned in medical journals articles or corresponding news.3 We used news coverage of a retrospective cohort study, published in Nature Medicine in 2022,4 as a case study to assess news reporting quality. The index study used national data from US Department of Veteran Affairs to characterise the post-acute cardiovascular manifestations of COVID-19. We chose this study because of its potential public health impact (ie, reporting increased cardiovascular diseases after even mild COVID-19 infection) and its enormous media attention: one of the highest Altmetric scores ever (>20 k, coverage in over 600 news outlets and 40 000 tweets). Our study supplements a previous analysis limited to Italian news.5

To assess news quality, we derived a coding scheme (online supplemental appendix 1) from published quality measures developed to capture proper reporting of observational research6 7: the need to refrain from inappropriate causal inferences and unsupported …