‘Substantial’ Heart Risks Up to a Year After COVID-19

Feb. 9, 2022 — People who have had COVID-19 have an increased risk of heart disease 12 months after infection, a danger that is substantial and spans an array of heart and vasculars disorders, a deep dive into federal data suggests.

“I went into this thinking that this is most likely happening in people to start with that have a higher risk of cardiovascular disorders, smokers, people with high BMI, diabetes, but what we found is something different,” Ziyad Al-Aly, MD, says. “It’s evident in people at high risk, but it was also as clear as the sun, even in people who have no cardiovascular risk whatsoever.”

Rates were increased in younger adults, people who’ve never smoked, whites and Black patients, males and females, he says. “So, the risk confirmed by the SARS-CoV-2 virus seems to spare almost no one.”

Although heart problems were higher in cases of severe COVID-19, the risks and burdens were also found in patients who were never hospitalized – a group that represents the majority of people with COVID-19, says Al-Aly, who directs the Clinical Epidemiology Center at the Veterans Affairs St. Louis Health Care System.

“This study is very important because it underscores not just the acute cardiovascular risk associated with COVID but the increased risk of chronic cardiovascular outcomes as well,” cardiologist C. Michael Gibson, MD, professor of medicine at Harvard Medical School, says. “Given the number of patients in the U.S. who have been infected with COVID, this could represent a significant chronic burden on the health care system, particularly as health care professionals leave the profession.”

For the study, the investigators used national VA databases to analyze health data of 153,760 veterans with COVID-19 between March 1, 2020 and January 2021. They were compared with another group of 5.6 million veterans who never tested positive for COVID-19 and a third group of 5.8 million veterans using the system in 2017 prior to the pandemic.

As the study, published in Nature Medicine, found, the risk of a major heart event, which included heart attack, stroke, and all-cause mortality, was 4% higher in people who had been infected with COVID-19.

“People say 4% is small but actually it’s really, really big if you think about it in the context of the huge number of people that have had COVID-19 in the United States, and also globally,” Al-Aly says.

The results show that the coronavirus “can leave a sort of scar or imprint on people and some of these conditions are likely chronic conditions,” Al-Aly says. “So you’re going to have a generation of people that will bear the scar of COVID for their lifetime and I think that requires recognition and attention.”

With more than 77 million COVID-19 cases in the U.S., that effort will likely have to be at the federal level, similar to President Joe Biden’s recent relaunch of the “Cancer Moonshot,” he says. “We need a greater and broader recognition at the federal level to try and recognize that when you have an earthquake, you don’t just deal with the earthquake when the earth is shaking, but you also need to deal with the aftermath.”

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