Nature Med | Long-term cardiovascular outcomes of COVID-19
Abstract
The cardiovascular complications of acute coronavirus disease 2019 (COVID-19) are well described, but the post-acute cardiovascular manifestations of COVID-19 have not yet been comprehensively characterized. Here we used national healthcare databases from the US Department of Veterans Affairs to build a cohort of 153,760 individuals with COVID-19, as well as two sets of control cohorts with 5,637,647 (contemporary controls) and 5,859,411 (historical controls) individuals, to estimate risks and 1-year burdens of a set of pre-specified incident cardiovascular outcomes. We show that, beyond the first 30 d after infection, individuals with COVID-19 are at increased risk of incident cardiovascular disease spanning several categories, including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease. These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection and increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care). Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial. Care pathways of those surviving the acute episode of COVID-19 should include attention to cardiovascular health and disease.
Reuters summary.
Risk of new heart problems much higher after COVID recovery
Long after recovery from COVID-19, people face significantly higher risks for new heart problems, a large study has found.
Researchers at the U.S. Department of Veterans Affairs compared rates of new cardiovascular problems in 153,760 individuals infected with the coronavirus before vaccines were available, 5.6 million people who did not catch the virus, and another 5.9 million people whose data was collected before the pandemic. An average of one year after their recovery from the acute phase of the infection, the COVID-19 survivors had a 63% higher risk for heart attack, a 69% higher risk for problematic irregular heart rhythm, a 52% higher risk of stroke, a 72% higher risk of heart failure, and a nearly three times higher risk of a potentially fatal blood clot in the lungs [pulmonary embolism] compared with the other two groups, according to a report published on Monday in Nature Medicine. The elevated risks among former COVID-19 patients were evident in young and old, Blacks and whites, males and females, people with and without diabetes and with and without kidney disease, as well as smokers and nonsmokers, said Ziyad Al-Aly of the VA St. Louis Health Care System and Washington University in St. Louis.
The risks were high even in people who had mild COVID-19 and did not need to be hospitalized for it, he noted in a Twitter thread. "It really spared no one," Al-Aly told Reuters. "People with COVID-19 should pay attention to their health and seek medical care if they experience symptoms like chest pain, chest pressure, palpitation, swelling in the legs, etc."
May the gods preserve and defend me from self-righteous altruists; I can defend myself from my enemies and my friends.
