Does Acute COVID-19 Infection Increase Long-Term Cardiovascular Risk?

A study, published in Nature Medicine, found that patients who had acute COVID-19 infections were at increased risk for long-term cardiovascular outcomes.

Data for this study were sourced from the United States Department of Veterans Affairs. Patients with COVID-19 (n=153,760) were matched with contemporary (n=5,637,647) and historical (n=5,859,411) cohorts of controls without COVID-19. The 1-year burden of cardiovascular outcomes was assessed and compared between cohorts.

Patients who survived the first 30 days of COVID-19 infection were found to have increased risk for 5 dysrhythmias (hazard ratio [HR] range, 1.53-1.84), 4 ischemic heart diseases (HR range, 1.52-1.75), 4 other cardiovascular disorders (HR range, 1.62-2.45), 3 thromboembolic disorders (HR range, 1.95-2.93), 2 cerebrovascular disorders (HR range, 1.49-1.52), and 2 inflammatory diseases of the heart (HR range, 1.85-5.38).

Acute COVID-19 infection was associated with increased risk for composite thromboembolic disorders (HR, 2.39; 95% CI, 2.27-2.51), inflammatory disease of the heart or pericardium (HR, 2.02; 95% CI, 1.77-2.30), other cardiovascular disorders (HR, 1.72; 95% CI, 1.65-1.79), dysrhythmia outcomes (HR, 1.69; 95% CI, 1.64-1.75), ischemic heart disease outcomes (HR, 1.66; 95% CI, 1.52-1.80), any cardiovascular outcome (HR, 1.63; 95% CI, 1.59-1.68), major adverse cardiovascular events (HR, 1.55; 95% CI, 1.50-1.60), and cerebrovascular outcomes (HR, 1.53; 95% CI, 1.45-1.61).

Comparing and contrasting between the historical and contemporary control cohorts found that all cardiovascular outcomes were substantially higher after the COVID-19 period compared with before.

This study was limited by its heterogeneous population, which was dominated by White men. These findings may not be generalizable to a more diverse population or among women.

Previous studies have linked acute COVID-19 infection with increased burden for cardiovascular outcomes. This study extended the association between COVID-19 infection and cardiac harm by finding evidence that these negative effects extend well beyond the acute phase of COVID-19 infection, even among individuals who did not require hospitalization.

“Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial,” the study authors wrote. “Care pathways of those surviving the acute episode of COVID-19 should include attention to cardiovascular health and disease.”

Reference

Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. Published online February 7, 2022. doi:10.1038/s41591-022-01689-3