COVID-19 infection is linked to an increased risk of poor cardiovascular health and death, especially among those who needed hospital treatment, researchers report today.
An observational study, published in Heart today, found that the risk, independent of known contributory factors, is most acute within the first 30 days of infection, but remains heightened for months afterwards.
Researchers from Queen Mary University of London, UK, examined data from 53,613 UK Biobank participants – 17,871 of whom were diagnosed with COVID-19 infection between March 2020 and March 2021, and 35,742 who were not.
The COVID-19 cases included more men, people from less affluent areas and who had poorer cardiometabolic profiles. Of those who were hospitalised, 866 were admitted to hospital for another condition, while 14,304 didn’t need hospital treatment.
All participants were tracked until they were diagnosed with a cardiovascular health problem, they died, or until the end of March 2021. This provided an average of 141 days of monitoring.
Those who had COVID but did not require hospital treatment were almost three times as likely to have venous thromboembolism (VTE) and more than 10 times as likely to die of any cause than those who did not test positive.
But those admitted to hospital because of COVID-19 were more than 27 times as likely to develop VTE, more than 21.5 times as likely to be diagnosed with heart failure, and 17.5 times as likely to have a stroke.
The risk of newly diagnosed atrial fibrillation was nearly 15 times higher, pericarditis nearly 14 times higher, and heart attack nearly 10 times as high.
Among individuals who were admitted to hospital for reasons other than COVID-19, but subsequently tested positive, the risks of all the outcomes measured were also higher than those of people who hadn’t.
Those who were admitted with the virus as a primary reason were 118 times as likely to die as those who did not need hospital treatment, while those for whom COVID-19 was a secondary diagnosis were 64 times as likely to die.
The researchers add that most cardiovascular disease diagnoses, especially atrial fibrillation, VTE, pericarditis and death from any cause occurred within the first 30 days of infection and among those admitted to hospital for COVID-19 as the primary reason.
Heightened risk remained beyond 30 days, particularly for heart failure, atrial fibrillation, VTE, pericarditis and all-cause deaths.
The researchers say: “The long-term sequelae of past COVID-19 exposure is emerging as a dominant public health concern. Our findings highlight the increased cardiovascular risk of individuals with past infection, which are likely to be greater in countries with limited access to vaccination and thus greater population exposure to COVID-19.”
Raisi-Estabragh Z, Cooper J, Salih A et al. Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank. Heart 25 October 2022
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