People who have had COVID-19 have an increased risk of cardiovascular disease and death for up to 18 months after infection, a study published today shows.
Research that examined nearly 160,000 UK participants found the likelihood of COVID-19 patients dying was up to 81 times higher in the first three weeks of infection and remained five times higher up to 18 months later.
Study author Professor Ian Wong said: “The findings indicate that patients with COVID-19 should be monitored for at least a year after recovering from the acute illness to diagnose cardiovascular complications of the infection, which form part of long-COVID.”
This study, published in today’s Cardiovascular Research, compared the occurrence of cardiovascular conditions and death in infected individuals with uninfected individuals, all of whom were recruited before December 2020, when no vaccines were available in the UK.
More than 7,500 patients with COVID-19 infection diagnosed from 16 March 2020 to 30 November 2020 were identified from UK Biobank and each of these was matched with up to 10 individuals who had not tested positive for the virus during the study period, which was 16 March 2020 to the end of follow-up on 31 August 2021.
A third group was added from before the pandemic, from 16 March 2018 to 30 November 2018, to rule out the effect of routine healthcare services being reduced or cancelled during the pandemic, which led to worsening health and increased mortality even in uninfected people.
In all three groups, the average age was 66 years and there were nearly equal numbers of women and men.
Data were obtained from medical and death records for outcomes including major cardiovascular disease; numerous cardiovascular conditions such as stroke, atrial fibrillation and myocardial infarction; death from cardiovascular disease; and all-cause death.
Associations were evaluated for the acute phase of within 21 days of COVID-19 diagnosis and the post-acute phase, at 22 days after diagnosis continuing up to 18 months.
Compared with the two uninfected cohorts, patients with COVID-19 were approximately four times more likely to develop major cardiovascular disease in the acute phase and 40% more likely in the post-acute phase.
The risk of death in COVID-19 patients was up to 81-fold higher in the acute phase and five-fold higher in the post-acute phase compared to those who had not been infected.
Researchers also found patients who had had severe COVID-19 were more likely to develop major cardiovascular disease or die than non-severe cases.
COVID-19 patients had a greater likelihood of several cardiovascular conditions compared with uninfected participants in both the short- and long-term, while risks of some cardiovascular conditions – such as stroke and atrial fibrillation – were elevated in COVID-19 patients in the short-term but then returned to normal levels.
Professor Wong, from the University of Hong Kong, China, said: “This study was conducted during the first wave of the pandemic, and future research should evaluate subsequent outbreaks.
“Previous research has indicated that COVID-19 vaccination may prevent complications, and further studies are needed to investigate its effectiveness in reducing the risks of cardiovascular disease and death after COVID-19 infection in patients with COVID-19 vaccination compared to those without vaccination.”
Wan EYF, Mathur S, Zhang R, et al. Association of COVID-19 with short- and long-term risk of cardiovascular disease and mortality: A prospective cohort in UK Biobank. Cardiovasc Res. 19 January 2023; doi:10.1093/cvr/cvac195
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