New research published in the journal Nature Medicine has found that people with COVID-19 may be at “substantial” risk of heart complications for at least one year following testing positive. The heart complications can include blood clots, irregular heart rhythm, inflammation, heart attack, and heart failure. In some cases, the complications have even resulted in death.
In the study, which was published last Monday, researchers analyzed data from the U.S. Department of Veterans Affairs (V.A.) health system, with the results of 153,760 people who tested positive for COVID-19 between March 2020 and January 2021 being taken into account. The researchers then compared them to two control groups of people who, to their knowledge, didn’t have COVID-19 at the time of data collection. One was a group of 5.6 million people who accessed the V.A. medical system during the pandemic (the contemporary controls), as well as 5.8 million people (the historical controls) who accessed the V.A. system in 2017, before the pandemic. It is the first study to analyze such a large group in relation to cardiovascular outcomes after COVID-19.
The researchers analyzed the health results of these nearly 154,000 veterans with COVID-19, and compared to these two other groups, one year after the acute phase of infection—a time soon after the onset of infection when several physiological processes occur—patients who had been infected with COVID-19 were found to have increases in 20 different heart health issues. That included a 52% higher risk of stroke than the contemporary controls as well as a 63% higher risk for heart attack, a 69% higher risk for irregular heart rhythm, and a 72% higher risk of heart failure. “Because of the chronic nature of these conditions, they will likely have long-lasting consequences for patients and health systems and also have broad implications on economic productivity and life expectancy,” study co-author Ziyad Al-Aly, M.D., of the V.A. St. Louis Health Care System and Washington University in St. Louis said on Twitter.
Perhaps the most concerning finding in the research was that the heart-related risks were found to be common even in people who experienced COVID-19 in a mild form, such as those who were not hospitalized or in ICU care because of their symptoms. Plus, this higher risk for heart problems was also observed in people who are considered to be less vulnerable to the virus, like people under 65 years of age and not facing immunocompromising risks such as diabetes.
In the study, researchers acknowledge that the “mechanisms that underlie the association between COVID-19 and development of cardiovascular diseases in the post-acute phase of the disease are not entirely clear.” Some of the potential mechanisms to consider include endothelial cell infection (the cells that line blood vessels and regulate exchange between the bloodstream and surrounding tissue) and the downregulation of ACE2 (an enzyme attached to the membrane of cells in the intestines, kidneys, and other organs). As the reasons are not yet entirely clear, further research is required. “Addressing the challenges posed by long COVID will require a much needed, but so far lacking, urgent and coordinated long-term global response strategy,” Dr. Al-Aly said on Twitter. “I am happy that the Cancer Moonshot is being re-launched. We need a Long Covid Moonshot.”