Even mild COVID increases the risk of heart attack and stroke


Even a mild case of COVID-19 can increase long-term risks of serious cardiovascular diseases such as stroke, heart attack and heart failure, according to a report published recently in naturopathy.

The study highlights our limited understanding of the full implications of COVID infection and the long-term impact of the COVID pandemic.

Australia has reported more than 10 million cases of acute COVID infection and more than 14,000 deaths.

Worldwide, at least 600 million people have been infected.

The immediate effects of COVID infection on the heart are well documented, with myocarditis (inflammation of the heart muscle) a rare but potentially fatal complication. But myocarditis only occurs in about 40 people per million infected.

The major concern raised by this research is that medium to long-term damage to the body’s blood vessel network (the vascular system) is much more common than that.

It could trigger another cardiovascular disease pandemic in the coming years.

What did they find?

The study, led by researchers at Washington University, showed an increased risk of future cardiovascular events in people who have recovered from COVID.

The authors analyzed the health records of approximately 150,000 U.S. veterans, who are often studied because they are a well-documented group within a separate health care system.

They compared the rates of cardiovascular disease in veterans who had experienced COVID infection with uninfected control groups of about 10 million people.

Between 30 days and a year after recovering from COVID, survivors were 52 percent more likely to have a stroke, 63 percent more likely to have a heart attack, and 72 percent more likely to have heart failure.

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This means that over a year, for every 1,000 people who had COVID, there would be five extra strokes, three extra heart attacks and 12 extra cases of heart failure.

There was also evidence of an increased risk of serious blood clots in the lungs.

These numbers may sound small to some, but when scaled up to 600 million COVID infections worldwide, the implications are huge.

A particularly concerning finding was that while those with more severe acute COVID infections had the highest risk of cardiovascular events in the following year, even those with mild infection were at increased risk.

And that risk wasn’t limited to those who’d had heart problems before — it could affect anyone.

Necessary Warnings

The study was large and had many strengths. But the findings should be viewed with some caution.

It was an observational study (in which researchers draw conclusions from what they see in a population, rather than control variables for an experimental study).

So we can’t be sure that the increased risk of heart disease or stroke was definitely caused by the COVID infection. The people who were infected with COVID were not identical to the people who were not infected.

That said, the researchers made statistical adjustments and could find no other explanation for the large increase in the observed risks.

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It is also likely that some people with asymptomatic COVID infection were accidentally included in the control groups.

However, the effect of this would have been to underestimate the risks of COVID infection on cardiovascular risk.

And, of course, American veterans are a very special group of individuals (usually older, male, and white).

Even if the effects of COVID on cardiovascular risk to them are real, there must be some uncertainty as to whether the same effects would be seen in other populations.

COVID and hearts

The clear but low risk of heart disease at the time of COVID infection also supports a medium to long-term link between COVID infection and heart disease.

Even before the pandemic, there was a clear link between inflammation caused by infection and the risk of heart attack.

A heart attack occurs when an artery supplying the heart with blood is blocked and the heart muscle is deprived of oxygen.

This usually happens when a rupture of a fatty plaque in the artery causes a blood clot. This process is driven by inflammation in the tissues and thickening of the blood, both of which can occur with COVID, and both of which can persist long after the initial infection has cleared.

This data reminds us once again of the importance of limiting the spread of the COVID virus.

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The best way to reduce COVID-related risks is to prevent COVID infection and reduce the severity of the infection.

We must maintain high vaccination rates and support infection control measures, such as wearing masks, in high-risk situations. Increasingly strong evidence of the long-term effects of COVID is doubling the importance of these efforts.

Future issues

We rightly feared the respiratory complications of COVID in 2020 and 2021, but only now are we appreciating the full impact of the pandemic on other body systems.

Doctors will need to view COVID infection as a long-term risk factor for cardiovascular disease, in much the same way many other chronic inflammatory conditions, such as rheumatoid arthritis, are now viewed.

We must advocate for fair access to heart disease prevention and treatment in all Australians, especially those at the highest risk, such as First Nations people.

And most importantly, as patients, we should prioritize our own heart health.

And we must remain vigilant for the effects of new species. In the coming decades, we will have to plan for the lasting effects of COVID.

Clare Arnott, co-director of Global Chronic and Complex Diseases, George Institute for Global Health; Bruce Neal, Executive Director, George Institute Australia, George Institute for Global Healthand Jamie Cham, teacher, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.


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