Study Links COVID-19 Infection With Elevated Risk of Poor Cardiovascular Health, Death

COVID-19 infection was associated with a subsequent increased risk of poor cardiovascular health and death, specifically among patients whose infection was severe enough to require hospitalization, according to a study by UK Biobank. The risk was found to be highest within the first 30 days of infection, but remained elevated for some time afterwards, according to the study.

A growing body of evidence indicates that individuals who have had been infected with COVID-19 have a greater risk of subsequent cardiovascular problems. However, these studies have been mostly retrospective, included only a few selected health outcomes, and did not consider the severity of the COVID-19 infection, according to the authors of the current study.

The researchers analyzed 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. Additionally, the COVID-19 cases included more men, less affluence, and poorer cardiometabolic profiles.

The UK Biobank tracks the health and survival of its participants through medical records and death registration data. Out of the 17,871 COVID-19 cases, 2701 required hospital admission for their infection, 866 were admitted to the hospital for another condition, and 14,304 did not require hospitalization.

Each participant was tracked until a cardiovascular problem arose, they passed away, or until the end of March 2021, providing an average of 141 days of monitoring, ranging from 32 to 395 days.

The cardiovascular outcomes that were considered were heart attack, stroke, heart failure, atrial fibrillation, venous thromboembolism (VTE), pericarditis, death from any cause, death from cardiovascular or ischemic heart disease.

Compared with their matched peers who did not catch the virus, those not requiring hospital admission for COVID-19 infection were nearly 3 times as likely to have a blood clot in a vein and more than 10 times as likely to die of any cause. However, those admitted to the hospital because of COVID-19 had higher risks of all the outcomes considered irrespective of potentially influential demographic and cardiometabolic factors.

The results showed that these participants 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. Additionally, the risk of newly diagnosed atrial fibrillation was nearly 15 times higher, the risk of pericarditis was nearly 14 times higher, and the risk of heart attack was nearly 10 times as high.

The risk of death from any cause was lower than this population among those who had COVID-19, and the risks of death from cardiovascular or ischemic heart disease were higher. This finding likely parallels the original reason for admission rather than COVID-19 itself, according to the researchers.

Death was higher among people with COVID-19 infection. Those admitted with the virus as a primary reason were 118 times as likely to die as those who did not need hospitalization, whereas those for whom COVID-19 was a secondary diagnosis were 64 times as likely to die.

Further, most cardiovascular disease diagnoses, specifically atrial fibrillation, VTE, pericarditis, and death from any cause occurred within the first 30 days of infection and among those admitted to the hospital for COVID-19 as the primary reason.

However, heightened risk remained beyond 30 days, particularly for heart failure, atrial fibrillation, VTE, pericarditis, and all-cause deaths.

Limitations to the study include that it was observational, so no definitive conclusions can be drawn about cause and effect. Additionally, the analysis did not consider other potentially influential factors, such as the impact of vaccination, new virus variants, or serial infections.

“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,” the study authors said in a press release. “Such risks are almost entirely confined to those with disease requiring hospitalization and highest in the early (first 30 days) postinfection period.”

REFERENCE

COVID-19 infection linked to heightened risk of poor cardiovascular health/death. EurekAlert! October 24, 2022. Accessed October 25, 2022. https://www.eurekalert.org/news-releases/968662