Some survivors of covid-19 will be dealing with heart-related issues even after their initial infection is over, new research this week suggests. The study found that covid-19 patients were more likely than others to report a variety of heart conditions over the following 12 months. This increased risk was greatest for those hospitalized but could still be seen in mild to moderate cases.
It’s well understood by now that people can experience illness well past the acute bout of sickness brought on by the coronavirus. This constellation of lingering symptoms has come to be known as long covid and can include fatigue, cognitive impairment, and an impaired sense of smell. But much is still unknown about long covid, including its root causes and the impact it can have on various parts of the body.
The new research, published this week in Nature Medicine, appears to be one of the deeper looks yet at heart-related complications that may be linked to covid. The researchers used national data from those with medical coverage from the U.S. Department of Veterans Affairs, the country’s largest integrated healthcare system. They compared the long-term cardiovascular outcomes of over 150,000 patients who survived covid-19 to two sets of similarly matched control patients: people during the pandemic and people before the pandemic. Including both comparisons is important, because it could account for pandemic-related trends that might have affected people’s heart health in other ways.
They found a consistent pattern no matter which group was used for comparison: Covid-19 survivors had an increased risk of being diagnosed with cardiovascular problems, including those that led to their eventual death, over the next 12 months (to account for the initial illness, they only looked at outcomes reported 30 days after a covid-19 diagnosis). Compared to people not diagnosed with covid-19 during the pandemic, for instance, survivors had a 52% higher risk of stroke, a 72% higher risk of atrial fibrillation (a type of irregular heartbeat), and a twofold higher risk of heart inflammation, including myocarditis.
“What we’re seeing isn’t good,” said study author Ziyad Al-Aly, an assistant professor of medicine at Washington University, in a statement from the university. “Covid-19 can lead to serious cardiovascular complications and death. The heart does not regenerate or easily mend after heart damage. These are diseases that will affect people for a lifetime.”
Severe covid-19 can regularly involve heart damage, and as other studies have shown, the increased risk of long-term complications was largest in people who needed intensive care, followed by those hospitalized. But a higher risk of many conditions could often still be found in non-hospitalized patients, and in those without preexisting risk factors for heart disease, including younger people. And because hundreds of millions of people around the world have survived covid-19, if not more, the number of non-hospitalized individuals with long-term heart problems is likely to be sizable, even if their risk in general is low.
The team’s data only covered people in the first year of the pandemic, before the emergence of the more severe variant Delta or the more recent Omicron. It’s not yet clear how much prior immunity, whether from vaccination or past infection, can blunt the risk of long-term symptoms after a breakthrough infection, though some data does point to a substantial protective effect. Vaccines also still lower the risk of infection and severe illness. So there is a good chance that the risk of long covid will continue to decline over time. Even so, the world has to do more to vaccinate people, the authors say, and to help those survivors who are already facing these persistent problems.
“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,” Al-Aly said. “Addressing the challenges posed by long-COVID will require a much-needed — but so far lacking — urgent and coordinated long-term global response strategy.”