Giant study shows striking rise in long-term heart and vessel disease
https://www.science.org/content/article/covid-19-takes-serious-toll-heart-health-full-year-after-recovery
https://www.science.org/content/article/covid-19-takes-serious-toll-heart-health-full-year-after-recovery
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Now, the first large study to assess cardiovascular outcomes 1 year after SARS-CoV-2 infection has demonstrated that the virus' impact is often lasting. In an analysis of more than 11 million U.S. veterans' health records, researchers found the risk of 20 different heart and vessel maladies was substantially increased in veterans who had COVID-19 1 year earlier, compared with those who didn't. The risk rose with severity of initial disease and extended to every outcome the team examined, including heart attacks, arrhythmias, strokes, cardiac arrest, and more. Even people who never went to the hospital had more cardiovascular disease than those who were never infected.
The results are "stunning … worse than I expected, for sure," says Eric Topol, a cardiologist at Scripps Research. "All of these are very serious disorders. … If anybody ever thought that COVID was like the flu this should be one of the most powerful data sets to point out it's not." He adds that the new study "may be the most impressive Long Covid paper we have seen to date."
Others agree the results of the study, published in Nature Medicine on 7 February, are powerful. "In the post-COVID era, COVID might become the highest risk factor for cardiovascular outcomes," greater than well-documented risks such as smoking and obesity, says Larisa Tereshchenko, a cardiologist and biostatistician at the Cleveland Clinic, who recently conducted a similar, much smaller analysis. She cautions that the new study will need to be replicated, and that it was retrospective, possibly introducing inaccuracies such as incorporating faulty diagnoses from patient records. "It looked back. We have to do prospective studies to calculate accurate estimates."
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The researchers drew on the largest set of electronic health records in the United States, at the Department of Veterans Affairs (VA). They analyzed data from nearly 154,000 people who contracted COVID-19 between March 2020 and January 2021, and who survived at least 30 days after becoming infected. They also identified two control groups: 5.6 million people who sought VA care during the pandemic but were not diagnosed with COVID-19, and 5.9 million people who sought VA care in 2017.
One limitation of the study is that the veteran population skews older, white, and male: In all three groups, about 90% of patients were men and 71% to 76% were white. Patients were in their early 60s, on average.
The researchers controlled for the possibility that the people who contracted COVID-19 were already more prone to developing cardiovascular disease. They found that "COVID is an equal opportunity offender," Al-Aly says. "We found an increased risk of cardiovascular problems in old people and in young people, in people with diabetes and without diabetes, in people with obesity and people without obesity, in people who smoked and who never smoked."
