SARS-CoV-2COVID-19 infections increase risk of heart conditions up to a year later – Washington University School of Medicine in St. Louis
The first comes from Washington University School of Medicine in St Louis, Missouri, USA where, by analysing federal health data, researchers have found that people who have had COVID-19 are at increased risk of developing cardiovascular complications within the first month to a year after infection.
According to the Washington University School of Medicine in St Louis:
Such complications include disruptive heart rhythms, inflammation of the heart, blood clots, stroke, coronary artery disease, heart attack, heart failure or even death.The Washington University team's findings are published open access in the journal Nature Medicine:
We wanted to build upon our past research on COVID’s long-term effects by taking a closer look at what’s happening in people’s hearts. What we’re seeing isn’t good. 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.Such problems occur even among previously healthy individuals and those who have had mild COVID-19 infections, according to the study.
…COVID-19 infections have, thus far, contributed to 15 million new cases of heart disease worldwide. This is quite significant. For anyone who has had an infection, it is essential that heart health be an integral part of post-acute COVID care
For people who were clearly at risk for a heart condition before becoming infected with SARS-CoV-2, the findings suggest that COVID-19 may amplify the risk.
But most remarkably, people who have never had any heart problems and were considered low risk are also developing heart problems after COVID-19. Our data showed an increased risk of heart damage for young people and old people; males and females; Blacks, whites and all races; people with obesity and people without; people with diabetes and those without; people with prior heart disease and no prior heart disease; people with mild COVID infections and those with more severe COVID who needed to be hospitalized for it.
Some people may think 4% is a small number, but it’s not, given the magnitude of the pandemic. That translates to roughly 3 million people in the U.S. who have suffered cardiovascular complications due to COVID-19.
Governments and health systems around the world should be prepared to deal with the likely significant contribution of the COVID-19 pandemic to a rise in the burden of cardiovascular diseases. 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. Addressing the challenges posed by long-COVID will require a much needed, but so far lacking, urgent and coordinated long-term global response strategy.
Assistant Professor Ziyad Al-Aly, MD, senior author
Assistant professor of medicine
Washington University.
[…]
Cardiovascular disease — an umbrella term that refers to various heart conditions, thrombosis and stroke — is the leading cause of death in the United States and the world. The Centers for Disease Control and Prevention (CDC) estimates that one out of every four Americans dies of heart disease each year. Additionally, heart disease comes with a hefty price tag, according to the CDC, costing the U.S. about $363 billion each year in health-care services, medications and productivity lost to death.
[…]
The researchers analyzed de-identified medical records in a database maintained by the U.S. Department of Veterans Affairs, the nation’s largest integrated health-care delivery system. The researchers created a controlled dataset that included health information of 153,760 people who had tested positive for COVID-19 sometime from March 1, 2020, through Jan. 15, 2021, and who had survived the first 30 days of the disease. Very few of the people in the study were vaccinated prior to developing COVID-19, as vaccines were not yet widely available at the time of enrollment.
Statistical modeling was used to compare cardiovascular outcomes in the COVID-19 dataset with two other groups of people not infected with the virus: a control group of more than 5.6 million patients who did not have COVID-19 during the same time frame; and a control group of more than 5.8 million people who were patients from March 2018 through January 2019, well before the virus spread and the pandemic settled in.
The study does not include data involving the virus’s delta and omicron variants, which began spreading rapidly in the latter half of 2021.
The COVID-19 patients in the study were mostly older, white men; however, the researchers also analyzed data that included women and adults of all ages and races.
The researchers analyzed heart health over a year-long period. Heart disease, including heart failure and death, occurred in 4% more people than those who had not been infected with COVID-19.
Compared with those in the control groups without any infections, people who contracted COVID-19 were 72% more likely to suffer from coronary artery disease, 63% more likely to have a heart attack and 52% more likely to experience a stroke.
Overall, those infected with the virus were 55% more likely than those without COVID-19 to suffer a major adverse cardiovascular event, which includes heart attack, stroke and death.
Abstract
The cardiovascular complications of acute coronavirus disease 2019 (COVID-19) are well described, but the post-acute cardiovascular manifestations of COVID-19 have not yet been comprehensively characterized. Here we used national healthcare databases from the US Department of Veterans Affairs to build a cohort of 153,760 individuals with COVID-19, as well as two sets of control cohorts with 5,637,647 (contemporary controls) and 5,859,411 (historical controls) individuals, to estimate risks and 1-year burdens of a set of pre-specified incident cardiovascular outcomes. We show that, beyond the first 30 d after infection, individuals with COVID-19 are at increased risk of incident cardiovascular disease spanning several categories, including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease. These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection and increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care). Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial. Care pathways of those surviving the acute episode of COVID-19 should include attention to cardiovascular health and disease.
Xie, Yan; Xu, Evan; Bowe, Benjamin; Al-Aly, Ziyad
Long-term cardiovascular outcomes of COVID-19
Nature Medicine (2022). DOI: 10.1038/s41591-022-01689-3
Copyright: © 2022 The authors. Published by Springer Nature Ltd.
Open access
Reprinted under a Creative Commons Attribution 4.0 International license (CC BY 4.0)
All the figures now show that vaccinated and boosted people are far less likely to catch COVID-19, far less likely to be seriously ill if they are unlucky enough to catch it and will recover more quickly, than unvaccinated people. In the UK, where 91.2% of people are vaccinated, although case numbers are relatively high due to the virulence of the Omicron variant which is now the dominant variant by far, hospitalisations are far lower than on much lower case numbers before the vaccination campaign, and patients need mechanical assistance with breathing have fallen from around 16% of hospitalised patients to around 3.3%, partly due to the lower morbidity of the Omicron variant but also because infection is less severe and recovery is quicker for vaccinated people.
SARS-CoV-2 particles isolated from a patient.
Credit: National Institute of Allergy and Infectious Diseases
Release: NIH-funded study suggests COVID-19 increases risk of pregnancy complications | NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development
According to a study by Torri D. Metz, M.D., of the University of Utah, Salt Lake City, and colleagues in the NICHD Maternal-Fetal Medicine Units Network:
Pregnant women with COVID-19 appear to be at greater risk for common pregnancy complications—in addition to health risks from the virus—than pregnant women without COVID-19.The study was funded by the US National Institutes of Health and included nearly 2,400 pregnant women infected with SARS-CoV-2. It found that:
…those with moderate to severe infection were more likely to have a cesarean delivery, to deliver preterm, to die around the time of birth, or to experience serious illness from hypertensive disorders of pregnancy, postpartum hemorrhage, or from infection other than SARS-CoV-2. They were also more likely to lose the pregnancy or to have an infant die during the newborn period. Mild or asymptomatic infection was not associated with increased pregnancy risks.
The findings underscore the need for women of child-bearing age and pregnant individuals to be vaccinated and to take other precautions against becoming infected with SARS-CoV-2. This is the best way to protect pregnant women and their babies.
The difference between pregnant women infected with the virus and those who were not infected was marked. Pregnant women with a moderate to severe illness, compared to uninfected women and women with mild or asymptomatic illness were about 50% more likely to need a caesarean delivery, almost twice as likely to deliver preterm and more than twice as likely to have a foetal or new-born death.
Diana Bianchi, M.D.
Director of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
Director of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
The study included more than 13,000 pregnant individuals from 17 U.S. hospitals, approximately 2,400 of whom were infected with SARS-CoV-2. Participants delivered between March 1 and December 31 2020, before SARS-CoV-2 vaccination was available. The researchers compared outcomes among those with COVID-19 to those from uninfected patients, and tabulated the study results as a primary outcome—whether the patient had died from any cause or had a serious illness or condition related to common obstetric complications. They also evaluated the results in terms of several secondary outcomes, including cesarean delivery, preterm birth, and fetal and newborn death. Compared to uninfected patients, those with moderate to severe COVID-19 were more likely to experience the primary outcome, (26.1 vs 9.2%). They were also more likely to deliver by cesarean (45.4 vs 32.4%) or preterm (26.9 vs 14.1%) or to have a fetal or newborn death (3.5 vs 1.8%). Mild or asymptomatic COVID-19 was not associated with any of adverse outcomes.The findings are published in the Journal of the American Medical Association, very sadly behind a paywall. However, it can be read freely online here and a PDF copy can be download from here.
The facts are now clear: vaccines hugely reduce the risk of serious, even fatal complications in pregnancy. Not only do they make it much less likely that someone will catch the virus and, if they are unlucky enough to, that the illness will be mild or asymptomatic, meaning that the risk during pregnancy is not significantly different to being uninfected.
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