Heart damage plagues COVID-19 survivors one year after infection, study finds

The heart damage from Covid-19 extends far beyond the initial stages of the disease, according to a study which found that even people who have never been sick enough to require hospitalization are at risk of developing heart failure and fatal blood clots a year later.

Heart disease and stroke are already the leading causes of death around the world. The increased likelihood of fatal heart complications in Covid survivors – who number in the hundreds of millions worldwide – will add to its devastation, according to the study, which is being considered for publication by a journal Nature.

The risks of a heart attack, stroke, or other major cardiovascular event in the first 12 months of recovery from Covid increase with the severity of the initial illness

– Researchers

“The aftermath of Covid-19 is substantial,” said Ziyad Al-Aly, director of the Center for Clinical Epidemiology of the Veterans Health Care System in St. Louis, Missouri, who led the research. “Governments and health systems need to realize the reality that Covid will cast a shadow in the form of a long Covid, and has devastating consequences. I fear we are not taking this seriously enough.”

The risks of a heart attack, stroke, or other major cardiovascular event in the first 12 months of recovery from Covid increase with the severity of the initial illness, the researchers found. They compared the risks of heart complications in 151,195 veterans who survived Covid to the risk of more than 3.6 million of their peers who did not contract the pandemic disease.

The data was collected from the largest integrated healthcare system in the United States. Most of its users are white and male, which may limit the generalization of the study’s results to other groups, the authors said.

They found that out-of-hospital Covid patients had a 39% increased risk of developing heart failure and a 2.2 times higher risk of a potentially fatal blood clot, known as pulmonary embolism, the following year, compared to someone who has not developed the disease. This equates to 5.8 more cases of heart failure and 2.8 cases of pulmonary embolism per 1,000 Covid patients who have never been hospitalized.

Hospitalization for Covid is associated with a 5.8-fold increased risk of cardiac arrest and an almost 14-fold increased risk of myocarditis, inflammation or heart muscle, according to the study. Covid patients who have required intensive care are at significantly higher risk, with nearly one in seven suffering from a major adverse heart event that they otherwise would not have had within a year.

The increased risks of cardiovascular complications for 12-month Covid survivors compared to those not diagnosed with pandemic disease are listed below:

Researchers are still trying to unravel the causes of heart damage in Covid patients. Possible mechanisms include persistent damage from direct viral invasion of heart muscle cells and cells that line blood vessels, blood clots, and aberrant and persistent inflammation, the authors said.

Results from previous natural disasters and pandemics suggest that the indirect effects of Covid-19, including social isolation, financial distress, changes in eating and physical activity habits, as well as trauma and bereavement, may also influence the risks of cardiovascular disease, they said.