Journal: Nature

Publishing date: February 7, 2022

Authors : Yan Xie et.al

Long term cardiovascular complications have been found to be higher in patients who have had COVID-19 infection regardless of pre-existing risk factors.

Why does this study matter?

This cohort study conducted by Yan Xie et al on long-term cardiovascular outcomes of COVID-19 showed that beyond the first 30 days of infection, people with COVID-19 exhibited increased risks and 12-month burdens of incident cardiovascular diseases including cerebrovascular disorders, dysrhythmias, inflammatory disease of heart or pericardium, ischaemic heart disease, heart failure, thromboembolic disease, and other cardiac disorders. 

Study Design

The study was conducted using the 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. 

Results and Conclusion

1. The risks were evident regardless of age, race, sex, and other cardiovascular risk factors, including obesity, hypertension, diabetes, chronic kidney disease and hyperlipidemia. 

2. The risks were also evident in people without any cardiovascular disease before exposure to COVID-19, providing evidence that these risks might manifest even in people at low risk of cardiovascular disease

3. Analyses of the risks and burdens of cardiovascular outcomes across care settings of the acute infection revealed two key findings: 

1. The risks and associated burdens were evident among those who were not hospitalised during the acute phase of the disease—this group represents the majority of the people with COVID-19.
2. The risks and associated burdens exhibited a graded increase across the severity spectrum of the acute phase of COVID-19 (from non-hospitalised to hospitalised individuals to those admitted to intensive care). 

4. The risks and associated burdens were consistent in analyses considering the contemporary control group and, separately, the historical control group as the referent category.

5. Risk of myocarditis and pericarditis without COVID-19 vaccination: Because some COVID-19 vaccines might be associated with a very rare risk of myocarditis or pericarditis, measures were taken to eliminate any putative contribution of potential vaccine exposure to the outcomes of myocarditis and pericarditis in this study. The results showed an increased risk of myocarditis regardless of vaccination status.

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