People who have had Covid-19 are at higher risk of developing cardiovascular disease, and it can happen a year after infection, according to an analysis of US health data by Washington University researchers.
Those complications include disruptive heart rhythms, inflammation of the heart, blood clots, stroke, coronary artery disease, heart attack, heart failure or even death, said the study published in the journal Nature Medicine on Monday.
The researchers said previously healthy people and young people were among those who had developed such heart problems.
Senior author Ziyad Al-Aly, an assistant professor at Washington University's School of Medicine in St Louis, said governments and health systems should be prepared to deal with "the likely significant contribution" of the Covid-19 pandemic to a rise in cardiovascular disease.
"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 wrote on Twitter on Monday. "Addressing the challenges posed by long Covid will require a much needed, but so far lacking, urgent and coordinated long-term global response strategy."
For the study, the researchers analysed anonymous medical records in a database kept by the US Department of Veterans Affairs. They looked at the records of 153,760 people who had tested positive for Covid-19 from March 1, 2020 to January 15, 2021. This health information was compared with that of two control groups: more than 5.6 million patients who did not have Covid-19 during that period; and over 5.8 million people who were patients in 2017, before the pandemic.
The study did not give details of which coronavirus variants people were infected with or how many had been vaccinated, but vaccines were not widely available in the period and the Delta and Omicron strains had yet to emerge.
Heart health was followed and analysed over a period of about a year. The researchers found that cardiovascular disease - including heart failure and death - occurred in 4 per cent more people who had been infected with Covid-19 than who had not.
Compared to those in the control groups, people who had contracted Covid-19 were 72 per cent more likely to suffer from coronary artery disease, 63 per cent more likely to have a heart attack, and 52 per cent more likely to have a stroke.
The researchers said the risk of developing heart problems after having Covid-19 was evident regardless of age, sex and other cardiovascular risk factors - including obesity, hypertension, diabetes and chronic kidney disease - and could develop in people who had not previously had cardiovascular disease.
They said the risk was also evident among those who had not been hospitalised during the acute phase of the disease - a group representing the majority of people who have had Covid-19. And the risk increased according to the severity spectrum of Covid-19 they experienced, from non-hospitalisation to hospitalisation and intensive care.
Can existing vaccines keep long Covid at bay?
The researchers concluded there was substantial risk of developing cardiovascular problems after going through the acute phase of Covid-19, even after a year, and that care strategies after infection should include attention to heart health and disease.
"The findings emphasise the need for continued optimisation of strategies for primary prevention of Sars-CoV-2 infections," the authors wrote, referring to the virus that causes Covid-19. "The best way to prevent long Covid and its myriad complications, including the risk of serious cardiovascular sequelae, is to prevent Sars-CoV-2 infection in the first place."
Given the growing number of people globally with Covid-19, this risk could potentially affect a large number of people around the world, according to the researchers.
More than 397 million people have been infected with the virus worldwide, with more than 5.75 million deaths, since the pandemic began.
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