COVID-19 has been found to increase the risk of heart attack and stroke

An analysis of data in the UK Biobank has found that COVID-19 infection can increase the risk of heart attack, stroke and death from all causes for up to three years for people with and without cardiovascular disease, a report found today of the new study published in the peer-reviewed journal of the American Heart Association Arteriosclerosis, Thrombosis and Vascular Biology (ATVB).

We have identified a long-term cardiovascular health risk associated with COVID, particularly in people with more severe cases of COVID-19 that required hospitalization. This increased risk of heart attack and stroke persisted three years after COVID-19 infection. Remarkably, in some cases the increased risk was almost as high as that of a known cardiovascular risk factor such as type 2 diabetes or peripheral artery disease.”

James Hilser, MPH, Lead author of the study, Doctoral candidate at the Keck School of Medicine at the University of Southern California in Los Angeles

Previous research has shown that COVID-19 increases the risk of serious cardiovascular complications within the first month of infection. This study looked at how long the increased risk lasted and whether it subsided after recovery from a COVID-19 infection.

Researchers reviewed health and genetic data in the UK biobank of more than 10,000 adults, including about 8,000 who tested positive for the COVID-19 virus from February 1 to December 31, 2020, and about 2,000 who were hospitalized tested positive for the virus in 2020. For comparison, a group of more than 200,000 adults who did not have a COVID-19 infection in the British biobank during the same period were also examined. None of the participants were vaccinated at the time of infection as COVID-19 vaccines were not yet available in 2020.

The analysis showed:

• During the nearly three-year follow-up period, the risk of heart attack, stroke and death was more than twice as high in adults with COVID-19 and nearly four times higher in adults hospitalized with COVID-19 than in the adult group with no history of COVID -19 infection.
• People hospitalized with COVID-19 without cardiovascular disease or without type 2 diabetes had a 21% higher risk of heart attack, stroke and death compared to people with cardiovascular disease and without COVID-19 infection.
• There was a significant genetic interaction between non-O blood types and hospitalizations due to COVID-19. People with severe COVID-19 infections had an increased risk of heart attack and stroke. However, this risk was even higher in people with non-O blood types (people with blood types A, B, or AB).
• The risk of heart attack and stroke was about 65% higher in adults with non-O blood type than in adults with type O blood. A preliminary analysis did not show that Rh blood type (positive or negative) interacts with severe COVID-19, the authors stated.

“Over a billion people worldwide have already experienced a COVID-19 infection. The reported results do not represent a small impact in a small subgroup,” said co-senior study author Stanley Hazen, MD, Ph.D., chair of cardiovascular and metabolic disease sciences at Cleveland Clinic Lerner Research Institute and deputy director of the preventive cardiology. “The results covered nearly a quarter of a million people and suggest a finding of global health importance that may explain the global increase in cardiovascular disease.”

Study details, background and design:

• Health data comes from the UK Biobank, a large-scale study of 503,325 adults living in the UK who were 40 to 69 years old at enrollment between 2006 and 2010. The detailed health and biomedical information was collected for the participants registered in the UK National Health Service with a UK GP (similar to a GP in the US).
• This analysis included health data from 10,005 adults who tested positive for the COVID-19 virus or were hospitalized with COVID-19 between February 1, 2020 and December 31, 2020. A further 217,730 peers enrolled in the UK Biobank who did not have COVID-19 during the same period were included. During the analysis, all participants were matched as closely as possible on demographics and similar health conditions.
• Serious adverse cardiovascular events (myocardial infarction, stroke and death from any cause) were assessed for long-term risk until October 31, 2022, approximately three years later.

“This interesting paper is actually two studies in one,” said Sandeep R. Das, MD, MPH, MBA, FAHA, co-chair of the American Heart Association COVID-19 CVD Registry Committee and director of quality and value in the Division of Cardiology for UT Southwestern Medical Center in Dallas. “First, the authors show that hospitalization with COVID is an indicator of increased cardiovascular risk, equivalent to a pre-existing diagnosis of cardiovascular disease. However, it is very difficult to find out direct cause and effect in a study that has only one direct cause and effect.” Analyzing previous data collected for other purposes, this result is important because it suggests that a previous COVID hospitalization, even without a history of cardiovascular disease, should be considered to initiate and potentially accelerate efforts to prevent cardiovascular disease. “The effects on the vascular system are also an interesting area of ​​research,” said The.

“The second ‘study’ in this work looks at the association between ABO blood type and COVID outcomes. They show that something close to the genetic home of the ABO blood type is associated with varying degrees of susceptibility to COVID. This is really fascinating, and I look forward to seeing scientists figure out what the specific pathway might look like.”

The study had several limitations, including that the data came from patients who had the original strain of the COVID-19 virus before vaccines were widely available in 2021. In addition, the researchers found that the UK Biobank information on drug use was not specific to the beginning of the pandemic in 2020 or the date that patients were infected with the COVID-19 virus. Additionally, as the majority of participants in the UK Biobank are white, further research is needed to confirm that these results are applicable to people from different racial and ethnic backgrounds.

“The results of our study highlight the long-term cardiovascular effects of COVID-19 infection. Given the increased risk of heart attack, stroke and death, the question arises as to whether or not severe COVID-19 should be considered another risk factor for cardiovascular disease.” “, similar to type 2 diabetes or peripheral arterial disease, “Where treatment aimed at preventing cardiovascular disease may be valuable,” said co-senior study author Hooman Allayee, Ph.D., professor of population and public health sciences at the University of Southern California Keck School of Medicine in Los Angeles. “The results suggest that people with a previous COVID infection may benefit from preventive treatment for cardiovascular disease.”