COVID-19, even mild, associated with heart complications up to a year post-infection, study finds

COVID-19 infection heightens risk of cardiovascular complications, with dysrhythmia the most common individual outcome seen in patients analyzed, according to the study.

The study, published in Nature Medicine, evaluated the long-term cardiovascular outcomes associated with a coronavirus infection. It relied on data from the U.S. Department of Veterans Affairs to analyze veterans with COVID-19 and various cardiovascular diseases for up to a year after infection. In total, 2021 data on more than 153,000 veterans with COVID-19 were analyzed. 

“The surprising thing is that COVID-19 can result in all of these chronic conditions,” said Ziyad Al-Aly, M.D., a researcher on the study and chief of research and development at the Veteran Affairs St. Louis Health Care System. He was especially surprised to see that these outcomes can be present even among those who had not been hospitalized for the infection—such as someone with a mild case. 

Dysrhythmia was the most common individual outcome seen in patients, while MACE (major adverse cardiac events) was the most common if taken as a category of several outcomes. Patients in intensive care were most likely to develop complications compared to those hospitalized but not in the ICU or those not hospitalized. Those in the ICU developed dysrhythmia at a notably higher rate than their counterparts.

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The findings highlight the best way to prevent complications is to prevent COVID infection to begin with.

“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,” the study said. “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.”

Fatima Rodriguez, M.D., a volunteer expert for the American Heart Association and an assistant professor at the Stanford University School of Medicine, cautioned that despite the careful statistical techniques used by the researchers, patients with a COVID-19 infection were also likely more frequently screened for heart problems.

Nonetheless, “we should all be prepared to deal not only with the cardiovascular sequelae of COVID infections but also with the consequences of delayed routine cardiovascular care,” she said.

Because the best way to mitigate the possibility of complications is avoiding infection, she added, widespread public health campaigns are needed to continue vaccinations and other cautionary measures.

“Given the large number of infected patients, even rare cardiac manifestations and late-term consequences can have profound impacts on our health system,” Rodriguez said.