Possibly the last thing you want to hear about is COVID! However, with more than 770 million cases reported globally to date, and with the increasing trend, COVID is a problem that is far from over . Therefore, knowing the implications that COVID can have on the risk of cardiovascular disease and how to prevent them is essential! With what we know now, when more than 3 years have passed since the start of the pandemic, there are at least 3 messages to remember about COVID: It has not disappeared, and it seems to have come to stay; It increases the risk of cardiovascular complications; Vaccination against COVID is the best way to prevent complications. COVID is here to stay The infection caused by SARS-Cov-2 will continue to be part of our daily lives and will be very difficult to eradicate. The number of cases may vary according to the time of year and region of the world, but as is the case with other viral infections, such as the flu, we have to learn to live with COVID in the years to come! In most cases, COVID has mild symptoms and up to 50% of infected patients may not even have symptoms. A small percentage of patients may develop serious complications, requiring hospital admission. It is estimated that in unvaccinated populations, mortality may vary between 2%-5%. There are groups at higher risk: The elderly, namely the age group over 80 years of age in which mortality can be 20 times higher than that of patients under 60 years of age. Chronic patients - heart and respiratory diseases, diabetes, obesity, among others - are at risk of complications from SARS-Cov-2 infection. These risk groups must pay particular attention to prevention measures, including the use of masks, frequent hand washing and, of course, vaccination. COVID increases the risk of cardiovascular complications We now know that COVID-19 is a risk factor for the development of cardiovascular disease . SARS-CoV-2 infection can cause complications in the acute or chronic phase of the disease, through different mechanisms. The virus can directly affect the heart and cause myocarditis, that is, infection and inflammation of the heart muscle, which can result in heart failure and arrhythmias. The systemic inflammatory reaction caused by the virus can cause damage to blood vessels and widespread formation of clots, increasing the risk of pulmonary embolism and acute myocardial infarction. The more serious the COVID infection, the greater the risk of cardiovascular complications! Furthermore, people with pre-existing heart disease are also at greater risk of having a more serious infection. After acute infection, persistent symptoms attributed to long COVID may also be due to the worsening of a pre-existing heart disease or the development of new cardiovascular manifestations. It is estimated that in the 12 months after acute infection, the risk of cardiovascular events increases by 50%-60% , so control and surveillance of risk factors and any existing heart disease are essential to minimize possible complications. Vaccination against COVID is the best way to prevent complications As with influenza, for which it is well established that vaccination prevents and reduces the severity of the infection, as well as the possible serious and fatal complications of the disease, also in the case of COVID, vaccination is today the best way to protect ourselves . Depending on the type of vaccine, the effectiveness against SARS-Cov-2 infection can be greater than 80% in the first months after administration of the first doses. We know that the effectiveness of the vaccine decreases over time after vaccination and hence the importance of annual revaccination. Some side effects of the vaccine have been reported on the heart, including myocarditis and pericarditis. These cases occur in 1 to 10 people for every million vaccines administered and are thought to be related to the body immunological reaction. The reported cases occurred predominantly in young people, between 12-17 years old and the majority are self-limited and with a benign evolution. As already mentioned, COVID is also associated with complications of myocarditis and pericarditis. However, in this case, the risk is 2-5 times higher than the risk of the same complications associated with the vaccine. And, when in doubt, the vaccine always has a lower risk than the disease itself ! In general, vaccination against COVID has proven to be safe and was the decisive factor in us being able to resume a normal life! For those with an already established cardiovascular disease, the risk of complications after COVID is higher. Also in this group, vaccination has been shown to reduce the risk of acute myocardial infarction and stroke, so there should be no doubt about the increased benefit in this patient population too! References Akhtar Z, Trent M, Moa A, et al. The impact of COVID-19 and COVID vaccination on cardiovascular outcomes. Eur Heart J Suppl 2023;25:A42-9. WHO Coronavirus (COVID-19) Dashboard . World Health Organization. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA 2020;323:1239-1242. Author : José Ferreira Santos Meet the cardiology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
