February 16, 2022 Author : Victor Gil A lot of information is now available about the short-term sequelae of the SARS-CoV-2 infection, which causes COVID-19, for different organic systems. Over time and with the high volume of data available, we are now beginning to have a clearer picture of the disease sequelae in longer periods after infection and of the implications these can have on health care. A paper recently published in Nature reveals that in patients who have had COVID-19, the cardiovascular risk is quite high in the year following infection. A large population studied For this study, the authors used data from the US Department of Veteran Affairs database and compared a group of patients who had COVID-19 with two control groups : 153 thousand patients who had COVID-19 (131 thousand not hospitalized, 16 thousand hospitalized, 5 thousand admitted in intensive care units), studied for a year starting 30 days after infection; Contemporary group, with around 5.5 million people who were not infected; Historic group, from 2017, also with around 5.5 million people. These groups were c ompared for the occurrence of a previously specified set of cardiovascular events within one year. Importance of the results obtained Among the results obtained for the 12-month period in the group of 153,000 patients who had COVID-19 the following stood out: Cerebrovascular diseases : increased risk of stroke of 52% and of transient ischemic attacks of 49%; Ischemic heart diseases : increased risk of acute coronary disease by 72%, of myocardial infarction by 63%, of ischemic cardiomyopathy and of angina; Arrhythmias : increased risk of atrial fibrillation by 71% and of other heart rhythm disorders; Inflammatory heart diseases : increased risk of pericarditis and myocarditis; Other heart diseases : increased risk of heart failure by 72%, of non-ischemic cardiomyopathy by 62%, of cardiac arrest and cardiogenic shock; Thromboembolic events : increased risk of pulmonary embolism, superficial and deep venous thrombosis. This increased risk of cardiovascular events in the year after the acute illness COVID-19: Occurs even in patients who did not need inpatient hospital care . It was even more important in patients who required hospitalization and peaked in those who were admitted to intensive care units; Happens r egardless of age, race, sex and other cardiovascular risk factors , such as obesity, hypertension, diabetes, among others; It is also evident in people with no evidence of cardiovascular disease prior to COVID-19. What are the implications of these findings for cardiovascular follow up? Although this study has some limitations regarding the population studied (mostly white and male individuals), which may somehow limit the generalization of its results, it is a large scale study, which involved more than 150 thousand people infected with COVID-19 and compared their cardiovascular risk with that of about 11 million other people. For this reason and because the prognosis for cardiovascular risk in the longer term is still unknown, these numbers that suggest t he need of cardiovascular follow up of patients infected with COVID-19, even when they had a low risk before the disease , should deserve our attention. Cardiovascular follow up of people who have had COVID-19, regardless of their previous risk, should therefore be considered . Source Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19 . Nat Med 2022. doi: 10.1038/s41591-022-01689-3. Meet the cardiology clinical team from Hospital da Luz network and book your consultation. 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.
