COVID-19 may result in long-term heart issues
As the COVID-19 pandemic enters its third year, scientists are finding that the coronavirus has far-reaching effects on health beyond the acute phase of illness. One recent study has found that people with COVID-19 are at an increased risk for cardiovascular diseases for at least a year after recovery.
The study, published this month in the journal Nature Medicine, used data from U.S. Department of Veterans Affairs national health care databases to follow over 153,000 veterans with a history of COVID-19 infection for up to a year after their recovery.
Compared with those who were never infected, people who had a coronavirus infection were more likely to have symptoms, including inflammatory heart disease, heart failure, dysrhythmia, heart attacks, strokes and clotting, in the long term. People with prior COVID-19 infections were more than 60% more likely to develop any cardiac issue. Many of these conditions, such as pulmonary embolisms, are life-threatening.
“One thing that was sobering was that the risk was evident even in people who had very mild disease or did not need hospitalization,” said lead researcher Dr. Ziyad Al-Aly, chief of research and development at the VA St. Louis
Health Care System.
As disease severity increased, so did the risk of cardiovascular complications in the long run. People who had been treated in an ICU had the highest risk for cardiovascular disease after recovery. For example, people who weren't hospitalized were twice as likely to have a pulmonary embolism than people who had not had COVID-19, and those treated in the ICU were more than 21 times more likely to have one. This risk for problems was also found across all ages, sexes, races and cardiac risk factors
such as smoking, high blood pressure and obesity.
People with a history of COVID-19 infection were more than five times more likely to develop myocarditis — inflammation of the heart muscle — a year later. Although studies have shown that myocarditis may be a rare reaction to an mRNA vaccine, this research found that risk of myocarditis from COVID-19 infection was evident regardless of vaccination status.
Although the study had a robust sample size, most of the people in the research were White men. In addition, because the study enrollment period ended on Jan. 15, 2021, before COVID-19 vaccinations were widely available, almost none of the participants was vaccinated before infection.
According to Al-Aly, dysrhythmias, such as atrial fibrillation, were the most common cardiac issues after infection.
“In my own practice, I was more likely to see people who had more of the arrhythmias or report a rapid heartbeat after the COVID infection. Many times, over several months, the heart rate came down and improved,” Dr. Nieca Goldberg, an NYU Langone cardiologist and the medical director of Atria New York City, told CNN. She was not involved in the new study.
According to Goldberg, people who've had COVID-19 and other viral infections can develop a condition called postural orthostatic tachycardia syndrome, or POTS, in which someone's heart rate spikes when they stand up. With proper hydration, these symptoms will usually improve on their own. Some people who continued to have symptoms required treatment with medications, Goldberg said.