COVID-19 infection linked to heightened risk of poor cardiovascular health and death: UK study


A large UK Biobank study, published online in the journal, found that COVID-19 infection is associated with a subsequent increased risk of poor cardiovascular health and death, particularly among those with severe infection requiring hospitalization. heart.

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The results indicate that the risk, independent of known contributing factors, is greatest during the first 30 days of infection, but remains high for some time afterward.

Emerging evidence suggests that people who have been infected with COVID-19 are at increased risk of developing subsequent cardiovascular problems. But these studies tend to be mostly retrospective, to include only a few select health outcomes, and to exclude consideration of the severity of COVID-19.

To explore these issues further, the researchers relied on 53,613 UK Biobank participants, of whom 17,871 had been diagnosed with COVID-19 infection between March 2020 and March 2021, and 35,742 of whom were not.

COVID-19 cases have included more men, less wealthy people, and poorer heart and bone profiles.

The UK Biobank tracks the health and survival of its participants through medical records and death registration data.

Of the 17,871 COVID-19 cases, 2701 required hospitalization due to being infected; 866 people were hospitalized due to another condition; And 14304 do not require hospital treatment.

All participants were tracked until a cardiovascular problem developed, or died, or until the end of March 2021, providing 141 days of monitoring, on average, but ranging from 32 to 395.

Cardiovascular outcomes included: Heart attack. brain attack; heart failure; atrial fibrillation (Arrhythmia); VTE (A blood clot in a vein); Pericarditis (inflammation of the lining of the heart). death from any cause; Death from cardiovascular disease or ischemic heart disease.

Compared with their matched peers who did not have the virus, those who did not require hospitalization for COVID-19 infection were three times more likely to develop a blood clot in a vein (VTE) and more than 10 times more likely to die from any cause.

But those hospitalized with COVID-19 had a higher risk for all outcomes considered regardless of potential influencing demographic and metabolic factors.

They were 27 times more likely to have venous thromboembolism, 21.5 times more likely to be diagnosed with heart failure, and 17.5 times more likely to have a stroke. The risk of newly diagnosed atrial fibrillation was about 15 times higher, the risk of developing pericarditis was about 14 times higher, and the risk of heart attack was about 10 times higher.

The risks of all outcomes measured among those who were admitted for other reasons but had COVID-19 were also higher than among people who did not have the virus.

But their risk of dying from any cause was lower than that accepted for COVID-19, although the risk of dying from cardiovascular disease or ischemic heart disease was higher, which is likely related to the original cause of admission rather than COVID-19 itself, researchers. They also have a higher risk of atrial fibrillation and heart attacks.

Unsurprisingly, deaths were higher among people with COVID-19 infection: those admitted with the virus as the primary cause were 118 times more likely to die than those who did not require hospital treatment, while those diagnosed with COVID- 19 was a secondary diagnosis. He was 64 times more likely to die.

Most diagnoses of cardiovascular disease, particularly atrial fibrillation, venous thromboembolism, pericarditis, and death from any cause occurred within the first 30 days of infection and among those hospitalized with COVID-19 as the main cause.

But the increased risks remained beyond 30 days, particularly for heart failure, atrial fibrillation, venous thrombosis, pericarditis, and all-cause mortality, albeit to a lesser extent.

This is an observational study, so no definitive conclusions can be drawn about cause and effect. The analysis also did not consider other influencing factors such as the effect of vaccination, novel viral variants, or serial infection.

But the researchers note: “The long-term consequences of previous exposure to COVID-19 emerge as a dominant public health concern. Our findings highlight increased cardiovascular risk in individuals with prior infection, which is likely to be greater in countries with limited access to vaccination and thus greater exposure of the population to COVID-19.”

But they add: “These risks are almost entirely limited to those with illness requiring hospitalization and are highest in the early (first 30 days) post-infection period.”

In a related editorial, doctors from the University of Edinburgh’s Center for Cardiovascular Sciences, UK, consider the therapeutic implications of the findings.

“The thrombotic effects of COVID-19 already raise the question of whether anticoagulant strategies are necessary to prevent such a large excess of events,” they wrote.

They add, “Perhaps the broader question is whether anticoagulant therapies should be considered in all individuals, including initiation of antiplatelet or anticoagulant therapies.”

“The duration of treatment is clearly relevant, and these data question whether 7 days of prophylactic anticoagulation is sufficient for patients with COVID-19.”

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