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Long Term Cardiovascular Outcomes of COVID-19



The title of today's post is the title of a recently released research paper that has hit the COVID-19 world by storm. In just 3 days since its release the article has been accessed by 94K people. It has been tweeted just over 14000 times. Over 100 news outlets have cited it. So why the huge buzz?


The team led by Dr Ziyad Al-Aly (who is a huge Long Covid advocate)

studied a cohort of more than 153 000 people with Covid-19. They also had 5.6 million controls with no evidence of infection (non-COVID-19 infected people during the pandemic) and 5.8 million historical controls (non-COVID-19 infected people pre pandemic). These huge numbers make the results highly significant.

The cohort consisted of people from the US Veterans Health Administration. They looked at people who were infected with Covid-19 who were admitted to ITU, hospitalised and, my favourite part, NON-HOSPITALIZED (yay!). Here is what they were able to show:


1. There are increased risks of a wide range of cardiovascular diseases at one year post infection


These diseases included:

  • Cerebrovascular disorders - such as Transient Ischaemic Attacks and Strokes

  • Dysrhythmias - such as Atrial Fibrillation, Sinus Tachycardia, Sinus Bradycardia, Ventricular arrhythmias and Atrial Flutter

  • Ischaemic Heart Disease - such as Angina, Acute Coronary Syndrome, Myocardial Infarction

  • Inflammatory Heart Disease - such as Myocarditis and Pericarditis

  • Heart failure and Cardiomyopathy

  • Thrombotic Disorders -such as Pulmonary Embolism, Deep Veins Thrombosis and Superficial Vein Thrombosis.


Where are you on this chart? I have sinus bradycardia, sinus tachycardia, ventricular ectopics and angina.


2. The risks of cardiovascular diseases were evident in ALL subgroups

  • Young and old

  • White and People of Colour

  • Males and Females

  • Overweight or not overweight

  • Smoker or non-smoker

  • Diabetic or not diabetic

Hopefully this will debunk some common myths about who is at risk.



3. The risks were evident in people who had NO prior history of any cardiovascular disease

- see the last line of the above chart


4. The risks were evident in people who did not need hospitalisation or ICU care during the acute phase of the infection




This is probably seen more clearly in the following chart:


MACE = Major Adverse Cardiovascular Event


I'll conclude this post with words from Dr Al-Aly himself;


"Governments and health systems around the world should be prepared to deal with the likely significant contribution of the Covid-19 pandemic to the rise in the burden of cardiovascular diseases. Because of the nature of these conditions they will likely have long- lasting consequences for patients, health systems and also have broad implications on economic productivity and life expectancy.
Addressing the challenges posed by LONG COVID will require a much needed, but so far lacking, urgent and coordinated long -term global response strategy.
We need a LONG COVID Moonshot".


Reference

https://www.nature.com/articles/s41591-022-01689-3

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