Kieran Quinn, MD, PhD, and his team recently published a study that revealed alarming long COVID findings. Their conclusions underscore the significant cardiovascular risks related to A-Fib. Our study shows that long COVID more than doubles the risk for developing new cardiac symptoms. This finding is alarming and highlights the potential long-term impacts of COVID-19 on heart health. This is particularly the case for those who have had acute infections with the virus.
This systematic literature review and meta-analysis, which included over 5.8 million individuals from 11 studies, found that … The results showed that those with a history of long COVID had a 2.3 to 2.5 increased risk of cardiac complications. Unfortunately, this increased risk creates a pressing need. Health care providers should keep in mind the potential cardiovascular impacts of COVID-19, even in acutely ill patients, as well as those who continue to experience symptoms.
Stanley Hazen, MD, PhD, was a principal investigator on this study. He claimed that people who have just recovered from life-threatening COVID-19 have comparable risks to those associated with coronary artery disease. Hazen reiterated how crucial it is to understand these implications in order to improve disease management and enable preventive care for patients.
The Impact of Severe COVID-19 on Heart Health
Quinn’s analysis found a direct correlation between hospitalization for COVID-19 and increased risk of MACEs. This result underscores how harmful COVID-19 can be to heart health. In pandemic times, this study showed that people with COVID-19 have a hazard ratio of 2.09 (P < .000005) for developing MACEs. Compared to those hospitalized because of the virus, they are at even higher risk— HR 3.85 (P < .0005).
Hazen highlighted that severe COVID-19 is a coronary artery disease risk equivalent, suggesting that patients recovering from serious infections should receive care similar to those diagnosed with traditional heart disease risk factors.
“Severe COVID is a coronary artery disease risk equivalent,” – Stanley Hazen, MD, PhD
Quinn voiced doubts about whether or not severe COVID-19 should be classified as an independent coronary artery disease risk factor. He mentioned, “I don’t think we have sufficient evidence to identify it as a separate risk factor. It just doesn’t stack up against more traditional ones, like smoking and diabetes and hypertension.” This complex view begs more exploration into the mechanisms at play behind COVID-19’s cardiovascular impacts.
Long COVID and Its Ramifications
About 15% of adult Canadians who get infected with SARS-CoV-2 will develop post-COVID conditions, or long COVID. Quinn’s results show a surprising link. Cardiac events among patients with severe COVID-19 equal to those in people with a history of heart attacks over three years of follow-up.
Quinn and his research team combed through massive online databases and pulled 260 articles. From there, they further honed in on five studies that really fit their analysis criteria. They wanted to arm clinicians with effective, evidence-based guidance. This guidance is aimed at adult clinicians addressing unexplained cardiac symptoms in patients with long COVID.
“My advice to all physicians caring for people living with long COVID is to use these guidelines to guide shared decision-making around testing and treatments,” – Kieran Quinn, MD, PhD
Cardiac events are just the tip of the iceberg. In patients requiring hospitalization for COVID-19, the one-year risk of venous thromboembolic disease dramatically increases with an adjusted hazard ratio of 1.77. Quinn noted that the burden of post-acute medical and mental health conditions among those who survived hospitalization for COVID-19 was comparable to other acute infectious illnesses, including chronic cardiovascular conditions like heart failure.
“Apart from an elevated risk of venous thromboembolism within 1 year, the burden of post-acute medical and mental health conditions among those who survived hospitalization for COVID-19 was comparable with other acute infectious illnesses,” – Kieran Quinn, MD, PhD
This emerging evidence suggests that a substantial share of post-acute consequences can be attributed to the severity of illness resulting in hospitalization. They are not necessarily the direct result of the virus per se.
Quinn and Hazen dug deeper into these alarming results and recommend applying more proactive management approaches. These strategies are focused on patients recovering from the most severe forms of COVID-19. Hazen is a strong proponent of much more aggressive cholesterol lowering—aiming for low-density lipoprotein levels below 70, or even lower. He encourages increasing antiplatelet therapy to a higher-than-usual level, advocating low-dose aspirin.
“We are arguing that if you had severe COVID, we should be treating these patients as if they have coronary artery disease and really escalate their preventive care,” – Stanley Hazen, MD, PhD
In particular, Quinn went on to emphasize how vaccination can help reduce the risks posed by COVID-19. Furthermore, he pointed out that their study sample was not able to evaluate vaccination effects. He agrees that vaccines probably increase the odds of avoiding bad infections overall, so they reduce his cardiac risk that way too.
“There is every reason to believe vaccines will attenuate this risk because they reduce the likelihood of serious infection,” – Kieran Quinn, MD, PhD
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