Study: Severe COVID raised risk of heart attack, stroke as much as having heart disease

People hospitalized for COVID-19 early in the pandemic suffered an increased risk of serious “cardiac events” such as heart attacks and strokes that was akin to people with a history of heart disease, a newly released study has found.

Researchers from USC, UCLA and the Cleveland Clinic analyzed more than 10,000 COVID cases tracked by the UK Biobank to examine how COVID affected the risk of heart attacks and other cardiac threats.

Their study, released Wednesday in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, assessed outcomes for people sickened in the first year of the pandemic and followed for a period of nearly three years.

The findings underscore that among “people who don’t have any evidence of heart disease, having severe COVID put them at a significantly increased risk of heart attack, stroke and death,” said principal investigator Hooman Allayee, professor of population and public health sciences at USC’s Keck School of Medicine.

Among the most striking findings: Being hospitalized for COVID in 2020 amplified the risk of heart attacks and other cardiac events so much that it ended up being comparable to people who had a history of heart disease but who hadn’t gotten COVID, the study found.

Although the analysis showed that the added risk was especially stark among people with severe cases, researchers stressed it was still apparent for patients who had gotten any form of COVID.

Such risks were roughly twice as high in people who had gotten COVID at all levels of severity, and four times as high for hospitalized cases, compared with people who hadn’t gotten COVID, the study found.

The study indicates that the increased risk “shows no apparent signs of attenuation up to nearly three years after SARS-CoV-2 infection and suggest that COVID-19 continues to pose a significant public health burden with lingering adverse cardiovascular risk,” they wrote.

Scientists also found that the risk differed by blood type: Being hospitalized for COVID ramped up the risks among people with blood types A, B or AB more than it did among people with type O blood.

“Your genetics actually plays a role in this increased risk of developing future heart attacks and stroke,” said James Hilser, a Keck doctoral candidate in biochemistry and molecular medicine who helped write the paper.

Researchers said their findings could help shape how doctors try to head off such health problems in the future. Doctors routinely offer preventative treatment to patients with medical conditions such as cardiovascular disease or diabetes that put them at a higher risk of heart attack or stroke.

Allayee said that if someone walks into a doctor’s office and is newly diagnosed with diabetes, “it doesn’t matter what their cholesterol is … They get put on a lipid-lowering medication. They get put on a baby aspirin.”

But when physicians think about preventing heart attacks, “nobody is taking into consideration COVID — whether it’s severe or otherwise — in how to manage a patient,” Allayee said. In light of the findings, he said, “this is something that doctors should be discussing,” as should regulatory bodies for cardiac care.

The study, which was funded by the National Institutes of Health, had some limitations: It examined only COVID cases early in the pandemic before vaccines became available. (Another study published earlier this year, which also relied on the UK Biobank data, found that the incidence of heart attacks and strokes was generally lower after each dose of a COVID vaccine.)

Researchers also cautioned that some COVID patients may have had undiagnosed heart disease when they were hospitalized, which would not be evident in the UK Biobank data.