'We feared this already'
Those who have gone through corona are more likely to have a heart attack
2 hours 33 minutes ago - Updated: 6 seconds ago
It is what cardiologists already feared: some of the people who seem to have recovered from corona turn out to have an increased risk of cardiovascular disease after the infection. The world should therefore be prepared for an increase in people with these heart problems, scientists warn. "The numbers involved are really significant."
The study, conducted by Washington University School of Medicine and others, was published earlier this week in
Nature Medicine. The researchers looked at the medical records of 153,760 people who tested positive. They compared them over a one-year period with people who did not have corona.
72 percent greater chance of heart failure
The researchers' conclusion is firm. People who had experienced a corona infection were 63 percent more likely to have a heart attack, 84 percent more likely to have an arrhythmia of the ventricles and 72 percent more likely to have congestive heart failure than people without corona.
Heart disease was actually 4 percent more common. "Some people may think 4 percent is little, but it's not, given the magnitude of the pandemic," one of the authors, Ziyad Al-Aly, told
Science Daily.
In the U.S. alone, this means 3 million new heart patients, and an estimated 15 million worldwide. These are diseases that are permanent, and therefore don't just go away.
'Very large numbers'
We put the figures to two Dutch experts. Marijke Linschoten, physician-researcher at UMC Utrecht: "If you look at this study, an average of 3 to 10 additional cases of heart attack, heart failure or arrhythmia of the ventricles were identified for every thousand people who had experienced corona. When you consider how many millions of people have now had corona, that would be very large numbers in practice." She adds: in daily practice in the hospital, this is not yet directly reflected.
"These are significant numbers," also says Harald Jorstad, a cardiologist at Amsterdam UMC. "We were already preparing for this. We already feared this." He explains that it has long been known that corona can cause problems during the acute phase of infection. This concerns, for example, people with cardiovascular disease who become sicker. It is also known that scarring of the heart can occur.
But this study is much broader. It involves problems that arose after 30 days. "What you see here: the virus is much more than the acute form of being sick," says Jorstad. "We also need to pay attention to the aftermath, such as pulmonary covid and the impact on the cardiovascular system."
In non-vulnerable youth as well
Why some get heart problems and others don't needs to be investigated. The most striking thing according to the researchers is that people who never had heart problems before and who were not considered vulnerable, also developed heart problems after a corona infection.
Heart problems thus occurred not only in old people but also in young people. And also in people without obesity and people without diabetes. Cardiovascular disease was also found in people who had had a mild infection.
Exercise, exercise, exercise
According to cardiologist Jorstad, this research indicates that the cause of heart problems must be sought much more broadly. He stresses the importance of a healthy lifestyle.
"This should be a wake-up call. Make work of your good intentions. Ask yourself the question: what can you yourself do to live a healthier life? Well, that is exercise, exercise, exercise. And eating healthy, maintaining a healthy weight, not smoking and checking your cholesterol and blood pressure. Something has to be done about the unhealthy lifestyles that are present in society, that underlie almost all cardiovascular disease." Prevention is an understudied issue in the Netherlands, he argues. "Corona is not solved with one miracle drug."
Long-term implications
Researcher Ziyad Al-Aly suggests that people who have recovered from corona should be closely monitored. And governments must be ready to handle the increase in patients, he writes
on Twitter. He fears long-term consequences for patients and health systems. It will also affect the economy and life expectancy.
Suppose you've had corona, do you need to be extra vigilant? Cardiologist Jorstad "If you get chest pain four months later during exercise, you should have that looked at. It could be a thousand things, so we don't need to send everyone to the cardiologist right away, but it's important to have this evaluated by an expert at the family doctor's office."
The best way to prevent problems with the heart, according to the researchers, is simple: first of all, make sure you don't get infected by the virus. Cardiologist Jorstad wants to take the opportunity to advise people to really get vaccinated after all. "The message seems clear to me," he says.
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Study deals with the first corona wave
For the study, published in Nature Medicine, the scientists analyzed anonymized medical records in a database maintained by the U.S. Department of Veterans Affairs. The researchers created a data-set containing health information from 153,760 people who had tested positive for corona between March 1, 2020, and January 15, 2021, and who had survived the first 30 days of the disease. Very few of the people in the study had been vaccinated before developing corona because vaccines were not widely available at the time of enrollment.
"So this data was collected in the time before the vaccination campaign, at the beginning of the pandemic," says Jorstad. "We don't know which variant was at play here. We also can't translate this directly to omicron. We're all waiting for positive news, but whether omicron and the vaccination will ensure that the problems are less severe now, we won't know until, say, two years from now."
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Large Dutch study
Marijke Linschoten, physician-researcher at UMC Utrecht believes it is important that more studies are done on the long-term effects of corona on the heart and vessels. "It is crucial that we look at whether other studies show the same results. At the moment, such studies are still very scarce."
UMC Utrecht and the Dutch Cardiovascular Alliance (DCVA) have themselves been conducting a large nationwide study since September. It looks at anonymized data collected during the first wave of the pandemic, enriched with data on causes of death and hospitalizations. It covers 40 percent of all patients who ended up in the hospital at the time.
"Also, since May last year, as part of another study, we have been looking at people who are hospitalized to see how often heart damage can be identified. Hopefully this will also allow us to learn more about any differences between the first corona variant and delta and omicron."
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