COVID-19 Patients Retain Elevated Risk of Death for 1.5 Years After Acute Infection
New research definitively linked COVID-19 infection to a heightened risk of cardiovascular disease and death—both short- and long-term.
The study, published in Cardiovascular Research, evaluated the association between COVID-19 and development of cardiovascular disease and mortality.
“COVID-19 patients were more likely to develop numerous cardiovascular conditions compared to uninfected participants, which may have contributed to their higher risks of death,” said Ian C.K. Wong, BSc (Hons) Pharmacy, MSc, PhD, a professor at the University of Hong Kong and an author of the study.
The prospective cohort study consisted of a general population of 7584 COVID-19 patients, recruited between March 16-November 30, 2020. The participants were recruited from UK Biobank, and followed until August 31, 2021 (up to 18 months).
The COVID-19 patients were randomly matched with up to 10 participants without COVID-19 from 2 cohorts. The contemporary cohort, from March 16-November 30, 2020, never contracted COVID-19 during this time. There was also a historical cohort, from March 16-Movember 30, 2018, to ensure adequate controls.
“The historical control cohort was included to rule out the effect of routine healthcare services being reduced or cancelled during the pandemic, which led to worsening health and increased mortality even in uninfected people,” explained Wong.
The COVID-19 patients were matched with the 2 control groups by age within 5 years and sex. Additionally, the more than 70000 non-COVID-19 participants were similar to the COVID-19 patients for smoking, diabetes, ethnicity, high blood pressure, body mass index, deprivation, and cardiovascular and other health conditions. All study patients averaged 66 years of age and there were nearly equal numbers of men and women.
The investigators utilized Cox regression to determine the association of COVID-19 with cardiovascular disease and death within 21 days of diagnosis (acute phase) and beyond (post-acute phase).
In the short-term acute phase, the risk of cardiovascular disease was 4.3 times higher in the COVID-19 cohort than in the control groups. Staggeringly, the COVID-19 patients were also 81.1 times more likely to die in the acute phase than the contemporary and historical cohorts.
In the post-acute phase, the COVID-19 patients’ risk of cardiovascular disease was 1.4 times higher than both control groups, and their risk of mortality was 5.0 times higher.
Among the COVID-19 patients, disease severity was also a significant indicatory of heart disease and mortality. Participants with severe COVID-19 were more likely to develop major cardiovascular disease and/or die than non-severe cases.
The fact that the risk of death for COVID-19 patients remained 5-fold higher at 18 months after acute infection merits close monitoring and further study.
“The findings indicate that patients with COVID-19 should be monitored for at least a year after recovering from the acute illness to diagnose cardiovascular complications of the infection, which form part of long COVID,” said Wong.
