While people infected during the first wave of COVID are at a high risk of heart attack and stroke, the study also found that a person's blood type is also a factor in it.
Published Oct 14, 2024 | 7:00 AM ⚊ Updated Oct 14, 2024 | 7:00 AM
People infected during COVID first wave more at risk of heart attack
The COVID-19 pandemic, which has killed millions of people and infected over 700 million worldwide, has also had significant financial and psychological impacts.
Likewise, the pandemic’s effects on COVID-infected patients continue to linger, long after they test negative and recover. In recent years, there have been numerous reports of young individuals suffering from strokes and heart attacks.
Now, a new study has found that the infection may have increased the risk of heart attack, stroke, and death from any cause for up to three years since the infection. The increased risk applies even to people who do not have a pre-existing cardiovascular disease.
The risk for individuals who recovered from the infection without needing to be hospitalised is twofold while the risk for ones who had to be hospitalised to recover is fourfold.
“Worldwide, over a billion people have tested positive for COVID so far. The findings are not a small effect on a small subgroup,” said the study’s co-author Stanley Hazen in a statement.
“The study included nearly a quarter of a million people and points to a finding of global healthcare importance and can translate into a rise of cardiovascular diseases globally.”
This research, led by the Cleveland Clinic and the University of Southern California (USC), was published in the American Heart Association’s peer-reviewed journal Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
The researchers utilised data from the UK Biobank, analysing 10,005 individuals who had COVID and 2,17,730 individuals who were not infected between February and December 2020.
Previous research had already shown that COVID-19 increases the risk of serious cardiovascular complications within the first month of infection. This new study focused on understanding how long this increased risk persists and whether it decreases over a period of time.
It is important to note that, a study by the Indian Council of Medical Research (ICMR) in November 2023 suggested that the increasing number of young adults dying from sudden heart attacks is not related to COVID-19 vaccination.
After a surge of youngsters in India dying due to unexplained heart attacks, a much-anticipated study was initiated earlier this year, driven by public’s concern that these incidents might be linked to COVID-19 vaccination.
“There was a lot of apprehension among people about vaccines leading to an increase in sudden deaths. Several reports were coming out. Therefore, it was important to undertake this study and empirically show that such sudden deaths are not linked to COVID vaccination,” said Dr. Manoj Murhekar, the study’s co-author.
Certain genetic variants are already known to be linked to coronary artery disease, heart attack, and COVID-19 infection.
In this context, the study conducted a genetic analysis to determine whether those genetic variants contribute to an increased risk of coronary artery disease after COVID-19. Research revealed that it is not a factor.
However, it highlighted a significant association between elevated risk of cardiovascular disease and blood type in COVID recovered individuals.
The study found that individuals with blood types A, B, or AB were twice as likely to experience cardiovascular events following COVID-19 compared to those with an O blood type. Previous research had also indicated that people with blood types A, B, or AB are more susceptible to contracting COVID-19.
“Given our collective observations and the fact that 60% of humans have non-O blood types, our study raises important questions of whether more aggressive cardiovascular risk reduction efforts should be considered,” said co-author Hooman Allayee.
He continued, “Possibly by taking into account an individual’s genetic makeup.”
“Results of our study highlight the long-term cardiovascular effects of COVID-19 infection. Given the increased risk of heart attack, stroke, and death, the question is: Should severe COVID be considered a risk factor for cardiovascular disease, similar to Type 2 diabetes or peripheral artery disease? If so, focus on CVD prevention may prove valuable,” he added.
Researchers reviewed health and genetic data from the UK Biobank, focusing on over 10,005 adults who tested positive for COVID between 1 February and 31 December, 2020, including about 2,000 who were hospitalised.
They compared these individuals to 217,730 adults with no history of COVID during the same period. The study specifically evaluated the long-term risk of major adverse cardiovascular events till 31 October 2022.
Results showed that adults hospitalised with COVID but without cardiovascular disease or Type 2 diabetes had a 21 percent higher risk of heart attack, stroke, and death compared to those with heart disease but not infected by COVID.
It also highlighted a significant link between non-O blood types and the severity of COVID infection and hospitalisation.
While people with severe COVID-19 are at an increased risk, they are at more prone if they have non-O blood types.
The risk of heart attack and stroke was about 65 higher in adults with non-O blood types compared to those who had type O blood. A preliminary analysis did not show that Rh (positive or negative) blood type interacted with severe COVID-19, the authors noted.
“These findings reveal that while it’s an upper respiratory tract infection, COVID-19 has a variety of health implications and underscores the importance of considering history of prior COVID-19 infection when formulating cardiovascular disease preventive plans and goals,” said Dr. Hazen.
“This interesting paper is really two studies in one,” said Sandeep R Das, co-chair of the American Heart Association’s COVID-19 CVD Registry committee in a statement.
“First, the authors show that having been hospitalised with COVID is a marker of increased cardiovascular risk, on par with having a pre-existing diagnosis of cardiovascular disease.”
Proving direct cause and effect is very difficult to tease out in a study that only analyses past data collected for other purposes.
However, “this finding is important because it suggests a history of prior COVID hospitalisation, even without a history of CVD, should be considered to initiate and possibly accelerate CVD prevention efforts. Whether severe COVID has a direct impact on the vascular system is an interesting area for study as well,” Das said.
“The study only showed an association, and a cause-and-effect relationship cannot be established based on this study. The role of stricter preventive measures like maintaining LDL cholesterol below 70 mg/dL and the use of aspirin among those with a history of COVID, in preventing stroke and heart attack need to be evaluated,” Dr Sudhir Kumar, a Hyderabad-based neurologist, told South First.
Dr. Rajeev Jayadevan, Co-Chairperson of the National Indian Medical Association’s COVID Task Force, pointed out several limitations of the study.
“The authors did not look at people who were COVID-positive but not hospitalised. Without this information, it is impossible to conclude that COVID was the cause of increased cardiovascular events in the future. It is possible that those hospitalised already had undiagnosed baseline cardiovascular disease,” he explained.
He pointed out that it is a pre-vaccine era study, pertaining to the original version of the virus.
“It does not apply to the vast majority of people who were infected later with the relatively mild Omicron variant or those who were vaccinated. The impact of repeated infections is not addressed. If this observation is genuine, it is likely due to the endothelial effects of the SARS-CoV-2 infection and thrombotic tendencies, particularly in immune-naive individuals,” he noted.
“The authors studied people who were hospitalised with COVID-19 and compared them to apparently uninfected ones. An increased rate of cardiovascular events was noted in the three years that followed, which was equivalent to having other cardiovascular risk factors,” Dr. Jayadevan explained.
(Edited by Neena)
