Oct. 9, 2024 -- New research shows that severe COVID-19 could be a major risk factor for heart attack and stroke — on par with diabetes or heart disease. The risk may last for three years after infection, according to researchers at the University of Southern California, Los Angeles.
The USC team hopes their study findings, published today, spark conversation about preventive care for people who survive serious COVID infections. Maybe, the researchers say, COVID should be considered a heart disease risk equivalent, like diabetes.
"If we're treating diabetics with the cocktail of drugs that we're giving to heart disease patients, should we be giving the severe COVID patients the same cocktail of drugs to prevent their first heart attack and stroke?" said lead study author Hooman Allayee, PhD, a professor at USC's Keck School of Medicine.
"Our data doesn't mean that cardiologists should start doing that right away," Allayee said. "We want people to start thinking about [severe COVID-19] this way and start talking about it."
The new study builds on a robust body of research linking viruses to heart problems. Having the flu can increase your risk of heart attack by six times during the first week after diagnosis. Earlier studies suggest that COVID increases the risk of heart problems and stroke for up to a year after infection, with or without vaccination. A 2024 study showed that the risk of death and many health effects, including cardiovascular complications, may decline but not disappear for up to three years following COVID hospitalization.
"This is an association that's been in science for a long time," said Patricia Nguyen, MD, an associate professor of cardiovascular medicine at Stanford University, who was not involved in the study.
Allayee and his team wanted to explore long-term cardiovascular risks of COVID infection. But they also wondered how the heart risks posed by severe COVID compare to having heart disease or type 2 diabetes.
To find out, they analyzed data from the UK Biobank, a resource that has health, genetic, and lifestyle data on a half million U.K. residents. They compared the risk of heart complications among 10,000 adults infected with COVID in 2020, before vaccines hit the market, and 200,000 adults not infected during that time.
The researchers found that infection may double the risk of heart attack, stroke, or dying from any cause for up to three years – even in people without heart disease. People who were hospitalized with COVID faced a nearly four times greater risk of cardiovascular complications and death than those who had not been infected.
Blood type also factored into their analysis. Existing research shows that non-O blood types (that’s A, B, or AB) have an increased risk of heart attack, and type A blood may be more vulnerable to COVID infection. Knowing that, the researchers wondered if blood type might also affect long-term cardiovascular outcomes.
They found a “multiplier effect,” said co-lead author James Hilser, MPH, a doctoral candidate in biochemistry and molecular medicine at USC. Among those hospitalized with COVID, people with non-O blood types had a 65% higher risk of heart attack and stroke than people with type O blood.
The UK Biobank lacked detailed information about vaccination, including vaccination dates — crucial information for understanding how vaccination might affect these risks, said Allayee. That’s why the team decided to focus on people infected between February and December 2020, before vaccines became available. Recent research suggests that getting vaccinated reduces your risk of heart attack and stroke for at least six months.
“The data are probably going to change if you did have vaccines or not. Not to mention different variants,” Allayee said.
What to Know, and What to Ask Your Doctor
If you've had COVID but you were not hospitalized, don’t panic — the risks don't equate to having heart disease.
Still, adopting or maintaining a healthy lifestyle is important. "Everybody should,” Nguyen said, “but especially people who may be more vulnerable to cardiovascular episodes if they do have a virus."
COVID can cause inflammation of plaque (a fatty buildup known as atherosclerosis) inside coronary arteries, increasing the risk of heart attack and stroke.
"If your risk for having atherosclerotic heart disease is high based on your age [or] having hypertension or diabetes, you should engage in a healthy lifestyle and take your statins that you're prescribed,” Nguyen said.
Despite vaccines and boosters, people are still being hospitalized with COVID. The findings are relevant to their treatment too, Allayee said. His uncle was hospitalized with the virus.
"I would tell him, ‘Why don't you talk to your doctor?’" Allayee said.
If you're overweight or have high blood pressure or cholesterol, you could ask your doctor about preventive cardiovascular drugs, like aspirin, a statin, or blood pressure lowering medication, said Allayee.
“Hopefully, doctors will start saying, ‘Maybe I should look in the patient chart to see if they had severe COVID or not, and then rethink how I’m going to assess their future cardiovascular health,’” he said.
