For the study, researchers examined data on about 10,000 people who had COVID-19 and more than 217,000 individuals who didn’t between February 1, 2020, and December 31, 2020. None of these people were vaccinated, and most cases occurred before vaccines were available. Researchers followed them for up to about three years.
Compared with people who didn’t have COVID-19 early in the pandemic, those who did were roughly twice as likely to experience major cardiovascular crises like heart attack and stroke by the end of the follow-up period, according to findings published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology. People who were hospitalized with severe COVID infections had an almost quadrupled risk of heart attacks and strokes, the study also found.
“Our results suggest that risk of future heart attacks and stroke in subjects who had severe COVID is comparable to the risk in patients who already have heart disease,” says senior study author Hooman Allayee, PhD, a professor of population and public health services at the University of Southern California in Los Angeles.
The study wasn’t designed to prove whether or how COVID-19 might directly cause heart attacks or strokes. But it’s possible that the increased risk of blood clots and fatty deposits known as plaques inside arteries — triggered by COVID-19 — might linger long after people recover from acute infections, Dr. Allayee says.
“This could then lead to a heart attack or stroke should that plaque rupture and possibly be the underlying reason why we saw increased heart attacks and stroke even three years later,” Allayee says. “Presumably, this pathological process would be even worse in COVID patients who were hospitalized.”
Heart Risks After COVID Infection May Depend on Blood Type
Even among people with severe infections who required hospitalizations, the risk wasn’t the same for everyone. Researchers found that people with severe COVID infections were much more likely to experience heart attacks or strokes when they had A, B, or AB blood types than when they had O blood types. This suggests genetics may play some role in determining risk, although more research is needed to understand the implications of this finding, according to the study.
Unclear How Vaccination or Latest Strains May Change Risks
One limitation of the study is that researchers focused only on COVID cases early in the pandemic, and it’s possible results would differ for people who received vaccines or who got infected with strains circulating more recently.
The cardiovascular risk after a COVID infection likely varies based on what strain of the virus people had and based on their vaccination status, says Patricia Best, MD, an associate professor of internal medicine and cardiovascular disease at the Mayo Clinic in Rochester, Minnesota, who wasn’t involved in the new study.
“The COVID vaccine decreases the likelihood of severe infection, hospitalization, and death,” Dr. Best says. “Although any COVID infection increases heart attack and stroke risk, more severe infections increase the risk further.”
Beyond staying up to date on COVID vaccinations, there are plenty of heart-healthy lifestyle choices people can make to reduce their risk of heart attacks and strokes after they recover from a COVID infection, Allayee says.
“Lifestyle changes that have always been recommended to reduce cardiovascular disease risk, such as a healthy diet, regular exercise, and cessation of smoking, are important things that people can do,” Allayee says. “In addition, it might be prudent to have a conversation with your doctor about measuring your blood pressure or cholesterol if it hasn’t been done already.”
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