Scientists are just starting to unravel COVID’s long-term cardiac effects.
Scientists have long been aware that respiratory infections—such as influenza or certain types of coronaviruses—can trigger heart disease. This happens because they cause inflammation, which plays a major role in cardiovascular problems.
A Serious Public Health Problem Al-Aly and his colleagues crunched the numbers on heart and other cardiovascular issues during the first year after infection among 153,760 COVID patients from the national health care databases of the VA. The researchers compared these patients with two control groups: a contemporary cohort who never became infected and a historical group from before the pandemic.
“It is not only surprising but also profoundly consequential that the risk is evident even in those [who had mild infections],” Al-Aly says. Such cases comprise the vast majority of COVID infections—within the study’s population, 85 percent of those diagnosed with the disease were not hospitalized. “That’s what makes this likely a serious public health problem,” he says.
COVID’s Long-Term Heart Burden While it is very likely that inflammation plays a role in the cardiovascular events seen in people with COVID, it is still a mystery why some individuals continue to be at increased risk long after SARS-CoV-2 has left their bodies. There is also a growing body of evidence suggesting that COVID affects the vascular endothelium, the inner lining of blood vessels, according to cardiologist Bernard Gersh, a professor of medicine at the Mayo Clinic College of Medicine and Science. “This leads to what is called microvascular dysfunction of the small vessels, which may not dilate or constrict the way they should,” Gersh says. That could explain why long-lasting post-COVID symptoms are not restricted to the heart.
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