Study published in the journal Nature Medicine | The higher heart risk after a diagnosis of COVID-19

The risk of heart disease increases during the year following a diagnosis of COVID-19, whether there was hospitalization or not, according to a large American study. The risk of heart attack is, for example, 72% higher.

Mathieu Perreault
The Press

“It’s quite striking, because it affects all groups,” says Ziyad Al-Aly, an epidemiologist at Washington University in St. Louis, who is the lead author of the study published in the journal NatureMedicine this week. “Men and women, all ethnic groups, old and young. Cardiacally, COVID-19 is a very fair disease, not hitting one group much more than another. »

At the Montreal Heart Institute, Dr.^r Philippe L’Allier, head of the prevention department, confirms having seen cases of heart disease subsequent to hospitalization due to COVID-19. “It’s not the majority of patients or the majority of COVID-19 patients, but we had people who came with heart failure and who had been hospitalized in the months before for COVID-19. You can’t say there’s a causal link for any particular individual, though. »

“We must avoid alarmism”

The D^r L’Allier thinks that we should not be alarmed by this study which he considers rigorous, in particular because it included 150,000 patients with COVID-19 from the hospital system for veterans of the American army and more than five million control patients. But he thinks that hospitalization for COVID-19, particularly in intensive care, could be part of the risk factors to consider when evaluating a patient in cardiology, at least for the next few years.

Could a patient hospitalized in intensive care with COVID-19 see new hypercholesterolemia or hypertension treated more effectively with medication? “It’s possible, but it’s really too early to tell,” says the D^r The Allier. These results have the merit of informing patients so that they do not neglect cardiovascular symptoms, but alarmism must be avoided. He gives the example of a patient with a 0.2% risk of having heart disease in a given year. If his risk is three times higher, he will have 0.6% risk, which is still low.

Lower risk in non-hospitalized

For patients who were diagnosed with COVID-19 without being hospitalized, the increase in cardiovascular risk in the following year is small, notes the D^r The Allier. “We see it on the population level, but it is not a large enough increase for it to pose a problem for the hospital system. For the same heart disease with an annual risk of 0.2%, the 15% increase in heart risk observed in non-hospitalized people puts the new risk at 0.23%.

The D^r Al-Aly will continue to follow this cohort of 150,000 patients on the vascular level. “We will be able to observe what happens with vaccination, if it reduces the cardiovascular risk. We had very few vaccinated patients at the start of the one-year follow-up. We will also have to see what happens with the Omicron variant, which seems to give less serious symptoms. »

The D^r L’Allier does not have the impression of seeing fewer patients with Omicron, but he points out that the number of infected patients is much higher than in other waves.