Suffering from long COVID can dramatically increase your risk of cardiovascular complications, a new study and meta-analysis have revealed.

More than three years into the COVID-19 pandemic, we’re starting to get a much better handle on the disease which has so far claimed the lives of over a million people in the US alone.

Long COVID, however, is still as elusive as ever. We still don’t even have a single accepted definition of the syndrome – that’s why estimates of how many people are affected by the illness are so variable, ranging from as low as five percent of COVID-19 patients to as high as 50 percent.

And even as we hone in on the condition, it evidently continues to surprise us. The new study – a systematic literature review and meta-analysis covering close to six million people – found strong evidence that patients who developed long COVID were significantly more likely than control subjects to experience heart problems down the line. 

“COVID-19 is more than a simple respiratory disease – it is a syndrome that can affect the heart,” said Joanna Lee, a medical student at David Tvildiani Medical University in Tbilisi, Georgia, and lead author of the study, in a statement on the results.

“Clinicians should be aware that cardiac complications can exist and investigate further if a patient complains of these symptoms, even a long time after contracting COVID-19,” she advised. “For patients, if you had COVID-19 and you continue to have difficulty breathing or any kind of new heart problems, you should go to the doctor and get it checked out.”

The study marks the most comprehensive investigation to date into the effects on cardiovascular health from long COVID – a condition which, for the purposes of this analysis, was defined as “symptoms persisting for at least four weeks and occurring at least two months after the initial COVID-19 infection.”

And the results were stark: patients who experienced this extended version of the disease were around 2.5 times as likely as control groups to develop cardiac problems such as chest pain, shortness of breath, heart palpitations, and fatigue. That wasn’t just the case for those self-reporting symptoms, either: individuals with long COVID were also more likely to show markers of heart disease or elevated cardiovascular risk in medical imaging and diagnostic tests.

While the study didn’t investigate the reason for the link, the team suspects it might have something to do with one of the signature complications of long COVID: inflammation resulting from an overactive immune system. If so, it may be good news – there is already a growing body of research into countering these autoimmune mistakes that have made catching COVID such a long-term pain in the butt.

Nevertheless, it’s important not to take too much from these results just yet. With so much variability between data collection methods, study populations, and even the very definition of the condition being studied, the team was limited in how definitive any conclusions would be – although, with COVID-19 being as new as it is, this is a common problem with studies into the virus’s effects, they point out.

Still, the study is important for both patients and healthcare providers interested in looking after heart health. “Coordinated efforts among primary care providers, emergency room staff and cardiologists could help with early detection and mitigation of cardiac complications among long COVID patients,” Lee said.

Lee will present the study, “Cardiac Complications among Long Covid Patients: A Systematic Review and Meta-Analysis,” at ACC.23/WCC, the annual conference of the American College of Cardiology and World Congress of Cardiology, on Monday, March 6. 

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