People with long COVID are at increased risk of developing cardiovascular disease, according to a study from Karolinska Institutet published in eClinicalMedicine on Apr. 1. The research found that the risk of conditions such as cardiac arrhythmias and coronary artery disease is higher even among those who were not hospitalized during their initial infection.
The findings highlight the growing concern about long COVID as a significant health problem worldwide, especially given its potential to cause secondary cardiovascular diseases. Previous studies have mostly focused on patients who required hospitalization, but this new research examined risks for individuals who stayed at home or were treated by general practitioners.
The study included more than 1.2 million people aged between 18 and 65, of whom about 9,000 had been diagnosed with long COVID—approximately 0.7 percent of the total group. Two-thirds of these patients were women, and those with previous cardiovascular disease or hospitalization for COVID-19 were excluded from the analysis.
Over an average follow-up period of four years, researchers observed that people with long COVID experienced more cardiovascular events: 18.2 percent of women and 20.6 percent of men reported such events compared to 8.4 percent and 11.1 percent respectively in those without long COVID. After adjusting for age, socio-economic status, and other known risk factors, women with long COVID had just over twice the risk of receiving a cardiovascular diagnosis compared to women without it; men had approximately a third higher risk.
"We found that cardiac arrhythmias and coronary artery disease were more common among both women and men with long COVID. In women, there was also an increased risk of heart failure and peripheral vascular disease. However, no clear association was found between long COVID and stroke," said lead author Pia Lindberg, nurse and PhD student at the Department of Medicine at Karolinska Institutet.
Lindberg said many people with long COVID never required hospital care during their acute infection so there is a possibility that secondary conditions may be missed if monitoring is not systematic enough.
"Our results show that long COVID can be a risk factor for cardiovascular disease, even in younger people who were previously healthy. This underlines the need for structured follow-up that takes gender differences into account, particularly as cardiovascular disease in women often presents with more diffuse symptoms that can make diagnosis more difficult," concluded Lindberg.
The study was conducted by researchers from Karolinska Institutet together with Karolinska University Hospital, Academic Primary Care Centre/Region Stockholm and Uppsala University.
