Meta-analysis Links Long COVID to Increased Risk of Cardiac Symptoms

Pharmacists field a lot of questions about lingering symptoms following a bout with COVID-19. New research suggests that those patients should be urged to see their primary care provider or a cardiologist about any early signs of heart problems. A review of studies suggests that long COVID patients are much more likely to develop cardiovascular symptoms than those who have never had COVID. Here is more information.

NEW ORLEANS – COVID-19 survivors who continue to have symptoms months later appear to have more than double the risk of developing cardiovascular issues, according to new research.

A presentation planned for the American College of Cardiology’s Annual Scientific Session Together With the World Congress of Cardiology in New Orleans on March 4-6 bases that expectation on a systematic literature review and meta-analysis of 11 major studies involving a total of 5.8 million people. The research is touted as the most comprehensive effort to date to examine cardiovascular complications from long COVID.!/10674/presentation/12275

Recent surveys estimate that about 1 in 7 people in the United States have experienced post-acute sequelae from COVID-19.

Researchers from the David Tvildiani Medical University in Tbilisi, Georgia, and colleagues advise that they found consistent evidence indicating that long COVID patients were much more likely than those who never had COVID-19 to experience symptoms associated with heart issues such as chest pain, shortness of breath, palpitations and fatigue. Those patients also are more likely to exhibit signs of heart disease or elevated cardiovascular risk in medical imaging and diagnostic tests.

“COVID-19 is more than a simple respiratory disease—it is a syndrome that can affect the heart,” said lead author Joanna Lee, a medical student scholar at the Global Remote Research Scholars Program (GRRSP). “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. 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.”

For the study, GRRSP researchers systematically screened a total of 982 studies from PUBMED, EMBASE, and SCOPUS databases published between 2020-2022, selecting 74 studies for more intensive review. Ultimately, 11 studies were selected that included data on cardiovascular outcomes among long COVID patients with comparison to a control group of participants who never had COVID-19.

The researchers point out that almost 450,000 of the study participants experienced cardiac complications, with the rate 2.3-2.5 times higher in long COVID patients compared with those in the control group.

Specifically, 18,956 patients in the long COVID-19 arm and 430,272 patients in the control arm had heart issues. “The unadjusted odds of cardiac complications in long COVID-19 were significantly higher (OR 2.35, p=0.01) with high heterogeneity (I2=91%),” the authors write.

That led to the conclusion that patients with long COVID have significantly higher odds of developing cardiac complications compared to those who do not.

“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.

For purposes of the study, researchers defined long COVID as symptoms persisting for at least 4 weeks and occurring at least 2 months after the initial COVID-19 infection. The study did not investigate possible biological mechanisms that could explain the association between long COVID and heart complications, but the authors posit that chronic inflammation, which has been documented by persistently elevated inflammatory markers in people with long COVID, could be a factor.

The study team says further analyses are planned to determine whether patients with preexisting cardiovascular disease face different cardiovascular risks related to long COVID.

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