By Pat Anson, PNN Editor

Headaches, fatigue, shortness of breath, and cognitive problems are common symptoms of Long COVID, a persistent and puzzling illness that can linger for months or years after the initial COVID-19 infection.     

Two new studies being presented at the American College of Cardiology’s Annual Scientific Session suggest that people with Long COVID may also be at risk of long-term cardiovascular problems.

“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 and 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.”

Lee and her colleagues reviewed findings from 11 major studies involving 5.8 million people, in what’s believed to be the largest effort to date to examine cardiovascular complications from long COVID. They found that Long COVID more than doubles a person’s risk of developing cardiac complications compared to a control group.

Researchers did not investigate what caused the association between Long COVID and heart complications, but they suspect that chronic inflammation plays a role. People with Long Covid often have persistently high inflammatory markers – something healthcare providers should be alert to.

“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 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.”

In the second study, researchers at Intermountain Health in Salt Lake City looked at health data for nearly 150,000 patients who tested positive for COVID-19, and found that even those with mild symptoms had significantly higher rates of chest pain six months to a year after the initial infection. But there was no increase in heart attacks or other cardiovascular events.

“While we didn’t see any significant rates of major events like heart attack or stroke in patients who had an initial mild initial infection, we did find chest pains to be a persistent problem, which could be a sign of future cardiovascular complications,” said lead author Heidi May, PhD, a cardiovascular epidemiologist at Intermountain Health. 

A third study, recently published in JAMA Health Forum, supports many of these findings. Researchers at Elevance Health in Indiana compared more than 13,000 Long COVID patients to a control group of 26,000 people without COVID. Those with Long COVID had significantly higher rates of cardiac arrhythmia, blood clots, stroke, coronary artery disease, heart failure, asthma and mortality.

Notably, nearly 3 out of 4 had only mild COVID symptoms and were not hospitalized during the initial infection, suggesting that the health of all COVID patients needs to be monitored long-term.

“From a health policy perspective, these results also indicate a meaningful effect on future health care utilization, and even potential implications for labor force participation,” researchers said.

About one in every five patients infected with COVID-19 develops symptoms of Long COVID. A recent study found that COVID vaccines appear to significantly reduce the risk of getting Long COVID.

The CDC estimates there were 103 million confirmed U.S. cases of COVID-19, resulting in 1.13 million deaths.