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Researchers confirm COVID patients can suffer serious cardiac complications

A MARTINEZ, HOST:

After recovering from COVID, some patients are now suffering from serious cardiovascular complications, such as heart attacks and strokes, even if they never had any prior issues. Doctors first started noticing a trend, then a new study confirmed what they are observing and quantifies the risks of this happening up to a year later. NPR's Will Stone reports.

WILL STONE, BYLINE: Robi Tamargo never worried much about her heart. She started running competitively in middle school. In college, she played field hockey and lacrosse, and she kept up exercising as she got older. Until the pandemic hit, she went to the gym every morning.

ROBI TAMARGO: And I was still very, very active in my community athletically, so to have a heart condition was really quite shocking.

STONE: Tamargo is now 61 and lives in Florida. She's a clinical psychologist who was in the Navy before going into private practice. She got the coronavirus in the spring of 2020.

TAMARGO: I happened to catch it from an active-duty physician who didn't know yet that they had COVID.

STONE: It got bad quickly. She woke up at home to discover the left side of her face was numb.

TAMARGO: The emergency room did imaging of my brain. I had a blood clot in my right middle cerebral artery.

STONE: They gave her medications, which saved her from having a full-on stroke. But after being discharged, she kept developing new medical problems, like painful lung inflammation and horrible insomnia. And then three months later...

TAMARGO: I suddenly developed atrial fibrillation. My heart was coming out of my chest.

STONE: It's a type of arrhythmia. They rushed her to the hospital.

TAMARGO: I spent 10 hours in the emergency room with them trying to chemically convert my heart back to a normal rhythm.

STONE: They succeeded, but she continued to have serious heart problems, like the time she traveled to New York City for long COVID treatment and trying to walk up a slight hill.

TAMARGO: I basically had to squat down on my heels in Manhattan because I couldn't breathe. My phone starts ringing. It is the cardiac monitor company that I'm wearing the cardiac monitor for checking to see where I was. And she said, you need to go to the hospital.

STONE: Tamargo is far from the only one with serious cardiovascular problems after getting COVID-19. That's according to the new study led by Dr. Ziyad Al-Aly of the St. Louis VA.

ZIYAD AL-ALY: We could sum it up in one sentence, that people with COVID-19 exhibited increased risk of heart problems even a year later after the initial infection.

STONE: Al-Aly and his co-authors at Washington University combed through VA medical records. They identified more than 150,000 people infected with coronavirus between March 2020 and January of last year. Then they compared those patients to match control groups made up of millions of other VA patients. The cardiovascular outcomes included different kinds of clots, arrhythmias, heart failure, inflammation of the heart muscles.

AL-ALY: This is really going to create a generation of people with heart problems.

STONE: For some of the most serious outcomes, including heart attack and stroke, the rate of those problems was 4% higher among the patients who had COVID.

AL-ALY: Even though, to some people, 4% is a single-digit number, it may seem small to some people, you have to multiply that by the huge number of people in the U.S. and many, many more around the world who experienced COVID-19 infection.

STONE: What was also striking was this increased risk turned up even among the people who were not hospitalized. And Al-Aly says it wasn't just happening to people who were already at high risk of heart disease.

AL-ALY: Even in young people, people who were previously athletic, people who never smoked, who were not obese, people who never had diabetes or any problem with diabetes.

STONE: Cardiologists are taking notice. One of them is Dr. Harlan Krumholz at Yale who's been researching long COVID.

HARLAN KRUMHOLZ: I think that this is a wake-up call to us.

STONE: Krumholz says this new study is strong and comprehensive, but he also worries that it could create unnecessary anxiety.

KRUMHOLZ: In the end, you know, a small number of people end up getting cardiovascular disease. It's not like, oh, my gosh, everyone got COVID, and then the next thing you know, they all had heart attacks. That's not it.

STONE: Others have pointed out the study's limits. Dr. Betty Raman a cardiologist at the University of Oxford, notes, as the authors do, the VA population studied was majority white and male, and it only reveals a correlation. It can't prove cause and effect because of COVID. Finally, the study only covered the first year of the pandemic.

BETTY RAMAN: And since the vaccines have come into the picture, things are dramatically different, just in terms of the way the body is handling the infection.

STONE: She's hopeful vaccinated patients will have fewer cardiovascular problems. Dr. Peter Libby of Harvard says the findings do help get at the scale of the problem. He says inflammation that comes with the acute infection could be causing problems in the heart and blood vessels. And imaging studies have also revealed signs of scarring in the heart after COVID, which can then lead to arrhythmias.

PETER LIBBY: It doesn't take very big scar to predispose you to have arrhythmias. So fortunately, we have ways of dealing with that these days, but they're invasive. They have complications.

STONE: Some of this post-infection damage - it might turn out that other viruses can cause that, too. But with so many people infected by the coronavirus, the heart problems could be with us for a long time.

Will Stone, NPR News.

(SOUNDBITE OF HANNAH GREY'S "STILL WATERS") Transcript provided by NPR, Copyright NPR.

Will Stone