Risk of Major Adverse Cardiovascular Events After SARS-CoV-2 Infection in British Columbia: A Population-Based Study

Area of Science:

• Cardiology
• Infectious Diseases
• Epidemiology

Background:

• COVID-19 (coronavirus disease 2019) is linked to an elevated risk of post-acute cardiovascular complications.
• Limited population-based data exists for extended observation periods following SARS-CoV-2 infection.

Purpose of the Study:

• To investigate the long-term cardiovascular risk associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
• To quantify the population-attributable fraction of major adverse cardiovascular events due to SARS-CoV-2.

Main Methods:

• A population-based cohort study utilized data from the British Columbia COVID-19 Cohort (2020-2021).
• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive individuals were matched 1:4 with SARS-CoV-2 negative controls based on sex, age, and RT-PCR collection date.
• Multivariable survival models assessed the association between SARS-CoV-2 infection and major adverse cardiovascular events and acute myocardial infarction occurring >30 days post-infection.

Main Results:

• The study included 649,320 individuals (129,864 exposed, 519,456 unexposed) with a median follow-up of 260 days.
• Exposed individuals had a higher risk of major adverse cardiovascular events (aHR 1.34; 95% CI, 1.22-1.46), with risk escalating in hospitalized (aHR 3.81) and ICU patients (aHR 6.25).
• SARS-CoV-2 infection accounted for 7.04% of incident major adverse cardiovascular events (95% CI, 4.67-9.41%), with similar findings for acute myocardial infarction.

Conclusions:

• SARS-CoV-2 infection is associated with a graded increase in cardiovascular risk, directly correlated with acute COVID-19 severity.
• Approximately 7% of major adverse cardiovascular events can be attributed to SARS-CoV-2 infection.
• Long-term cardiovascular risk monitoring is essential for COVID-19 survivors.