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Cardiovascular risk and the COVID-19 pandemic: a population-based and case‒control studies
Małgorzata Chlabicz1,2, Jacek Jamiołkowski1, Marlena Dubatówka1
1Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, ul. Waszyngtona 15B, Bialystok, 15-269, Poland.
Insights
The COVID-19 pandemic did not increase cardiovascular (CV) risk for primary prevention. However, it encouraged better health awareness and control of CV risk factors in the post-infection population.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic has been linked to increased global morbidity and mortality.
- Investigating the mechanisms by which SARS-CoV-2 impacts cardiovascular health is crucial.
- Understanding the pandemic's effect on cardiovascular (CV) risk is essential for public health strategies.
Purpose of the Study:
- To assess the impact of the COVID-19 pandemic on cardiovascular (CV) risk.
- To evaluate changes in CV risk factors in a general population and post-COVID-19 individuals.
- To compare CV risk scores before and during the pandemic.
Main Methods:
- A population-based and case-control study conducted in a single center in Poland between 2018 and 2022.
- Utilized risk assessment models including SCORE2, SCORE2-OP, Framingham Heart Study, and LIFE-CVD.
- Categorized study populations into CV risk classes based on 2021 ESC Guidelines.
Main Results:
- The general population showed no significant increase in CV risk during the pandemic.
- Individuals post-COVID-19 infection exhibited lower LDL-c levels compared to controls.
- CV risk was found to be lower in the post-COVID-19 population using specific risk scores, despite no change in risk class frequency.
Conclusions:
- The COVID-19 pandemic did not elevate calculated CV risk for primary prevention.
- The pandemic heightened health consciousness, leading to improved control of certain CV risk factors.
- Leveraging increased health awareness from the pandemic for public health information campaigns is recommended.
Background:
The coronavirus disease 2019 (COVID-19) pandemic is associated with increases in morbidity and mortality worldwide. The mechanisms of how SARS-CoV-2 may cause cardiovascular (CV) complications are under investigation. The aim of the study was to assess the impact of the COVID-19 pandemic on CV risk.
Methods:
These are single-centre Bialystok PLUS (Poland) population-based and case‒control studies. The survey was conducted between 2018 and 2022 on a sample of residents (n = 1507) of a large city in central Europe and patients 6-9 months post-COVID-19 infection (n = 126). The Systematic Coronary Risk Estimation 2 (SCORE2), the Systematic Coronary Risk Estimation 2-Older Persons (SCORE2-OP), the Cardiovascular Disease Framingham Heart Study and the LIFEtime-perspective model for individualizing CardioVascular Disease prevention strategies in apparently healthy people (LIFE-CVD) were used. Subsequently, the study populations were divided into CV risk classes according to the 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.
Results:
The study population consisted of 4 groups: a general population examined before (I, n = 691) and during the COVID-19 pandemic (II, n = 816); a group of 126 patients post-COVID-19 infection (III); and a control group matched subjects chosen from the pre-COVID-19 pandemic (IV). Group II was characterized by lower blood pressure, low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) values than group I. Group III differed from the control group in terms of lower LDL-c level. There was no effect on CV risk in the general population, but in the population post-COVID-19 infection, CV risk was lower using FS-lipids, FS-BMI and LIFE-CVD 10-year risk scores compared to the prepandemic population. In all subgroups analysed, no statistically significant difference was found in the frequency of CV risk classes.
Conclusions:
The COVID-19 pandemic did not increase the CV risk calculated for primary prevention. Instead, it prompted people to pay attention to their health status, as evidenced by better control of some CV risk factors. As the COVID-19 pandemic has drawn people's attention to health, it is worth exploiting this opportunity to improve public health knowledge through the design of wide-ranging information campaigns.
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