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Long-term Cardiovascular Outcomes in US Medicare Beneficiaries After COVID-19 Hospitalization During the Omicron Era

Sérgio R R Decker1,2,3, Yang Song1, Issa J Dahabreh1,4,5

  • 1Richard A. and Susan F. Smith Center for Outcomes Research, Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA (S.R.R.D., Y.S., I.J.D., R.W.Y., D.S.K.).

Circulation. Population Health and Outcomes
|July 30, 2026
PubMed

Insights

Older adults hospitalized with COVID-19 during the Omicron variant era faced a lower death risk but a higher risk of major adverse cardiovascular events compared to the pre-Omicron era. However, risks remained higher than following influenza hospitalization.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • COVID-19 hospitalization in the pre-Omicron era increased major adverse cardiovascular events (MACE) risk.
  • Data on MACE risk during the Omicron era are limited.
  • This study compares MACE and mortality risks in older adults hospitalized during the Omicron era versus pre-Omicron and influenza cohorts.

Purpose of the Study:

  • To assess the risk of death and MACE in older adults hospitalized with COVID-19 during the Omicron era.
  • To compare these risks with those from the pre-Omicron era and a historical influenza cohort.

Main Methods:

  • Retrospective cohort study of Medicare beneficiaries aged 65+.
  • Cohorts included: Omicron (Nov 2021-Sep 2022), pre-Omicron COVID-19 (Mar 2020-Nov 2021), and influenza (Oct 2017-Sep 2018).
  • Primary outcome: composite of death and major cardiovascular events within 1 year, standardized using inverse probability weighting.

Main Results:

  • The Omicron cohort (n=361,382) had a slightly lower overall outcome risk than the pre-Omicron cohort (n=731,455) but higher than the influenza cohort (n=91,345).
  • The Omicron cohort showed a significantly lower risk of death (34.2% vs. 39.7%) compared to the pre-Omicron cohort.
  • However, the Omicron cohort had a higher risk of myocardial infarction, stroke, pulmonary embolism, deep vein thrombosis, and heart failure compared to the pre-Omicron cohort.

Conclusions:

  • Hospitalization with COVID-19 during the Omicron era was associated with lower mortality but higher MACE risk compared to the pre-Omicron era in older adults.
  • The risk of death or MACE after COVID-19 hospitalization remained higher than after influenza hospitalization.
  • Effective cardiovascular prevention strategies are crucial following COVID-19 hospitalization.
Abstract

Keywords:
COVID-19cardiovascular diseasesheart failurehospitalizationpulmonary embolism

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