As the Covid-19 pandemic stretches into its third year, the long-term effects of acute infection are beginning to become more evident. In its wake are new fears of chronic impacts on the health of individuals, as damage by the SARS-CoV-2 virus can exist beyond the pulmonary tract. Indeed, several studies during the pandemic have shown that Covid-19 can cause damage to the cardiovascular system and increase the risk of several adverse cardiovascular outcomes, such as heart failure (HF).

Excess release of inflammatory cells and plaque instability from Covid-19 can result in chronic inflammation and blood clots, leading to myocarditis and ischemic episodes on top of potential damage to conduction pathways in the heart by SARS-CoV-2. Such damage can increase the risk of more severe complications, such as HF. A study published earlier this year in Nature is among the first to quantify this risk. Using data from historical and contemporary cohorts of more than 12 million person-years in US Department of Veterans Affairs national healthcare databases, Yan Xie and colleagues identified that the risk of developing HF a year after Covid-19 infection was 72% higher compared to the control group of individuals who did not have confirmed Covid-19 infection in the previous year.

The impact of increases in such risk will likely subsequently impact HF incidence. According to GlobalData epidemiologists, there will be more than 1.2 million diagnosed incident cases of HF in the US in 2022. However, the impact of the Covid-19 pandemic will likely drive an increase in diagnosed incident cases of HF, resulting in diagnosed incident cases surpassing current forecast estimates. These changes, however, may be temporary, as the impacts of the Covid-19 pandemic lessen over time.

While the study by Xie and colleagues was based in the US, similar increases in HF risk will likely impact other markets as the physiological mechanisms resulting in the HF due to Covid-19 are nearly universal. Therefore, preventing Covid-19 transmission remains imperative to mitigate further increases in HF incidence. Moreover, because the early diagnosis of HF may result in more favourable outcomes, doctors should emphasise screening patients who have been diagnosed with Covid-19 for potential cardiovascular complications. Further research is also merited by the relative lack of longitudinal data on cardiovascular outcomes from Covid-19 patients.

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