Harlan Krumholz, a cardiologist at Yale School of Medicine, says he is concerned about two types of prolonged covid. The explicit version induces fatigue, while a covert version involves a higher risk of blood clots and stroke after a COVID recovery. He doesn’t want to scare people. Most of us would probably be fine. But new studies confirm that some will have an increased risk of blood clots, stroke or heart attack. People who have had COVID should pay attention to early warning signs such as chest pain, unusual swelling, numbness or weakness, or sudden changes in balance, speech, or vision.
In 2020, scary news of young people suffering a stroke during or just after the transition began to emerge. Doctors were beginning to suspect that Covid was not just a respiratory disease, but a blood vessel. Studies now support his suspicions. Their higher risk is even greater in patients with high blood pressure or diabetes. A recent study published in Heart tracked 54,000 people in the UK and concluded that those who were infected were 2.7 times more likely to develop venous thromboembolism, a dangerous type of blood clot, than those who had never been infected. . The study also showed that those who became infected but were not sick enough to require hospitalization were 10 times more likely to die from any cause during the 4.5-month study period than their uninfected counterparts. People who were hospitalized for Covid were almost 100 times more likely to die. Another new study published in Neurosurgery focused on the period when people were actively infected and concluded that COVID infection was associated with stroke.
Krumholz said we still don’t have enough data to know how much of these risks are reduced by vaccination or how long the increased risk lasts. It was known that the virus could have long-lasting effects, but until the Sars-CoV-2 pandemic, it had never been studied so thoroughly. There is a growing consensus that permanent damage is caused by inflammation—a necessary part of our immune defense system, but one that can cause damage when it’s in high gear.
Not everyone who gets COVID will suffer severe blood vessel inflammation, but the disease is still like a roll of the dice—or, as physician Ziad al-Ali puts it, Russian roulette. This doesn’t mean that people should despair or panic. Early treatment can save lives, which is why doctors urge infected people not to ignore any warning signs. Al-Ali was one of the first doctors to study long covid. “Something about Sars-CoV-2 increases its tendency to damage the lining of blood vessels and increases the likelihood of blood clots forming,” he said.
“This kind of dangerous disease primarily attacks these vessels,” said Pascal Jabbor, a neurosurgeon at Thomas Jefferson Hospital, Philadelphia. This disease can cause inflammation of blood vessels throughout the body, including the intestines. A condition called bowel ischemia. It is also at the root of a circulatory problem known as covid toes. Jabbor Neurosurgery is the lead author of the paper. His new research looks at 575 stroke patients – some with and some without COVID. People with covid had worse conditions and were harder to treat with surgery aimed at opening blocked vessels. The infected group consisted of younger, healthier people than the group of uninfected stroke patients, which is what you would expect to see if infections were increasing risk across the board.
Jabbor said some of the infected group had mild infections, and some were not known until they arrived at the hospital. This further complicates the already complex task of tallying Covid deaths. Should people who died of stroke and tested positive be counted as dying from covid or from covid?
Even something as neutral as heart disease risk is politicized when it intersects with the pandemic. After discussing his opening remarks on CNN in 2020 and the results of the study, Jabbor said, “You can’t imagine the attacks I made. The polarization has only deepened, something people refuse to believe.” That Covid could have lasting effects, and others are posting scare stories that the continued harsh lockdown in China is part of a plan to conquer the West as widespread prolonged Covid results in the collapse of the Western workforce.
Some people have been ravaged by Covid, even most have made a full recovery. That is the reality. Understanding the after-effects of infection takes time, good studies and a lot of cases, and this information is coming from countries that have seen the most cases. The take-home message is that even if you feel fine, a previous COVID infection is a cardiovascular risk factor, a bit like high cholesterol.
This is not a reason to despair, but a very good reason to be cautious.
Faye Flamm is a Bloomberg Opinion columnist covering science.
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