Hospitalization for COVID-19 tied to 45% higher risk of heart failure
COVID-19 hospitalization is associated with a 45% greater risk of subsequent heart failure (HF), particularly for patients who are younger, White, or previously diagnosed as having heart disease, according to a US study published late last week in Nature Communications.
A University of Arkansas researcher led the study of 587,330 patients hospitalized from Mar 1, 2020, to Mar 31, 2022, using data from the National COVID Cohort Collaborative Study. Of those patients, 257,075 tested positive for COVID-19. The COVID-19 patients were older (51 vs 46 years), more likely to be male (49% vs 42%), and less likely to be White (61% vs 69%).
During a median of 367 days of follow-up, 10,979 patients developed HF, and 17,641 died of any cause. In adjusted analyses, COVID-19 was tied to a 45% higher risk of HF (hazard ratio, 1.45; 95% confidence interval, 1.39 to 1.51), with the greatest risk among younger and White patients and those with established cardiovascular disease.
Relative to non-COVID patients, infected patients had a higher rate of new diagnoses of HF (2.3% vs. 1.5%), death (3.3% vs. 2.6%), and composite death or new HF (5.2% vs. 4.0%) after hospital release.
The crude HF rate was higher for COVID-19 patients, at 2.55 vs 1.44 events per 100 person-years. The median time to new HF after hospital release was shorter among COVID patients (69 vs 84 days), although a similar proportion occurred within 30 days of release (33% vs 30%).
The authors said that COVID-linked heart damage and inflammation of the heart muscle (myocarditis) may have a role in the development of new HF. "A suspicion of HF should be triggered in patients who experience respiratory or cardiac symptoms following recovery from COVID-19 hospitalization," they wrote.
Jul 15 Nat Commun study
Survey: 42% of women report heavier bleeding after COVID vaccines
Results of a Web-based survey published late last week in Science Advances reveal that 42% of women with regular menstrual cycles had heavier bleeding after receipt of one or two doses of any approved COVID-19 vaccine.
After vaccination, 42% of women with regular menstrual cycles said they bled more heavily than usual, while 14.3% noted lighter or unchanged flow, and 44% reported no changes. And among respondents on long-acting, reversible contraceptives, 71% reported breakthrough bleeding, as did 39% taking gender-affirming hormones and 66% of postmenopausal women.
Abnormally heavy and breakthrough bleeding was significantly tied to older age, fever and fatigue after vaccination, previous pregnancy or delivery, and non-White ethnicity.
The researchers noted that some medical professionals had dismissed previous observations of abnormal bleeding after vaccination, leading to distrust of clinicians. The reports also fueled concerns from both vaccine-hesitant and anti-vaccine Americans, who conflated the possible association of short-term menstrual changes after COVID-19 vaccination with long-term fertility problems.
"Pundits, politicians, religious leaders, and wellness influencers worked the oft-used framing of protecting women to advise against the vaccine," they wrote. "Generally, changes to menstrual bleeding are not uncommon or dangerous, yet attention to these experiences is necessary to build trust in medicine."
"We suspect that for most people the changes associated with COVID-19 vaccination are short-term, and we encourage anyone who is worried to contact their doctor for further care," said first author Katharine Lee, PhD, in a University of Illinois news release. "Getting the vaccine is one of the best ways to prevent getting very sick with COVID, and we know that having COVID itself can lead not only to changes in periods, but also hospitalization, long COVID, and death."
Jul 15 Sci Adv study
Jul 15 University of Illinois news release
Pre vaccines, teens and young adults had higher COVID-19 rates than older adults
A new study in JAMA Network Open shows a higher COVID-19 infection rate in adolescents and young adults compared with older adults before vaccines were available. The study is based on health department statistics from 19 states, and it contradicts previous studies from Europe and Asia that showed older adults were more at risk of contracting the virus during the early months of the pandemic.
The study used health statistics from 19 states that experienced a surge of virus activity in the fall of 2020, defined as an increase of at least 75% from a plateau 2 to 3 months earlier that lasted at least 1 month. The states also had to classify cases in age brackets.
The 19 states were Alabama, Alaska, Colorado, Florida, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, and Wisconsin.
In 16 of the 19 states, the incidence rate of COVID-19 was significantly higher in adolescents and youth than it was in older adults, the authors said. The incident rate ration (IRR) reached 1 or more in these 16 states.
Only three states—South Dakota, Michigan, and Pennsylvania—saw higher IRR in adults. The authors linked these increased rates to attendance at political rallies and the Sturgis motorcycle rallies, large unmasked events.
"Possible reasons for our findings are that adolescents had more contacts than adults; and that older adults, feeling vulnerable, were more likely to adhere to masking and/or social distancing " the authors concluded.
Jul 15 JAMA Netw Open study