Covid - Long Term Cardiovascular outcomes.

[imhotep]

A recent publication states...

"The cardiovascular complications of acute coronavirus disease 2019 (COVID-19) are well described, but the post-acute cardiovascular manifestations of COVID-19 have not yet been comprehensively characterized. Here we used national healthcare databases from the US Department of Veterans Affairs to build a cohort of 153,760 individuals with COVID-19, as well as two sets of control cohorts with 5,637,647 (contemporary controls) and 5,859,411 (historical controls) individuals, to estimate risks and 1-year burdens of a set of pre-specified incident cardiovascular outcomes. We show that, beyond the first 30 d after infection, individuals with COVID-19 are at increased risk of incident cardiovascular disease spanning several categories, including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease. These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection and increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care). Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial. Care pathways of those surviving the acute episode of COVID-19 should include attention to cardiovascular health and disease."

In brief the study showed that those who were Covid infected, regardless of age, sex, ethnicity, and other cardiovascular risk factors, such as obesity, diabetes, and hypertension, were at increased risk of suffering from several cardiovascular diseases. Therefore, those who survived the first 30 days of COVID-19 (acute phase of COVID-19) exhibited an increased risk of stroke, atrial fibrillation, pericarditis with hazard ratios (HRs) of 1.52, 1.71, and 1.85, respectively. Notably, the risk and excess burden of adverse cardiovascular outcomes extended up to 1 year.

The findings provided scientific evidence that these risks might manifest even in people at low risk of cardiovascular disease. However, the risks and associated burdens exhibited a gradual increase across the severity scale of the acute phase of COVID-19 among non-hospitalized, hospitalized, and individuals admitted to ICUs.

PS: Their findings listed as below.

Cerebrovascular disorders​

People who survived the first 30 d of COVID-19 exhibited increased risk of stroke (hazard ratio (HR) = 1.52 (1.43, 1.62); burden 4.03 (3.32, 4.79) per 10,00 persons at 12 months; for all HRs and burdens, parenthetical ranges refer to 95% confidence intervals (CIs)) and transient ischemic attacks (TIA) (HR = 1.49 (1.37, 1.62); burden 1.84 (1.38, 2.34)). The risks and burdens of a composite of these cerebrovascular outcomes were 1.53 (1.45, 1.61) and 5.48 (4.65, 6.35).

Dysrhythmias​

There were increased risks of atrial fibrillation (HR = 1.71 (1.64, 1.79); burden 10.74 (9.61, 11.91)), sinus tachycardia (HR = 1.84 (1.74, 1.95); burden 5.78 (5.07, 6.53)), sinus bradycardia (HR = 1.53 (1.45, 1.62); burden 4.62 (3.90, 5.38)), ventricular arrhythmias (HR = 1.84 (1.72, 1.98); burden 4.18 (3.56, 4.85)); and atrial flutter (HR = 1.80 (1.66, 1.96); burden 3.10 (2.55, 3.69)). The risks and burdens of a composite of these dysrhythmia outcomes were 1.69 (1.64, 1.75), and 19.86 (18.31, 21.46).

Inflammatory disease of the heart or pericardium​

Inflammatory disease of the heart or pericardium included pericarditis (HR = 1.85 (1.61, 2.13)); burden 0.98 (0.70, 1.30) and myocarditis (HR = 5.38 (3.80, 7.59); burden 0.31 (0.20, 0.46)). The risks and burdens of a composite of these inflammatory diseases of the heart or pericardium were 2.02 (1.77, 2.30) and 1.23 (0.93, 1.57).

Ischemic heart disease​

Ischemic heart disease included acute coronary disease (HR = 1.72 (1.56, 1.90); burden 5.35 (4.13, 6.70)), myocardial infarction (HR = 1.63 (1.51, 1.75); burden 2.91 (2.38, 3.49)), ischemic cardiomyopathy (HR = 1.75 (1.44, 2.13); burden 2.34 (1.37, 3.51)) and angina (HR = 1.52 (1.42, 1.64); burden 2.50 (2.00, 3.03)). The risks and burdens of a composite of these ischemic heart disease outcomes were 1.66 (1.52, 1.80) and 7.28 (5.80, 8.88).

Other cardiovascular disorders​

Other cardiovascular disorders included heart failure (HR = 1.72 (1.65, 1.80); burden 11.61 (10.47, 12.78)), non-ischemic cardiomyopathy (HR = 1.62 (1.52, 1.73); burden 3.56 (2.97, 4.20)), cardiac arrest (HR = 2.45 (2.08, 2.89); burden 0.71 (0.53, 0.93)) and cardiogenic shock (HR = 2.43 (1.86, 3.16); burden 0.51 (0.31, 0.77)). The risks and burdens of a composite of these other cardiovascular disorders were 1.72 (1.65, 1.79) and 12.72 (11.54, 13.96).

Thromboembolic disorders​

Thromboembolic disorders included pulmonary embolism (HR = 2.93 (2.73, 3.15); burden 5.47 (4.90, 6.08)); deep vein thrombosis (HR = 2.09 (1.94, 2.24); burden 4.18 (3.62, 4.79)) and superficial vein thrombosis (HR = 1.95 (1.80, 2.12); burden 2.61 (2.20, 3.07)). The risks and burdens of a composite of these thromboembolic disorders were 2.39 (2.27, 2.51) and 9.88 (9.05, 10.74).

Additional composite endpoints​

We then examined the risks and burdens of two composite endpoints, including major adverse cardiovascular event (MACE)—a composite of myocardial infarction, stroke and all-cause mortality—and any cardiovascular outcome (defined as the occurrence of any incident pre-specified cardiovascular outcome included in this study). Compared to the contemporary control group, there were increased risks and burdens of MACE (HR = 1.55 (1.50, 1.60); burden 23.48 (21.54, 25.48)) and any cardiovascular outcome (HR = 1.63 (1.59, 1.68); burden 45.29 (42.22, 48.45)).

 

[pradeepsu]

Have you got the full article / paper ? would like to read it through.

 

[imhotep]

Have you got the full article / paper ? would like to read it through.

It was published on the 7th February on Nature Medicine and has Open access.

https://www.nature.com/articles/s41591-022-01689-3

 

[ruchira55]

දිනපතා බ්ලඩ් තිනර් එකක් ගත්තොතින් රිස්ක් එක අඩු කරගන්න පුළුවන්ද?

 

[imhotep]

දිනපතා බ්ලඩ් තිනර් එකක් ගත්තොතින් රිස්ක් එක අඩු කරගන්න පුළුවන්ද?

Never take anything without proper medical supervision. Only those who are already on blood thinners are advised to continue.
The continued treatment of anticoagulation depends on the severity of the Covid infection and the patients' pre-existing medical conditions such as heart disease, brain stroke, diabetes, high blood pressure, kidney disease.
It's not for self medication. In the West the identifies patients are advised at the discharge time. Such patients are managed and there are tests like D-Dimers & Fibrinogen. Not everyone needs thinners too. There are markers that can test for high risk of clotting.
There are different blood thinners. But never take these at your own whims.

 

[Walter White]

Up !

 

[ruchira55]

Never take anything without proper medical supervision. Only those who are already on blood thinners are advised to continue.
The continued treatment of anticoagulation depends on the severity of the Covid infection and the patients' pre-existing medical conditions such as heart disease, brain stroke, diabetes, high blood pressure, kidney disease.
It's not for self medication. In the West the identifies patients are advised at the discharge time. Such patients are managed and there are tests like D-Dimers & Fibrinogen. Not everyone needs thinners too. There are markers that can test for high risk of clotting.
There are different blood thinners. But never take these at your own whims.

දැන් මෙහෙම රිසර්ච් එකක් කරලා. මේවායෙන් බේරෙන්න ක්‍රමයක් යෝජනා නොකර, බලාපොරොත්තු වෙන්නෙ මොකක්ද බන්? කට්ටියට එක දිගට ස්ට්‍රෝක් ඇවිල්ලා මැරෙනකොට "ආ අපි කලින්ම කිව්වා" කියලා කියන්නද?

ඇස්ප්‍රින් වගේ බෙහෙත් මිනිස්සු පැරසිටමෝල් ගන්නව වගේ වෛද්‍ය උපදෙස් නැතුව ගන්නව නේද? ඒකෙන් ලේ වල ඝනත්වෙ අඩු වෙනවා නේද?

 

[NRTG]

BUMP

 

[Stimulus mind]

TFS

 

[හෙනයා]

 

[imhotep]

දැන් මෙහෙම රිසර්ච් එකක් කරලා. මේවායෙන් බේරෙන්න ක්‍රමයක් යෝජනා නොකර, බලාපොරොත්තු වෙන්නෙ මොකක්ද බන්? කට්ටියට එක දිගට ස්ට්‍රෝක් ඇවිල්ලා මැරෙනකොට "ආ අපි කලින්ම කිව්වා" කියලා කියන්නද?

ඇස්ප්‍රින් වගේ බෙහෙත් මිනිස්සු පැරසිටමෝල් ගන්නව වගේ වෛද්‍ය උපදෙස් නැතුව ගන්නව නේද? ඒකෙන් ලේ වල ඝනත්වෙ අඩු වෙනවා නේද?

There are several low dosed anticoagulants. For eg whenever I fly out I always start a couple of days ahead and continue for another few days. That's a different story. I use Factor Xa inhibitors.
I am not saying that they are not beneficial in a Covid scenario. I did mention that in the West they follow up such patients with anticoagulants.
But always ask your doctor before taking these long term. Not as you wish.

PS: These type of research helps to plan follow-up treatment guidelines. In fact, even the WHO long while ago issued anticoagulant guidelines to clinicians.

 

[ruchira55]

There are several low dosed anticoagulants. For eg whenever I fly out I always start a couple of days ahead and continue for another few days. That's a different story. I use Factor Xa inhibitors.
I am not saying that they are not beneficial in a Covid scenario. I did mention that in the West they follow up such patients with anticoagulants.
But always ask your doctor before taking these long term. Not as you wish.

නැවතත් හෝ මුල් වතාවට බ්‍රේන් ස්ට්‍රෝක් එකක් හාට් ඇටෑක් එකක් ඇති වීමේ වැඩි සම්භාවිතාව වැඩියෙන් තියෙන්නෙ, දැනටමත් එහෙමෙ ලෙඩ ඇවිල්ලා ඒවට බෙහෙත් බොන අයටද? දැනට එහෙම ලෙඩක් ඇවිල්ලා නැති නිරෝගි කෙනෙකුටද?

 

[mayadmax]

1 - take maximum precautions to not get infected. thats number one. follow health guidelines and stay out of it
2 - i believe the vaccination also has a connection to all of the above mentioned. cant just say the risk is high just because someone catches covid. 90% of the people i talk to have some sort of a complication without getting infected after taking the vaccine

everything humans make have some kind of error. Following up is ok , but it becomes an never ending process of medication for each and every complication that arise because western medicine does not treat for the root cause

3 - Always stay healthy and fit with a good diet, natural immune boosters, and adequate exercises

 

[imhotep]

නැවතත් හෝ මුල් වතාවට බ්‍රේන් ස්ට්‍රෝක් එකක් හාට් ඇටෑක් එකක් ඇති වීමේ වැඩි සම්භාවිතාව වැඩියෙන් තියෙන්නෙ, දැනටමත් එහෙමෙ ලෙඩ ඇවිල්ලා ඒවට බෙහෙත් බොන අයටද? දැනට එහෙම ලෙඩක් ඇවිල්ලා නැති නිරෝගි කෙනෙකුටද?

If you are referring to people who are already on blood thinners, yes, they will have a reduced risk from clotting. A recent study shows that there is significant microclot formation in the blood of both acute Covid-19 and long Covid patients. With healthy person, clots may form (for instance, when you cut yourself). However, the body breaks down the clots efficiently by a process called fibrinolysis.
In blood from patients with long Covid, persistent microclots are resistant to the body’s own fibrinolytic processes. The presence of persistent microclots and hyperactivated platelets (also involved in clotting) perpetuates coagulation. So things are far complex than what appears on surface. So for Covid you need anti-platelet & anti-clotting agents. It's not home medication stuff.
Dr. Resia Pretorius (Stellenbosch University in South Africa) is a lead researcher in this area. Still many things are unknown.

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1 - take maximum precautions to not get infected. thats number one. follow health guidelines and stay out of it
2 - i believe the vaccination also has a connection to all of the above mentioned. cant just say the risk is high just because someone catches covid. 90% of the people i talk to have some sort of a complication without getting infected after taking the vaccine

everything humans make have some kind of error. Following up is ok , but it becomes an never ending process of medication for each and every complication that arise because western medicine does not treat for the root cause

3 - Always stay healthy and fit with a good diet, natural immune boosters, and adequate exercises

No #1 You are very correct.

No #2 Even though there are vaccine complications and side effects, there are disease complications and side effects too. About 10.4 Billion doses of vaccines have been administered but the side effects are not very large compared with the disease fatality figures. The problem we now face is the usage of the Gen#1 vaccine for the current variants. But these Gen#1 vaccines still offers some protection, though not against being infected but from death.
I hope they approve Gen#3 vaccines soon. At the moment the timeline is 2023.
90% of the people you talk doesn't probably include a large cohort because 90% of 10.4 billion doses are not reporting any issues.

No#3 Immune boosting is a myth and a big business. But as you say fit (healthy lifestyle) with a good diet and a stress free will help. If you talk with an expert immunologist he will tell that you need NOT like to make the immune system to be stronger, as it needs to be balanced. Both over reacting or under performing immune systems are BAD.
------ Post added on Feb 16, 2022 at 3:56 PM