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Three-Year Study Reveals Increased Heart and Stroke Risks Associated With COVID-19

Image Source: Battistoni et al., 2024

The research article by Battistoni, Volpe, and Morisco (2024) provides a meticulous analysis of the long-term cardiovascular and cerebrovascular risks associated with COVID-19. This study is pivotal in understanding the extended health implications of COVID-19, particularly concerning major adverse cardiovascular and cerebrovascular events (MACCE).


Literature Review


Long-term Cardiovascular Risks Post-COVID-19


The study by Battistoni et al. (2024) underscores a significant increase in cardiovascular risk among COVID-19 patients, extending well beyond the acute phase of the infection. This aligns with previous research indicating that COVID-19 survivors face an elevated risk of cardiovascular events. For instance, Xie, Xu, Bowe, and Al-Aly (2022) demonstrated that individuals recovering from COVID-19 had a heightened risk of cardiovascular complications up to one year post-infection. Similarly, Zuin et al. (2023) reported an increased risk of acute myocardial infarction and myocarditis following COVID-19 recovery, reinforcing the findings of Battistoni et al. (2024).


Incidence of MACCE


The study included anonymized data from 228,266 patients, with 31,764 confirmed COVID-19 cases. The analysis revealed a significantly higher proportion of new MACCE diagnoses in the COVID-19 group compared to the COVID-19-free comparator group, with an odds ratio of 1.73 (95% CI: 1.53–1.94; P < 0.001) (Battistoni et al., 2024). This finding is consistent with the work of Huang et al. (2021), who documented persistent symptoms and long-term health outcomes in COVID-19 patients, emphasizing the need for comprehensive post-acute care and monitoring.


Temporal Trends in Cardiovascular Risk


The incidence of MACCE was highest in the first year following the COVID-19 diagnosis, with rates of 1.39% and 1.45% for each six-month period, respectively. However, the risk remained significantly elevated throughout the three-year follow-up period (Battistoni et al., 2024). This prolonged risk period highlights the necessity for extended monitoring and follow-up programs for COVID-19 patients to prevent and manage potential cardiovascular and cerebrovascular events effectively. This is supported by the findings of Carfì, Bernabei, and Landi (2020), who also noted persistent symptoms in patients post-COVID-19, suggesting long-term health monitoring is crucial.


Broader Health Implications


The findings of Battistoni et al. (2024) contribute to the growing body of evidence on the broader health implications of COVID-19. Research by Singh et al. (2023) has highlighted the cardiovascular impact of post-acute sequelae of SARS-CoV-2, indicating that the virus's effects extend far beyond the initial infection period. Additionally, studies by Romero-Duarte et al. (2021) and Zhou et al. (2021) have documented sequelae and persistent symptomatology in COVID-19 patients, further emphasizing the need for long-term healthcare strategies.


Clinical and Public Health Implications


The implications of these findings are significant for clinical practice and public health policy. The prolonged cardiovascular risk associated with COVID-19 necessitates closer monitoring of cardiovascular health in COVID-19 patients, potentially leading to better preparedness for future pandemics (Battistoni et al., 2024). The study suggests that public healthcare systems may need to reconsider their policies to address the long-term socio-economic burden of COVID-19 and implement extended follow-up programs to promote earlier recovery and prevent subsequent major cardiovascular events.




In conclusion, the research by Battistoni et al. (2024) provides robust evidence of the persistent increase in cardiovascular and cerebrovascular events among COVID-19 patients over a three-year period. This study underscores the importance of long-term monitoring and follow-up care for COVID-19 patients to mitigate the elevated cardiovascular risk and improve overall health outcomes. The findings contribute to the broader understanding of the long-term health impacts of COVID-19 and highlight the need for comprehensive healthcare strategies to address these challenges.





Battistoni, A., Volpe, M., & Morisco, C. (2024). Persistent increase of cardiovascular and cerebrovascular events in COVID-19 patients: A 3-year population-based analysis. Cardiovascular Research, 120(6), 623–629.


Carfì, A., Bernabei, R., & Landi, F. (2020). Persistent symptoms in patients after acute COVID-19. JAMA, 324(6), 603–605.


Huang, C., Huang, L., Wang, Y., Li, X., Ren, L., Gu, X., Kang, L., Guo, L., Liu, M., Zhou, X., Luo, J., Huang, Z., Tu, S., Zhao, Y., Chen, L., Xu, D., Li, Y., Li, C., Peng, L., ... Cao, B. (2021). 6-month consequences of COVID-19 in patients discharged from hospital: A cohort study. The Lancet, 397(10270), 220–232.


Singh, T. K., Zidar, D. A., McCrae, K., Highland, K. B., Englund, K., Cameron, S. J., & Chung, M. K. (2023). A post-pandemic enigma: The cardiovascular impact of post-acute sequelae of SARS-CoV-2. Circulation Research, 132(10), 1358–1373.

Xie, Y., Xu, E., Bowe, B., & Al-Aly, Z. (2022). Long-term cardiovascular outcomes of COVID-19. Nature Medicine, 28(3), 583–590.


Zhou, M., Wong, C. K., Un, K. C., Lau, Y. M., Lee, J. C., Tam, F. C., Lai, W. H., Tam, A. R., Lam, Y. Y., Pang, P., Tong, T., Tang, M., Tse, H. F., Ho, D., Ng, M. Y., Chan, E. W., Wong, I. C. K., Lau, C. P., Hung, I. F., & Siu, C. W. (2021). Cardiovascular sequelae in uncomplicated COVID-19 survivors. PLoS One, 16(2), e0246732.


Zuin, M., Rigatelli, G., Battisti, V., Costola, G., Roncon, L., & Bilato, C. (2023). Increased risk of acute myocardial infarction after COVID-19 recovery: A systematic review and meta-analysis. International Journal of Cardiology, 372, 138–143.


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