People hospitalized with COVID-19 were more likely to have heart failure after discharge than those hospitalized for another reason, according to a Duke University study published this month.
The findings of the study, published in Nature Communicationsupport a growing body of research that suggests some people infected with COVID-19 develop long-term heart problems.
Using health records Of more than 580,000 patients admitted to US hospitals, Duke researchers tracked how often those with COVID visited the hospital for heart problems in the year after discharge. They found that the COVID group was 45% more likely to be diagnosed with heart failure compared to patients hospitalized with something other than COVID.
Duke’s study is the first to look at this question in a large, racially diverse population, said Dr. Marat Fudim, a Duke cardiologist and author of the paper.
An article published in February found a similar link between cardiovascular disease, including heart failure, and COVID hospitalization in hospitalized patients of US veterans.
Fudim said heart disease could over time turn out to be a complication for those who had a milder COVID-19 infection.
“I think in the next few years we will discover the true burden of long COVID,” he said. “This article just tells us the worst of the worst.”
Fudim is the first to admit that his study has limitations.
He and other researchers used a dataset of past hospitalizations and conducted a retrospective analysis. Which means they can’t say that COVID-19 causes heart failure, only that it’s associated.
Randomized, controlled experiments are the gold standard of scientific research because researchers randomly assign participants to the groups they are comparing, making each group as similar as possible.
But randomly assigning a group of people to contract COVID-19 is neither ethical nor feasible.
At present, Fudim’s study design is the best way for scientists to study the long-term impacts of COVID-19, said Dr. Ziyad Al-Aly, assistant professor of medicine at the Washington University in St. Louis, author of the article on VA hospitals.
“The truth is, there will never, ever be a randomized study for COVID,” he said.
Not everyone is convinced that the results indicate a serious side effect of COVID. There may be too many other factors that could explain the link between COVID hospitalization and heart failure, said UNC cardiologist Dr. Christopher Kelly.
For example, people hospitalized with COVID-19 likely had pre-existing health conditions that could also explain why they continued to develop heart failure, Kelly said.
People hospitalized for a non-COVID issue don’t necessarily have the same chronic health conditions if they were in the hospital for a minor procedure like gallbladder surgery, he said.
Duke researchers statistically adjusted for a number of health conditions that could cause heart failure such as obesity, diabetes, hypertension and kidney disease. Still, Kelly said there’s no way to fit in perfectly with the differences between the groups.
Al-Aly said the Duke researchers could have improved the study design slightly by comparing hospitalized COVID-19 patients to those hospitalized with an infection, who are more likely to have a similar set of pre-existing health conditions. .
“There are tons of ways to explain the data that don’t involve blaming COVID for their subsequent development of heart failure,” Kelly said. “There are differences that aren’t measurable and there are differences that you haven’t thought about.”
Teddy Rosenbluth covers science for The News & Observer in a post funded by Duke Health and the Burroughs Wellcome Fund. The N&O retains full editorial control of the work
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