Long COVID May Elevate Risk of Cardiovascular Disease

Postacute sequelae of SARS-CoV-2, also known as long COVID, may have an impact on the development of cardiovascular disease (CVD), according to nationally representative survey data presented by investigators at IDWeek. The conference took place from October 19 to 22, 2025, in Atlanta, Georgia.¹

How Long COVID Impacts Cardiovascular Risk

Long COVID has been associated with a host of adverse clinical presentations. Patients can experience a wide range of symptoms, from digestive to respiratory to, indeed, cardiovascular. In this vein, long COVID can impact the heart, leading to symptoms such as chest pain, shortness of breath, and rapid or irregular heartbeats. Combined with the higher likelihood of heart failure or myocardial infarction following a COVID-19 infection, assessing cardiovascular risk in patients with long COVID is essential for proactive patient care.^2,3

After years of barriers and obstacles to long COVID care for impacted patients, the health care system is increasingly recognizing the burden of the disease. As the study investigators discuss, despite cardiovascular manifestations of long COVID being well documented at this point, there remains a lack of clarity on epidemiologic and disease-specific factors influencing this bidirectional association.¹

Making things more complicated are the often hard-to-explain and hard-to-manage symptoms associated with long COVID. There are no available tests to explicitly diagnose long COVID and rule out other diseases. These pitfalls can result in delays in receiving appropriate treatment and care and can ultimately worsen long-term cardiovascular complications.^1,4

How Are Long COVID and CVD Risk Associated?

The current investigators utilized nationally representative data from the 2022-2023 US National Health Interview Survey (NHIS) and the 2022-2023 Medical Expenditure Panel Survey (MEPS). They aimed to examine the association between long COVID and CVD in US adults 18 years and older. The authors defined long COVID as self-reported COVID-19 symptoms that persist for more than 3 months after the initial infection. CVD was defined as a self-reported diagnosis of coronary heart disease, angina, myocardial infarction, or cerebrovascular disease.¹

Rao-Scott χ² and survey-weighted multivariate logistic regression models were used to assess associations between current and ever-long COVID and CVD in NHIS, with adjustments made for demographic and socioeconomic factors. In the MEPS database, temporal relationships were explored by incorporating self-reported age at CVD diagnosis into survey-weighted multivariate logistic regression, according to the investigators.¹

A total of 15,753 NHIS respondents were included in the analysis. Among these, 1237 (7.85%) reported current long COVID. Unadjusted analyses revealed 12.55% of individuals with current long COVID reported a CVD diagnosis, compared with 6.43% of those without long COVID (P < .001). Following adjustments in the multivariable analysis, current long COVID remained meaningfully associated with CVD (adjusted OR, 1.38; 95% CI, 1.09-1.74). This was especially true regarding angina and myocardial infarction.¹

Significant correlates between long COVID and CVD were observed. Obesity, female sex, former or current smoking, having received fewer COVID-19 vaccines, and harboring more chronic conditions were major correlates of CVD risk.¹

In the MEPS database, which included 8499 individuals, patients with long COVID were found to have increased odds of a subsequent CVD diagnosis (OR, 1.75; 95% CI, 1.04-2.96). Furthermore, there was a nonsignificant trend suggesting that preexisting CVD could elevate long COVID risk (OR, 1.30; 95% CI, 0.99-1.70).¹

“Our findings demonstrate the impact of long COVID on the development of CVD,” the study authors concluded. “Further research to understand the pathophysiology, treatment, and prevention of CVD in people with long COVID is needed to better inform health interventions.”¹

REFERENCES

1. Zhang GY, Lin J, Nguyen D, et al. (P-1607) Long COVID and cardiovascular diseases among US adults: a survey study. Presented at: IDWeek; October 22, 2025; Atlanta, GA. Accessed via IDWeek’s Virtual Platform on November 7, 2025.

2. Halpern L. In the fragmented landscape of long COVID care, pharmacists are essential. Pharmacy Times. October 20, 2025. Accessed November 7, 2025. https://www.pharmacytimes.com/view/in-the-fragmented-landscape-of-long-covid-care-pharmacists-are-essential

3. Heart problems after Covid. Cleveland Clinic. Updated January 25, 2024. Accessed November 7, 2025. https://my.clevelandclinic.org/health/articles/heart-problems-after-covid

4. Long COVID signs and symptoms. CDC. Updated July 24, 2025. Accessed November 7, 2025. https://www.cdc.gov/long-covid/signs-symptoms/index.html