Objective:

To investigate the association between long COVID and the risk of incident cardiovascular disease in patients without prior cardiovascular conditions.

Key Findings:

• Patients with long COVID had a higher cumulative incidence of cardiovascular events (18.2% vs 8.4% in women; 20.6% vs 11.1% in men).
• Long COVID was associated with a 2.06 greater likelihood of composite cardiovascular events in women and 1.33 in men.
• Cardiac arrhythmias had the strongest association, with a 3.11 greater likelihood in women and 1.61 in men.
• Increased likelihood of coronary artery disease (1.25 in women, 1.26 in men) and heart failure (1.25 in women) was noted.
• Long COVID was not associated with stroke in either sex.

Interpretation:

Long COVID significantly increases the risk of various cardiovascular diseases, particularly in women, highlighting the need for ongoing monitoring and management of cardiovascular health in these patients.

Limitations:

• Potential underdiagnosis of milder long COVID cases early in the pandemic.
• Reliance on physician-assigned diagnostic codes.
• Possible detection bias due to increased healthcare use.
• Residual confounding from unmeasured factors like vaccination status and reinfection.

Conclusion:

Long COVID is associated with increased cardiovascular disease risk, especially for cardiac arrhythmias, heart failure, and coronary artery disease.