Patients hospitalized for COVID-19 are at greater risk for coronary artery disease, and patients with non-O blood types are at an additional risk for post-acute myocardial infarction and stroke, a new analysis from the UK Biobank shows. These data were reported by James R. Hilser, PhD and MPH candidate at the Keck School of Medicine, University of Southern California, Los Angeles, and colleagues from the University of California – Los Angeles and the Cleveland Clinic, Ohio, in a manuscript published Wednesday online and in the November issue of Arteriosclerosis, Thrombosis, and Vascular Biology. “We found a long-term cardiovascular health risk associated with COVID, especially among people with more severe COVID-19 cases that required hospitalization,” said Hilser in a news release on Wednesday. The risk of major adverse cardiac events (MACE) is increased in patients who have the SARS-CoV-2 virus. Additionally, patients are at a higher risk for overall cardiovascular disease (CVD). The investigators in this study examined the duration of these heightened CVD risks and sought to determine underlying causes of CVD and MACE post-COVID-19. A total of 10,005 cases of COVID-19 were identified in the UK Biobank dataset between February 1, 2020, and December 31, 2020. The hospitalized/severe cases of COVID-19 totaled 1,943 patients (mean age=70.4 years, number of women=874, 90.1% white, 3.4% Asian, 3.9% Black), and the other 8,062 were identified using a positive polymerase chain reaction test. Population controls consisted of 217,730 patients (mean age=68.4 years; number of women=121,327; 94.3% white, 1.9% Asian, 1.6% Black), and propensity score-matched controls consisted of 38,860 patients (mean age=70.6 years; number of women=17,130; 90.2% white, 3.4% Asian, 3.6% Black), over the same period. Proportionate hazard models evaluated the association between COVID-19 and long-term risk of MACE and coronary artery disease. All levels of COVID-19 severity showed an elevated risk for MACE (hazard ratio [HR]=2.09, 95% confidence interval [CI]=1.94-2.25, p<0.0005), and even more so in patients who were hospitalized for COVID-19 (HR=3.85, 95% CI=3.51-4.24, p<0.0005). A coronary artery disease risk equivalent was represented by hospitalization for COVID-19 due to the higher number of incident MACE risk among patients who did not have a history of CVD, compared with patients who had CVD but did not have COVID-19 (HR=1.21, 95% CI=1.08-1.37, p<0.005). Additionally, a genetic interaction was observed between the ABO locus — in patients with non-O blood types — and COVID-19 hospitalizations (pinteraction=0.01). Patients with non-O blood also had a higher risk of thrombotic events (HR=1.65, 95% CI=1.29-2.09, p=4.8×10-5), compared with patients who had blood type O (HR=0.96, 95% CI=0.66-1.39, p=0.82). In summary, patients who are hospitalized with COVID-19 are at heightened risk for coronary artery disease, and patients with a non-O blood type are at even greater risk of thrombosis. Source: Hilser JR, Spencer NJ, Afshari K, et al. COVID-19 Is a Coronary Artery Disease Risk Equivalent and Exhibits a Genetic Interaction With ABO Blood Type. Arterioscler Thromb Vasc Biol. 2024 Oct 9 (Article in press). Image Credit: Prostock-studio – stock.adobe.com