Ken Sepkowitz is a doctor specializing in infectious disease at Memorial Sloan Kettering in New York and has been publishing commentaries on CNN's site throughout COVID. A commentary from 3/4/2022 summarized findings from a study of COVID patients as jaw dropping.
https://www.cnn.com/2022/03/04/opinions/covid-19-cardiovascular-symptoms-sepkowitz/index.htmlHis commentary references an underlying study published by Nature Medicine on 2/2/2022 here:
https://www.nature.com/articles/s41591-022-01689-3The Nature Medicine results were based upon analysis of medical evaluations of 153,760 individuals provided with care by VA hospitals who tested positive for COVID. Those individuals were contrasted against two much larger groups -- 5,637,647 individuals treated by the VA during the same time frame who had no testable signs of COVID infection and 5,859,411 VA patients from 2017 prior to the onset of COVID. Here is the key conclusion in the VA based study:
We show that, beyond the first 30 d(ays) after infection, individuals with COVID-19 are at increased risk of incident cardiovascular disease spanning several categories, including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease. These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection and increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care). Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial.
Figures 2 and 3 in the Nature Medicine report summarize the jump in incidence of subsequent cardiovascular issues between the group that experienced COVID and the control groups. Two factors are presented in each category.
Hazard Ratio -- the ratio between the share of COVID patients exhibiting a specific issue and the share in the control groups exhibiting the same symptom. For example, if 2.0 percent of the control group exhibited dysrhythmia and 3.6 percent of COVID patients exhibited dysrhythmia, the hazard ratio would be 1.8, meaning the actual incidence rate would be 80% above "normal." Excess Burden -- reflects the additional absolute number of patients exhibiting a particular symptom per one thousand patients in the test group over the control groups. For issues involving relatively small percentages of occurrence, this form of statistic scales values back into integer ranges to simplify comparison across factors where even small rates of occurrence in large populations still means dire consequences.The study results showed that the SMALLEST spike in the hazard ratio for cardiovascular problems for those infected by covid was about 1.6 and the cumulative excess burden of covid patients presenting cardiovascular issues was 45.29 per 1000 in the population.
The key to this study is that it compiled these stats against ANY patient interacting with VA healthcare providers who tested positive for COVID, not just those seeking COVID-specific treatment or requiring hospitalization for COVID. What that means is that ANY actual COVIDinfection, even mild or undetected cases, produced a much higher, statistically non-random jump in a full range of undesired cardiovascular health issues.
In Sepkowitz's commentary, he makes two important points.
The first point is that this VA study used data related to patients with "classic COVID", not delta or omicron variants so it is impossible at this point to predict if those variants will reflect similar outcomes to infected patients. It seems obvious to point out that because the original study group included those who didn't require hospitalization or may not have even known about their own case of "classic COVID," the lack of immediate acute symptoms or hospitalization for delta and omicron doesn't seem to warrant optimism. These issues seem to have nothing to do with the respiratory related issues that cause most hospitalizations.
The second point is that with over EIGHTY MILLION Americans infected with one of the COVID variants and these statistically significant "hazard ratios" for complex, dangerous, expensive-to-treat cardiovascular issues, the United States needs to begin planning to fund and staff the effort required to provide long-term treatment for these conditions. Using the "excess burden" number from this study of 45.29 per 1000, America's population of 80,000,000 (and counting) exposures could lead to 3.6 million new chronic patients requiring ongoing treatments over decades. There's no "if" involved. Only "when."
WTH
