Thread by @ZdenekVrozina

Even in the Omicron era, SARS-CoV-2 was linked to a several-fold increase in serious thromboembolic and cardiovascular events - and that risk persisted for months after infection🧵

A new European preprint cohort study looked at ~780,000 people with COVID-19 and 7.6 million pre-pandemic controls across three health databases in the UK, the Netherlands and Spain.

The main finding is hard to ignore.
In the first 30 days after infection, the standardized incidence of venous thromboembolism was about 3.6-4.1 times higher than expected!

Even after 180 days, the risk had not returned to baseline. It remained roughly 1.9-2.4 times higher!

The strongest signal was pulmonary embolism - a potentially fatal condition caused by a blood clot blocking the circulation in the lungs.

But this was not only about venous clots.

The study also reported increased signals for arterial and cardiovascular outcomes, including ischemic stroke, acute myocardial infarction, heart failure, arterial thromboembolism, and major adverse cardiovascular events.

The risk was highest in the first month after infection, but part of the signal persisted for up to six months!

Higher risks were seen especially in immunocompromised people and in those without a prior recorded SARS-CoV-2 infection.

Vaccination and prior infection likely reduced the risk, but they did not erase it. The authors also caution that some vaccine-stratified estimates were imprecise because of small event numbers and wide confidence intervals.

As always. Observational design, possible confounding, differences between databases, changing testing policies.

But the overall message is clear.
Omicron COVID was not simply a short respiratory illness.
It was associated with a meaningful vascular and cardiovascular risk, even in a population with widespread vaccination and prior infection.

And it matters for public health.
People were repeatedly told that a milder variant meant the consequences were minor. But a milder acute illness does not automatically mean no post-infectious vascular risk.

The cardiovascular consequences of SARS-CoV-2 remain under-communicated - by public health agencies and, too often, by medical societies that should be leading on this.
@ZdravkoOnline @szupraha @adamvojtech86 @strakovka

Reducing infections and reinfections still makes sense.
Protecting still makes sense.
And communicating the real risks of SARS-CoV-2 honestly still matters.

Li at al., Venous and arterial thromboembolic events after COVID-19 during the Omicron period in three European countries. nature.com/articles/s4159…

Prevention, as presented by @czechcardiology, increasingly looks less like cardiovascular protection - and more like digging the grave in slow motion.