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The long cost of Covid-19

Written By: - Date published: 11:56 am, February 13th, 2022 - 47 comments
Categories: covid-19, health, long covid, science - Tags:

There has been a depressing large study published looking at the medical risks of having covid-19 on the cardiovascular systems in Nature Medicine. Ars Technicia have a readable version.

The study tapped into a massive database of health records at the Department of Veterans Affairs, which has data from patients at 1,255 health care facilities across the US. The authors, led by clinical epidemiologists Yan Xie and Ziyad Al-Aly, focused on 153,760 veterans who tested positive for COVID-19 between March 1, 2020 and January 15, 2021 and survived at least 30 days afterward. They then assembled a comparison group of 5.6 million veterans from the same period who did not test positive and a historical comparison group that included health records from 2017 from an additional 5.9 million veterans.

Xie, Al-Aly, and coauthors then looked at the incidence of 20 pre-determined serious cardiovascular diseases over the course of a year in the three cohorts. They also calculated the excess burden of disease that linked with COVID-19.

Higher Risks

Overall, a COVID-19 infection significantly boosted the risks of developing cardiovascular diseases for a year afterward, compared with people who were uninfected. More specifically, people infected with COVID-19 had a 63 percent higher risk of developing any of the 20 cardiovascular diseases over the year than their uninfected contemporary cohort. In terms of excess burden, that meant that among the infected there were 45 additional people with any of the 20 cardiovascular diseases per 1,000 people at the end of the year, compared with the uninfected cohort.

When the researchers focused on the most devastating outcomes—heart attack, stroke, and death—those infected with COVID-19 had a 55 percent higher risk of those major events, which worked out to about 23 extra such cases per 1,000 people.

Ars Technicia: “COVID causes “substantial” longterm cardiovascular risks, huge study finds

To deal with the issues of age and previous factor demographics

While the large size of the study is a clear strength, the veteran population is not representative of the entire population. The groups in the study skewed white, male, and older (with mean ages in the low 60s). As such, Xie, Al-Aly, and coauthors did a series of adjustments, given known differences in risks among demographics. They also did a battery of control and sensitivity analyses, as well as subgroup analyses.

For instance, the researchers ran their analyses looking for things known to be linked to COVID-19—namely fatigue—and reproduced an association. They looked for things not known to be linked to COVID-19—such as melanoma—and didn’t find an association.

Future burden

They also split their groups into subgroups based on age, race, sex, obesity, smoking, hypertension, diabetes, chronic kidney disease, hyperlipidemia, and cardiovascular disease. They concluded that the higher risks of cardiovascular outcomes were “evident in all subgroups.”

The risks “were also evident in people without any cardiovascular disease before exposure to COVID-19, providing evidence that these risks might manifest even in people at low risk of cardiovascular disease,” the authors noted in their conclusion.

When they looked at care settings—that is, if people were not hospitalized, hospitalized, or admitted to intensive care—the researchers found that risks increased with needed care. But the higher risks of cardiovascular disease were still clearly evident in people who never needed hospitalization, which is the majority of people with COVID-19.

Ars Technicia: “COVID causes “substantial” longterm cardiovascular risks, huge study finds

This is a very comprehensive and large statistical study. They appear to have corrected for most of the factors that may be skewing the results. The only one I could identify as missing was what the effect of vaccinations have on the results. Since vaccinations only started in the US at the very end of 2020, it is unlikely that many of this study infected over 2020 and and early 2021 had been vaccinated before infection.

It should be noted that Omicron and Delta won’t be present in these results as they looked at people a year after being infected. But because the causation of these longer-term cardiovascular system effects from Covid-19 isn’t understood at a clinical level and in particular how they manifest long after infection and recovery, I wouldn’t be particularly hopeful that Omicron is any more benign.

As multiple political systems have shown over the course of this pandemic, running on hope and propaganda just causes more deaths and hospitalisations. Now it appears likely to also cause a higher than expected significiant effect on long-term healthcare as well.

There is nothing more debilitating for long term health than cardiovascular health. The only thing the comes near to it is lung damage or many disabilities. But the latter is measurable and something that can be anticipated. Many of the cardiovascular issues strike suddenly and have wide-ranging effects. I can speak with experience having had a stent for the last decade after a heart failure. Plus a TIA mini-stroke in 2020.

Look at these percentage increases and think what the effect will be in hospital systems like ours. Many of these are high in our lists of

Of course, people with COVID-19 had different relative risks depending on which of the 20 cardiovascular diseases researchers looked at. For instance, veterans with COVID-19 had a 72 percent higher risk of developing heart failure in the 12 months following their infection compared with uninfected people. Infected veterans also had a range of 53 percent to 84 percent higher risk of developing one of five arrhythmias. Among those disorders, people with COVID-19 had a 71 percent higher risk of developing atrial fibrillation. The infected also had a 52 percent higher risk of having a stroke, a 63 percent higher risk of a heart attack, and nearly three times the risk of pulmonary embolism (blood clot in the lungs).

Veterans infected with COVID-19 also had more than five times the risk of developing myocarditis, which is inflammation of the heart muscle. Because some COVID-19 vaccines are also linked to myocarditis, Xie, Al-Aly, and coauthors conducted two separate analyses to eliminate any possible contribution that vaccination could play in increasing risk. Both analyses held that COVID-19 alone could increase the risk of myocarditis.

Ars Technicia: “COVID causes “substantial” longterm cardiovascular risks, huge study finds

Hopefully this will be a ongoing time series study looking at the same or similar groups over time. Follow up studies in other nations will also fill out regional variations. Similarly looking at the effects of Covid-19 vaccinations in subsequent years.

That will at least start to prepare us for the longer-term endemic effects of Covid-19 in the population.

47 comments on “The long cost of Covid-19 ”

  1. weka 1

    it's also why avoiding omicron if one can is still a bloody good idea.

    • Belladonna 1.1

      TBH – unless you live like a hermit, I don't think you can.

      2 separate cases of friends overseas. Both caught Omicron, despite being fully vaxed, fully masked (outside the home) and associating only with people who were fully vaxed. One caught Omicron from a family member (impossible to judge just how rigorous other family members are about infection protocols). The other probably caught it from a friend during an outside walk, where both were fully masked/vaxed and boosted.

      If you're susceptible (and there are some people who simply don't seem to catch Covid – natural immunity? or an early, particularly effective prophylactic dose?) – then you're almost certainly going to get it. The only thing that the restrictions can do is slow down the infection rate so that the hospital system can cope.

      But, from the perspective of long Covid, it doesn't matter whether you catch it this week, or in 6 weeks time – the effect on your health will be the same.

    • Gosman 1.2

      In which case why has the government ditched lockdowns as a method for dealing with the virus?

  2. Barfly 2

    "That will at least start to prepare us for the longer-term endemic effects of Covid-19 in the population."

    I have read that vaccinated covid19 patients are not affected by long covid (don't remember where). Hopefully the endemic health problems are restricted the 4% of people who are unwilling or unable to be vaccinated. (making the problem 24x smaller)

    • weka 2.1

      research appears to be mixed but general gist is that vaccinated reduces risk but doesn't protect fully. And we don’t know what will happen with omicron given its ability to evade the vaccination response.



      I'm unclear if all long term effects are classified as long covid though eg if the heart issues Lynn wrote about are stand alone conditions, are they being counted separately from LC?

      • lprent 2.1.1

        Probably not seperate. Jusr about any cardio related problem can cause the kinds of problems attributed to some of the ling covid symptoms, as can lung damage as well. Most ofvthem read like insufficent oxygen getting where it needs to.

        • weka

          true, but how will they differentiate in any person between cardiac conditions that would have happened anyway and those that are from long covid?

        • Shanreagh

          In the article from NYT that I have just linked to they cover this very thing. See Post 7

          "Yet when the long Covid patients exercised on a stationary bicycle, Dr. Systrom found that some veins and arteries were not working properly, preventing oxygen from being delivered efficiently to their muscles.

          Nobody knows why these blood vessel problems occur, Dr. Systrom said, but another one of his recent studies suggested that long Covid patients experience damage to a certain kind of nerve fiber involved in how organs and blood vessel function."

  3. Rosemary McDonald 3

    And while I have temporary internet (no power in FFNorth, ? 2-3 days before fix and not willing to trust Uber gear on our generator..good old Bus solar is running this.)

    From Israel… and a very depressing read with regard to heart damage from the mRNA vaccines.

    New study: 133x risk of myocarditis after COVID vaccination

    Comparisons with myocarditis rates following infection now irrelevant as vaccination no longer prevents infection.

    A recent study published on January 25, 2022, on JAMA Network, has shown that the risk of myocarditis following mRNA COVID vaccination is around 133 times greater than the background risk in the population.

    The study, conducted by researchers from the U.S. Centers for Disease Control (CDC) as well as from several U.S. universities and hospitals, examined the effects of vaccination with products manufactured by Pfizer-BioNTech and Moderna. The study’s authors used data obtained from the CDC’s VAERS reporting system which were cross-checked to ensure they complied with CDC’s definition of myocarditis; they also noted that given the passive nature of the VAERS system, the number of reported incidents is likely to be an underestimate of the extent of the phenomenon.

    1626 cases of myocarditis were studied, and the results showed that the Pfizer-BioNTech product was most associated with higher risk, with 105.9 cases per million doses after the second vaccine shot in the 16 to 17 age group for males, and 70.7 cases per million doses after the second shot in the 12 to 15 age group for males. The 18 to 24 male age group also saw significantly higher rates of myocarditis for both Pfizer’s and Moderna’s products (52.4 and 56.3 cases per million respectively).


    We have known about the very real risk of heart damage from the mRNA 'vaccines' especially in younger men for some time now and NZ has had more than our share of reports. Reports to Medsafe here…https://www.medsafe.govt.nz/COVID-19/safety-report-39.asp

    You need to look not only at the myo/pericarditis reports but also at the ridiculously high number of people with other symptoms such as chest discomfort, dizziness, nausea. We may have a severe problem with some of our young people in the not too distant future because the experts simply don't know if vaccine damaged heart completely recover.

    Almost invariably the 'experts' have minimised or dismissed these cases claiming Covid presents a greater risk and if someone does get myocarditis from the vaccine it will be mild and transitory etc etc. https://www.stuff.co.nz/national/health/coronavirus/127337216/covid19-myocarditis-was-probably-due-to-vaccination-says-board-reviewing-mans-death Shame on Pertousis -Harris.

    I get concerns about Long Covid and I get concerns about at- risk older folks suffering long term cardiovascular damage from infections but I am more worried about the drive to 'vaccinate' young people who are more at risk of heart damage from the jab than they of of having severe disease from Covid.

    One of the reasons for the Wellington protest…everyone has a vaccine injury story and many involve heart issues.

    We need to end the mandates now and allow the young ones to live their lives.

    • Shanreagh 3.1

      Is this thread about vaccines?

      If it is about Long Covid why is there a post about vaccines.

    • lprent 3.2

      A recent study published on January 25, 2022, on JAMA Network, has shown that the risk of myocarditis following mRNA COVID vaccination is around 133 times greater than the background risk in the population.

      So where was their comparison population? We know that there is a chance of getting myocarditis with the vaccines. We also know that there is a chance of getting myocarditis with being infected with covid-19. Comparing either against a background incidence of a reaction is useless unless you compare both.

      After all the probability of getting covid-19 over the coming years is about 100%. The reason why the vaccines produce myocarditis is because they are training your immune system to recognise and deal with covid-19 – which also produces myocarditis effects. The only purpose of having the vaccine is to reduce the incidence of all effects from having covid-19. So that is what it needs to be measured against.

      I think that you or whoever you parroted that off are simply lying by omission. Not looking through the intent of the study. Which means that I think your comment is complete crap and an about as useless as the rarity of a extra finger.

      I'm not even going to look at the link because it isn't worth my time pointing out that I already know that a vaccine imitating a disease that causes myocarditis may also trigger a much lower incidence of myocarditis in young men. But that the probability of getting myocarditis from the vaccine is far lower than getting it from covid-19, and even less after getting covid-19 while vaccinated.

      I can’t be bothered explaining the issue to you. You'll just ignore any points I make anyway.


  4. Chris T 4

    Far out. While I hope I don't get the thing I probably will, but not that worried as vacced and relatively healthy, but the whole doomsday crap is getting on my tits.

    I thought we kind of got rid of it when Bush was trying to use it with terrorism after 9/11 as a political tool.

    • weka 4.1

      There were no weapons of mass destruction in Iraq, whereas long covid is an actual thing.

      • Chris T 4.1.1

        While that is a fair point at the time no one knew Bush was talking shit.

        At the end of the day my point stands. Fear tactics get tiresome.

        • lprent

          I knew that he was talking shit. Apparently most of the people actually making the decision knew that it was shit.

          Simple logic made it obvious. Interdicting supplies to make WOMD where you weren't finding the supplies even with strenuous effort actually being shipped made it obvious. A negative result in an embargo does not imply that you're just missing the shipments. It probably means that the supplies weren't being shipped.

          Not to mention the idea of Saddam Hussien helping out the same terrorists who were saying that he should die to run planes into buildings in The US was a ludicrous proposition in the first place.

          Those was the reasons that NZ under a Labour government didn't climb into bed with the coalition of the stupid nations.

      • Ross 4.1.2

        long covid is an actual thing.

        As is long flu…Covid isn't unique. There is an increased risk of heart attack and other serious side effects from flu including death.

        While there’s no doubt long Covid is a real condition worthy of diagnosis and treatment, “this isn’t unique to Covid,” Akiko Iwasaki, an immunologist at the Yale School of Medicine, said. Covid-19 appears to be one of many infections, from Ebola to strep throat, that can give rise to stubbornly persistent symptoms in an unlucky subset of patients. “If Covid didn’t cause chronic symptoms to occur in some people,” PolyBio Research Foundation microbiologist Amy Proal told Vox, “it would be the only virus that didn’t do that.”

        Even with growing awareness about long Covid, patients with chronic “medically unexplained” symptoms — that don’t correspond to problematic blood tests or imaging — are still too often minimized and dismissed by health professionals. It’s a frustrating blind spot in health care, but one that can’t be as easily ignored with so many new patients entering this category, said Megan Hosey, assistant professor at the Johns Hopkins Department of Physical Medicine and Rehabilitation.

        “It has always been [and] is the case that patients who get sick experience high levels of symptoms like those described by long-Covid patients,” she said. “We have just done a terrible job of acknowledging [and] treating them.”

        “I can’t find a single thing that the SARS-CoV-2 virus can do, that other viruses cannot,” Proal said. “It’s well understood and it’s been understood for decades that every major pathogen capable of infecting people has a syndrome associated with it in which a certain number of patients who get that pathogen,” she continued, “will develop chronic symptoms that never go away.”



        • lprent

          Oh I agree in the abstract like the quotes in your link.

          However theory doesn't produce actual numbers and risk assessments. It also doesn't look at the scale of the population

          There is a reason that the people quoted above weren't comparing with relative risks. That is because they don't know how big the subsets are for most diseases. All that they know is that they are smallish.

          What this study shows up is that the size of the subset with covid-19 after-effects from this particular is significantly higher than with other diseases where the values are known.

          Unlike the many strains of influenza of influenza and Ebola, it is unlikely that most of the worlds population will get each one of them. Whereas with Covid-19, currently the probability of infection over coming years looks to be 100% as it becomes an endemic disease.

          That means that in terms of total number affected by after-effects of covid-19 are likely to constitute a long-term health issue of monumental total numbers compared to other diseases.

          Basically trying to wave away total numbers with a brush of basic theory doesn’t make the problem disappear. It just shows people, presumably like you, stuffing the heads up their nice safe self-referential rectum and hoping it will all go away. It id delusional rather than facing reality.

        • joe90

          Covid isn't unique.

          Tell me, what other bat disease in humans primarily attacks one of the body's most critical systems?


          The vascular endothelium provides the crucial interface between the blood compartment and tissues, and displays a series of remarkable properties that normally maintain homeostasis. This tightly regulated palette of functions includes control of haemostasis, fibrinolysis, vasomotion, inflammation, oxidative stress, vascular permeability, and structure. While these functions participate in the moment-to-moment regulation of the circulation and coordinate many host defence mechanisms, they can also contribute to disease when their usually homeostatic and defensive functions over-reach and turn against the host. SARS-CoV-2, the aetiological agent of COVID-19, causes the current pandemic. It produces protean manifestations ranging from head to toe, wreaking seemingly indiscriminate havoc on multiple organ systems including the lungs, heart, brain, kidney, and vasculature. This essay explores the hypothesis that COVID-19, particularly in the later complicated stages, represents an endothelial disease. Cytokines, protein pro-inflammatory mediators, serve as key danger signals that shift endothelial functions from the homeostatic into the defensive mode. The endgame of COVID-19 usually involves a cytokine storm, a phlogistic phenomenon fed by well-understood positive feedback loops that govern cytokine production and overwhelm counter-regulatory mechanisms. The concept of COVID-19 as an endothelial disease provides a unifying pathophysiological picture of this raging infection, and also provides a framework for a rational treatment strategy at a time when we possess an indeed modest evidence base to guide our therapeutic attempts to confront this novel pandemic.


          • lprent

            That is one of the theories. One that has a bit more support for the causation in the 18 months since publication.

            But at present covid-19 is a bit like measles was. We had it for centuries before it was realised that it was a disease of the immune system like HIV. https://asm.org/Articles/2019/May/Measles-and-Immune-Amnesia

            The way the covid-19 is producing the effects, especially longer term effects, that it does is not understood. Lost of theories and despite the numbers of cases, very little information about causation. So far, like the study in the post, we’re barely getting to the point of being able to know the effects for sure in short-term studies. That is rather scary bearing in mind the size of the population that has been infected.

          • Chris T

            "Tell me, what other bat disease in humans primarily attacks one of the body's most critical systems?"

            You kind of have to give definitive prrof it came from bats first.

            And plenty of diseases attack the bodies most critical systems.

            • joe90

              Bats are a natural coronavirus reservoir.

              Almost every protective barrier in your body is made up of epithelial cells and dysfunction of those cells is the smoking gun in almost everything from allergies and autoimmune conditions to metabolic disorders like diabetes, obesity and rheumatoid arthritis.

              The protective barrier in your vascular system is made up of endothelial cells and dysfunction of those cells is the smoking gun in vascular disease.

              It appears that Covid is a disease of endothelial cells.

              • Chris T

                That didn't really answer my question.

                Proof it came from bats, and not just theory.And the claim it is some freak disease it is on the only one attacking the bodies most critical systems.

                There is no definitive proof it was bats and have people not heard now of the black death, multiple types of cancer, cholera, heart disease, HIV, AIDS, Malaria?

                You could even argue Dementia and Altzheimers as critical parts.

          • Chris T

            Oh forgot bats can also give humans rabies and ebola if you are a speaking specific, which both attack critical systems

        • weka

          What’s your point Ross? Because you appear to be saying that because flu also has a long term illness associated with it that long covid isn’t a big deal, and that it’s ok if we have LC on top of flu complications. 🤷‍♀️

  5. Stan 5

    Rosemary, that’s a good link from JAMA. I do think it’s a bit emotive to use the term “heart damage” as this implies irreversible damage to the heart (eg heart attack). Myocarditis is not “heart damage”, it is inflammation of the heart muscle. Usually benign, improves without problems, only small minority of patients end up with “heart damage”.

    105.9 cases per million doses. That's around 1 in 10000. Actually a pretty small risk of this particular side effect compared to the number of hospitalisations and ICU admissions prevented by the vaccination. What risk of side effects is acceptable to you? You can't say "zero" as there's no such thing as a medical intervention with zero risk.

    Useful link from Starship (look at the table just under "key points"):


    Most myocarditis and pericarditis associated with COVID vaccines run a mild course and patients recovered quickly. The younger the patient however, the risk does increase.

    • Stan 5.1

      And just to add, anaphylaxis (severe allergy, eg to nuts or antibiotics, other causes) is estimated to kill approximately 6 people yearly in NZ.

      Although the anti-vaccine groups state that the figures are hidden, there has only been 1 proven COVID vaccine death in NZ so far. Of course, it's possible there are more.

      Perhaps the anti-vaccine people would be more productive trying to ban peanuts as would save more lives!

      • KJT 5.1.1

        Only one, or even several, over ten million doses, makes it an extremely safe medical intervention.

        How many dead after a few thousand cases of Covid, again?

      • Molly 5.1.2

        The latest released government data corrects you:


        Summary of reported deaths

        Up to and including 31 December 2021, a total of 133 deaths were reported to CARM after the administration of the Comirnaty vaccine. Following medical assessments by CARM and Medsafe it has been determined that:

        • 54 of these deaths are unlikely related to the COVID-19 vaccine
        • 58 deaths could not be assessed due to insufficient information
        • 19 cases are still under investigation.
        • 2 deaths were likely due to vaccine induced myocarditis (awaiting Coroner’s determination)

        By chance, some people will experience new illnesses or die from a pre-existing condition shortly after vaccination, especially if they are elderly. Therefore, part of our review process includes comparing natural death rates to observed death rates following vaccination, to determine if there are any specific trends or patterns that might indicate a vaccine safety concern. See below for more information about these observed-versus-expected analyses.

    • Rosemary McDonald 5.2


      How may of your nearest and dearest have had the two doses (because of work and/ or wishing to see close family overseas)and have suffered two or more of the symptoms of myocarditis afterwards?

      • Myocarditis and pericarditis are treatable. Outcomes are better the sooner you start treatment.
      • In the first few days after your vaccination, seek urgent medical attention if you experience:
        • new-onset chest pain (or an increase in severity of existing chest pain), discomfort or heaviness
        • shortness of breath or difficulty breathing
        • an abnormal heartbeat or a racing fluttering feeling or a feeling of skipped heartbeats
        • dizziness, feeling lightheaded or fainting may also occur with the symptoms above.

        These are potential symptoms of myocarditis and pericarditis.


      I know of at least four people who have experienced all of these symptoms, some having to stay in bed for days. Two thought this was a normal 'side effecst' (because they were told that would be the case) and did not seek medical attention. Two others sought medical attention and were assured it was nothing to worry about and probably due to anxiety.

      One of these persisted and was Holter monitored for two days. She was still told it was nothing. The fainting at work a month or so later was put down to anxiety also…not having to wear masks and goggles and not being able to breathe. She…and yes we seem to have an unusually high number of females experiencing this in NZ…was still experiencing pain through her chest 6 months later. She is shitting herself that her workplace will mandate booster shots.

      As I said…Long Covid, like ME and CFS are real…but what is worse, IMHO, is forcing young people to risk heart damage caused by a product with a ridiculously high rate of adverse effects that is supposed to protect them from a disease that will leave the vast majority of that age group unscathed.

      And telling a person that they will need to have the requisite number(whatever the fuck that is on any given day) of Pfizer shots in order to keep their job does constitute force.

      The vast majority of cases of vaccine induced myo and pericarditis in New Zealand have likely gone undiagnosed and untreated because there was little in the way of advisories issued to doctors. And it has been considered almost heresy to admit that these serious side effects exist.

  6. Anker 6
    • Thanks for this article.
  7. I came across this article in the NY Times (by Melinda Wenner Moyer) about Long Covid from 12/2/22.


    There are also some interesting comments, many pointing out that the symptoms are similar to Chronic Fatigue Syndrome.

    Somewhere I read, not sure where the reference is, that the likelihood of getting Long Covid is not linked to the severity of the Covid infection you may have had.

    • KJT 7.1

      Having look term effects from a past pnuemonia infection, I'm not surprised that other respiratory infections, like Covid, cause ongoing health problems.

      It reinforces the growing overall body of evidence, that the chances of serious effects from Covid, when vaccinated, are many times less, than possible side effects from vaccinations.

  8. GreenBus 8

    KJT 7.1

    I had 1 week of pretty uncomfortable heart palpitations after my booster shot. The medic warned me go to Doctor if this happens. I didn't but would have if was increasing. It went away and now I'm fine. I'm used to severe palpitation and on strong meds for that but it would scare most people. I was a little worries I must admit, but it is small fry compared to ME/CFS. I really hope the Vaccine works when I get Covid and consider it a small risk to possibly save me from the worst and or another dose of LC on top of the one I've got. Bugger that get jabbed all you anti vax people, LC is no joke if same as ME/CFS, and it sounds exactly the same.

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