TOPLINE:

Long COVID was associated with a substantially higher risk for new-onset cardiovascular disease (CVD), particularly cardiac arrhythmias and coronary artery disease, in both women and men, with additional risks for heart failure and peripheral arterial disease in women.

METHODOLOGY:

• Researchers in Sweden conducted a population-based cohort study to assess whether individuals with long COVID have a higher risk of developing CVD than those without long COVID.
• They assessed 1,222,058 individuals (656,864 women) aged 18-65 years between October 2020 and January 2025; none had been hospitalised for acute COVID or had any preexisting CVD in the 5 years prior to study entry.
• Outcomes were compared between individuals with a physician-assigned diagnosis of long COVID in routine care and those without a diagnosis.
• The primary outcome was the first occurrence of a CVD event, including myocardial infarction, heart failure, stroke, cardiac arrhythmias, or peripheral arterial disease.

TAKEAWAY:

• Overall, 8999 individuals in the study cohort were diagnosed with long COVID.
• After adjustment for covariates, long COVID was linked to an approximately twofold higher risk for the composite CVD outcome in women (hazard ratio [HR], 2.06; 95% CI, 1.92-2.22) and a one-third higher risk in men (HR, 1.33; 95% CI, 1.20-1.48) than no long COVID.
• In both women and men, the risk for cardiac arrhythmia was higher among individuals with long COVID than among those without long COVID, with a stronger association in women (HR, 3.11) than in men (HR, 1.61; P < .0001 for both).
• Long COVID was associated with a higher risk for coronary artery disease in both women and men (HR, 1.25 for women and 1.26 for men; P < .05 for both); increased risks for heart failure and peripheral arterial disease were significant only in women.

IN PRACTICE:

"Taken together, our findings position long COVID as a clinically relevant, independent cardiovascular risk factor even in younger, previously healthy adults, and they argue for structured, sex-aware follow-up and preventive strategies in post-COVID care, particularly given that cardiovascular disease in women often presents with more diffuse and atypical symptoms, which may complicate early recognition and risk assessment," the authors wrote.

SOURCE:

The study was led by Pia Lindberg, Karolinska Institutet, Stockholm, Sweden. It was published online on April 01, 2026, in eClinicalMedicine.

LIMITATIONS:

Milder long COVID cases were likely underdiagnosed, particularly during the early phases of the pandemic. Individuals diagnosed with long COVID had more frequent healthcare contacts, and women were more likely than men to seek care for persistent symptoms and receive a diagnosis, which could have led to differential diagnostic capture by sex.

DISCLOSURES:

The study was supported by Region Stockholm and the Swedish Heart‑Lung Foundation. Several authors reported receiving compensation from LINK Medical that was unrelated to the present study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.