Thanks for sharing this! It is worrying, but the magnitude does not seem like it would change Zvi’s overall conclusion. Some reasons why:
Not enormous increase in absolute terms. Per the article
Increase in stroke: 0.4% pts
Increase in HF: 1.2% pts
Most participants likely were not vaccinated (looking at the study itself)
162,690 participants who had a positive COVID-19 test between 1 March 2020 and 15 January 2021 were selected into the COVID-19 group
Increase in any cardiovascular outcome for non-hospitalized individuals was 2.85% points (difference of 28.5 cases out of 1000) (Supplementary Table 8 in the study itself)
Stroke is 1.85 / 1000 (0.2% pts), heart failure is 6.05 / 1000 (0.6% pts)
I assume they highlighted stroke and HF because those are particularly severe issues, but eyeballing the table for other scary things (as someone who is not a medical expert): myocardial infarction 0.39, cardiac arrest −0.04, MACE (any major adverse cardiac events) 11.29 (all out of 1000)
Limitation with controls (though I dunno if this is likely to make a significant difference)
Ardehali cautions that the study’s observational nature comes with some limitations. For example, people in the contemporary control group weren’t tested for COVID-19, so it’s possible that some of them actually had mild infections. And because the authors considered only VA patients — a group that’s predominantly white and male — their results might not translate to all populations.
Thanks for digging into this a bit, and I should have linked directly to the paper rather than to an article with the headline “Heart-disease risk soars after COVID” with a focus on relative risks, since as you say the absolute risks are very important for putting things into perspective. For what it’s worth, I agree with Zvi’s final conclusion (“That’s not nothing, but it’s not enough that you shouldn’t live your life”).
That said, an additional 1.2 out of every 100 people experiencing heart failure in the first 12 months after COVID-19 infection, if that holds up in reality, seems like it may have some effects at a population level (suggests that cardiologists will be in more demand, if nothing else). I can imagine that for some people with low risk tolerances, or with high preexisting cardiac risk, it might be a factor in wanting to live one’s life slightly differently than one did prepandemic.
It’d have been nice if they’d included a breakdown of when the vaccinated participants tested positive relative to when they were vaccinated. Supplementary table 21 notes that virtually no one was vaccinated prior to enrollment in the study, but that 62% in the COVID group (56% in the control group) had been vaccinated by the end.
Thanks for sharing this! It is worrying, but the magnitude does not seem like it would change Zvi’s overall conclusion. Some reasons why:
Not enormous increase in absolute terms. Per the article
Increase in stroke: 0.4% pts
Increase in HF: 1.2% pts
Most participants likely were not vaccinated (looking at the study itself)
162,690 participants who had a positive COVID-19 test between 1 March 2020 and 15 January 2021 were selected into the COVID-19 group
Increase in any cardiovascular outcome for non-hospitalized individuals was 2.85% points (difference of 28.5 cases out of 1000) (Supplementary Table 8 in the study itself)
Stroke is 1.85 / 1000 (0.2% pts), heart failure is 6.05 / 1000 (0.6% pts)
I assume they highlighted stroke and HF because those are particularly severe issues, but eyeballing the table for other scary things (as someone who is not a medical expert): myocardial infarction 0.39, cardiac arrest −0.04, MACE (any major adverse cardiac events) 11.29 (all out of 1000)
Limitation with controls (though I dunno if this is likely to make a significant difference)
Ardehali cautions that the study’s observational nature comes with some limitations. For example, people in the contemporary control group weren’t tested for COVID-19, so it’s possible that some of them actually had mild infections. And because the authors considered only VA patients — a group that’s predominantly white and male — their results might not translate to all populations.
Thanks for digging into this a bit, and I should have linked directly to the paper rather than to an article with the headline “Heart-disease risk soars after COVID” with a focus on relative risks, since as you say the absolute risks are very important for putting things into perspective. For what it’s worth, I agree with Zvi’s final conclusion (“That’s not nothing, but it’s not enough that you shouldn’t live your life”).
That said, an additional 1.2 out of every 100 people experiencing heart failure in the first 12 months after COVID-19 infection, if that holds up in reality, seems like it may have some effects at a population level (suggests that cardiologists will be in more demand, if nothing else). I can imagine that for some people with low risk tolerances, or with high preexisting cardiac risk, it might be a factor in wanting to live one’s life slightly differently than one did prepandemic.
It’d have been nice if they’d included a breakdown of when the vaccinated participants tested positive relative to when they were vaccinated. Supplementary table 21 notes that virtually no one was vaccinated prior to enrollment in the study, but that 62% in the COVID group (56% in the control group) had been vaccinated by the end.