Could COVID Leave a Lasting Mark on Your Heart?

You survived COVID-19. Maybe it hit you hard, maybe it barely slowed you down.

But weeks—or even months—later, you still don’t feel right. Fatigue lingers, your heart races, you feel out of breath climbing the stairs.

You might think these symptoms are all in your head.

But they’re not.

New research is confirming what millions of long COVID patients already suspect: the virus may leave behind serious cardiovascular damage… and that damage could rival the heart risks of diabetes or smoking.

That’s right—some experts are now calling severe COVID-19 a “coronary artery disease risk equivalent.” That means the long-term risk of suffering a heart attack or stroke could be as high as it is for someone with full-blown heart disease.

The evidence is mounting

In a major study using data from the UK Biobank, researchers followed over 10,000 COVID-positive individuals and more than 250,000 controls for up to three years. Their findings were startling:

• Those who had COVID at any severity had double the risk of major adverse cardiac events (MACEs)—including heart attacks, strokes, and cardiac death.
• Patients who were hospitalized with COVID faced an almost fourfold increased risk.
• And even without a prior heart condition, their risk matched that of patients with known coronary artery disease.

In simple terms, if you had a severe case of COVID—one that landed you in the hospital—you may need to treat your heart like it’s already at risk.

That means aggressive prevention:

• Lowering LDL cholesterol below 70
• Considering low-dose aspirin (with doctor guidance)
• Monitoring for signs of inflammation and clotting

It’s not just the infection—it’s the lingering inflammation and oxidative stress COVID seems to trigger in the body, particularly in blood vessels. This “rewiring” of the immune system may last for years.

While some cardiologists are sounding the alarm, others say it’s too soon to classify COVID as a full-blown cardiovascular risk factor.

Dr. Kieran Quinn, a clinician-scientist at Sinai Health in Toronto, acknowledges the danger but urges caution.

His own research suggests that while venous blood clots are more common after COVID, the overall long-term risk of cardiovascular events isn’t necessarily worse than that of other serious infections like sepsis or influenza.

In other words, the severity of the illness may be the bigger culprit—not just the virus itself.

Still, Quinn and others agree: COVID—especially long COVID—can hit the heart hard. The most common lingering cardiovascular symptoms include:

• Fatigue
• Shortness of breath
• Chest pain
• Heart palpitations

These symptoms may stem from autonomic nervous system disruption, heart muscle inflammation, or microvascular changes—many of which don’t show up on standard tests.

If you’re still feeling off weeks or months after recovering from COVID—especially if you had a severe case—it’s time to take action:

• Don’t ignore persistent symptoms. Fatigue, shortness of breath, or rapid heartbeat may be signs of post-COVID cardiac stress.
• Ask for a thorough evaluation. This may include blood tests, ECG, or even cardiac imaging—depending on your symptoms and risk factors.
• Focus on heart-healthy habits. Even small improvements in diet, movement, stress management, and sleep can lower inflammation and support your heart.

And importantly, talk to your doctor about whether you need more aggressive prevention strategies moving forward—especially if you had a severe COVID case or now experience long-COVID symptoms.

COVID may be “over” for many people. But for millions more, the long-term consequences—especially for heart health—are just beginning.

Still feeling the aftershocks of COVID? Your heart might be, too. Don’t wait to get it checked,

Rachel Mace
Managing Editorial Director, e-Alert
with contributions from the research team

Sources:

Doheny, K. (2025, May 12). Cardiovascular Implications of Long COVID, Severe COVID: What to Know, How to Manage. Medscape. https://www.medscape.com/viewarticle/cardiovascular-implications-long-covid-severe-covid-what-2025a1000bfc