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If you’ve had even a mild case of COVID-19, you may have an increased risk of cardiovascular problems, according to a new study. From very early in the pandemic, doctors were vocal about SARS-CoV-2 being able to damage the heart and blood vessels. Since then, about 20-30% of patients hospitalized with COVID developed clots, heart inflammation, and heart failure.

Now, researchers at the U.S. Department of Veterans Affairs found people’s risk for heart problems jumped after catching COVID-19, even if they lacked risk factors like obesity and diabetes. In their analysis of more than 11 million U.S. veterans’ health records, they found COVID increased their risk for a heart attack by 63%, problematic irregular heart rhythm by 69%, a stroke by 50%, heart failure 70%, and a nearly three times higher risk of a potentially fatal blood clot in the lungs. Even people who never went to the hospital had more cardiovascular disease than those who were never infected.

COVID-19 patients in this study were infected before vaccines were available, so it’s unclear how the shots might alter the findings, but the authors say their findings suggest millions of COVID-19 survivors could suffer long-term consequences and health-care providers around the world should be prepared to address an increase in cardiovascular conditions.

It is not entirely clear how covid could cause heart problems over the long term, though it is known that the virus can affect blood vessels all over the body and in multiple organs, including the heart.