#18,929
While many people regard influenza and COVID as fairly minor respiratory illnesses, over the past few years we've seen a lot of research showing an apparent link between current (or recent) viral infection and cardiovascular complications, including heart attacks and strokes.
A few of many examples include:
- In 2023, an NIH study found SARS-CoV-2 Infects Coronary Arteries, Increases Plaque Inflammation, and likely leads to increased cardiac events.
- In 2022, in PloS One: Early Risk of Acute Myocardial Infarction Following Hospitalization for Severe Influenza found the absolute risk of having an AMI within 12 months of a severe influenza hospitalization was low (0.92%), but the relative risk (compared to non-hospitalized controls) was nearly doubled.
- In 2018's NEJM: Acute Myocardial Infarction After Laboratory-Confirmed Influenza Infection, we saw a study that found a `significant association ' between recent (lab confirmed) influenza infection and Myocardial Infarction.
- And in May 2017, in Int. Med. J.: Triggering Of Acute M.I. By Respiratory Infection we looked at research from the University of Sydney that found the risk of a heart attack is increased 17-fold in the week following a respiratory infection such as influenza or pneumonia.
Today the Journal of the American Heart Association has published what appears to be the most comprehensive review to date of how viral infections contribute to cardiovascular disease (CVD).
Instead of looking at just one pathogen, or one outcome, this review covers 10 major (acute & chronic) viral infections, and multiple CVD outcomes (CHD, stroke, heart failure, and CVD death).
First a link and excerpt from the press release, after which I'll have the link and abstract from the open access review.
Some acute and chronic viral infections may increase the risk of cardiovascular disease
Prevention measures, including vaccination, may play important role in cutting the risk of serious cardiovascular events, according to a new study in Journal of the American Heart Association
Research Highlights:
- A review of 155 scientific studies found influenza and COVID infections raised the risk of heart attack or stroke as much as three-to five-fold in the weeks following the initial infection.
- Viruses that linger in the body, such as HIV, hepatitis C and varicella zoster virus (the virus that causes shingles), can lead to long-term elevations in the risk of cardiovascular events.
- The study researchers say preventive measures, including vaccination, may play an important role in reducing the risk of heart attacks and strokes, especially in people who already have heart disease or heart disease risk factors.
DALLAS, Oct. 29, 2025 — In the weeks following a bout of influenza or COVID, the risk of heart attack or stroke may rise dramatically, and chronic infections such as HIV may increase the long-term risk of serious cardiovascular disease events, according to new, independent research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
“It is well recognized that human papillomavirus (HPV), hepatitis B virus and other viruses can cause cancer; however, the link between viral infections and other non-communicable diseases, such as cardiovascular disease, is less well understood,” said Kosuke Kawai, Sc.D., lead author of the study and adjunct associate professor in the division of general internal medicine and health services research at the David Geffen School of Medicine at the University of California, Los Angeles. “Our study found acute and chronic viral infections are linked to both short- and long-term risks of cardiovascular disease, including strokes and heart attacks.”
The researchers set out to systematically review all published studies that investigated the association between any viral infection and the risk of stroke and heart attack, initially screening more than 52,000 publications and identifying 155 as appropriately designed and of high quality allowing for meta-analysis of the combined data.
In studies that compared people’s cardiovascular risks in the weeks following documented respiratory infection vs. the same people’s risk when they did not have the infection, researchers found:
- People are 4 times as likely to have a heart attack and 5 times more likely to have a stroke in the month after laboratory-confirmed influenza.
- People are 3 times more likely to have a heart attack and 3 times as likely to have a stroke in the 14 weeks following COVID infection, with the risk remaining elevated for a year.
Viral Infections and Risk of Cardiovascular Disease: Systematic Review and Meta‐Analysis
Kosuke Kawai, ScD kkawai@mednet.ucla.edu, Cresencia Felician Muhere, MD, Elkin V. Lemos, MD, PhD , and Joel M. Francis, MD, PhD Author Info & Affiliations
Journal of the American Heart Association
https://doi.org/10.1161/JAHA.125.042670
Abstract
Background
We conducted a systematic review and meta‐analysis of studies examining the association of viral infections with the risk of cardiovascular disease, including coronary heart disease (CHD) and stroke.
Methods
MEDLINE, Embase, Web of Science, African‐Wide Information, and the Cochrane Library database were searched from inception to July 2024.
Results
We included 155 studies. HIV infection was consistently associated with an elevated risk of CHD (pooled adjusted risk ratio [RR], 1.60 [95% CI, 1.38–1.85]) and stroke (RR, 1.45 [95% CI, 1.26–1.67]). SARS‐CoV‐2 infection was associated with an increased risk of CHD (RR, 1.74 [95% CI, 1.44–2.11]) and stroke (RR, 1.69 [95% CI, 1.23–2.31]). In self‐controlled case series studies, laboratory‐confirmed influenza infection was associated with an elevated risk of acute myocardial infarction (pooled incidence rate ratio, 4.01 [95% CI, 2.66–6.05]) and stroke during the first 1 month (incidence rate ratio, 5.01 [95% CI, 3.41–7.37]). In cohort studies, hepatitis C virus infection was associated with a higher risk of CHD (RR, 1.27 [95% CI, 1.13–1.42]) and stroke (RR, 1.23 [95% CI, 1.04–1.46]). Herpes zoster was also associated with an elevated risk of CHD (RR, 1.12 [95% CI, 1.08–1.15]) and stroke (RR, 1.18 [95% CI, 1.09–1.27]). There is insufficient evidence to determine the effect of cytomegalovirus on cardiovascular disease. Although on a limited basis, hepatitis A virus, herpes simplex virus type 1, respiratory syncytial virus, human papillomavirus, dengue, and chikungunya have been linked to an increased risk of cardiovascular disease.
Conclusions
Influenza, SARS‐CoV‐2, HIV, hepatitis C virus, and herpes zoster were associated with an increased risk of major cardiovascular events. Vaccines may play an important role in preventing the risk of cardiovascular disease.
While there's a popular belief that `What doesn't kill you, makes you stronger', the reality is, what doesn't kill you can sometimes set you up for something that will.
We've seen growing, and consistent, evidence that repeated viral infections exact a hidden toll on one's health, which may show up weeks, months, or sometimes even years post-infection (see Nature: Viral Infections and the Risk of Neurodegenerative Diseases (Meta-Analysis & Systemic Review)
Which is why, for the past 20+ years, I've gotten the flu shot each fall, I've stayed current with COVID shots/boosters since early 2021, and I've recently taken my first (of two) Shingles vaccines.
None are guaranteed to protect me, of course. But the evidence suggests they improve my odds.
And at my age, that's all I can reasonably expect.
