The largest study conducted on the effects of COVID-19 shows that the disease has serious implications for cardiovascular health.

The impact of long COVID-19 has been documented in thousands of people. Still, since the disease is still new, researchers have only been able to provide estimates and rough numbers, unable to see the big picture. The first large study to assess health one year after a COVID-19 infection found some disturbing results, particularly within the cardiovascular health area.

The study, published in the Nature Journal, analyzed more than 11 million records of U.S. veterans who experienced COVID-19 the previous year.

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Researchers found connections between patients who struggled with COVID-19 and over 20 different cardiovascular disease issues. The risk and damage rose with the severity of the disease, but even patients who didn’t need to attend the hospital to treat their COVID-19 symptoms still experienced more risks than people who were never infected.

Science magazine spoke with cardiologist Eric Topol, who said these numbers were “worse than I expected.” “All of these are very serious disorders,” said. “If anybody ever thought that COVID was like the flu, this should be one of the most powerful data sets to point out it’s not.”

Other experts say that, in the future, COVID-19 might become the biggest risk factor for heart disease, outperforming smoking, obesity, and more.

While researchers only looked into cardiovascular health, they speculate that other organs affected by long COVID might show these types of results. “Similar things could be happening in the brain and other organs resulting in symptoms characteristic of Long COVID, including brain fog,” said the study’s senior author, Ziyad Al-Aly.

When it comes to caveats to the research, there are a few. The study was conducted on veterans who sought medical help between 2020 and 2021, for reasons other than COVID-19. Ninety-percent of these subjects were white, male, and elderly.

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Researchers make it clear that these results were surprising for all, and that they should encourage unvaccinated people to get their COVID-19 vaccines as soon as possible. While the pandemic may pass, heart disease is something that will linger, and that must be monitored for the remainder of people’s lives.