COVID may cause 'rapid progression' of coronary plaques, imaging study suggests

The virus that causes COVID-19 may inflict more cardiovascular damage than previously believed. 

New research findings offer evidence that SARS-CoV-2 infections can cause accelerated growth of plaque in the coronary arteries, thus significantly increasing patients’ risk of adverse cardiovascular events. What’s more, these risks extend well beyond the initial infection period, experts involved in the analysis suggest. 

“COVID-19, caused by SARS-CoV-2, is initially characterized by acute lung injury and respiratory failure. However, emerging evidence indicates COVID-19 also involves an extreme inflammatory response that can affect the cardiovascular system,” study senior author Junbo Ge, MD, professor and director of the Cardiology Department at Zhongshan Hospital in Shanghai, China, and colleagues write in Radiology. 

The team studied a group of more than 800 patients who had undergone coronary CT angiography (CCTA) scans either before or during the onset of COVID. This included 2,588 coronary artery lesions—2,108 lesions among COVID patients and 480 lesions among individuals who had not yet been infected. All patients had baseline and follow-up imaging available for the team to use to measure changes in plaque volume, the presence of high-risk plaque and inflammation.  

According to the group’s measurements, plaque volumes in the COVID group grew significantly faster than in the uninfected group. Lesions in the COVID group also were more likely to progress to high-risk plaques (20.1% versus 15.8%) and coronary inflammation (27% versus 19.9%); these patients were at higher risk of target lesion failure (10.4% versus 3.1%) as well. The post-COVID effects were consistent even when accounting for other comorbidities, such as hypertension and diabetes. 

“Inflammation following COVID-19 can lead to ongoing plaque growth, particularly in high-risk, noncalcified plaques.” the authors note, adding that these patients may be at increased risk of major adverse cardiovascular events for up to a year. 

The team suggests their findings signal the potential for a prolonged increase in cardiovascular patient burden in the future, though they are not yet certain about what the best management strategy for these patients should be. 

Learn more about the study’s findings here. 

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.

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