Evidence map›Paper›PMID 42077647›Full record

ArticleEClinicalMedicine2026

Long COVID and risk of incident cardiovascular disease: a prospective cohort study using the Multimorbidity Integrated Registry Across Care Levels in Stockholm (MIRACLE-S) cohort.

Pia Lindberg, Samuel Wiqvist, Maria Juszczyk, Seika Lee, Marta A Kisiel, Caroline Wachtler, Marcus Ståhlberg, Åsa M Wheelock, Artur Fedorowski, Axel C Carlsson

Abstract read
In one paragraph

Article in EClinicalMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Pia LindbergDivision of Immunology and Respiratory Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Samuel WiqvistDepartment of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
Maria JuszczykDepartment of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
Seika LeeDepartment of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
Marta A KisielDepartment of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
Caroline WachtlerDivision for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
Marcus StåhlbergDepartment of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
Åsa M WheelockDivision of Immunology and Respiratory Medicine, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Artur FedorowskiDepartment of Cardiology, Karolinska University Hospital, Stockholm, Sweden.
Axel C CarlssonDivision for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Long COVID has emerged as a global health challenge, with increasing evidence of cardiovascular sequelae. Most previous studies have focused on hospitalised cohorts, whereas cardiovascular risk in community-managed long COVID cases remains less explored. We aimed to investigate the incidence of major cardiovascular events in individuals with long COVID compared to those without long COVID in a large population-based setting. Methods: Multimorbidity Integrated Registry Across Care Levels in Stockholm (MIRACLE-S) is a population-based cohort that covers all providers of healthcare for around 2.5 million residents in Stockholm County. Individuals aged 18-65 years with a physician-assigned long COVID diagnosis (ICD-10: U09.9) between October 2020 and January 2025 were identified. Exclusion criteria were hospitalisation for acute COVID-19 or pre-existing cardiovascular disease. Cox proportional hazards models estimated the effect of long COVID on a composite cardiovascular outcome (myocardial infarction, heart failure, cardiac arrhythmias, stroke, peripheral arterial disease), adjusting for demographic, lifestyle, and mental health factors. Findings: Among 1,217,693 individuals, 8999 (0.7%) had long COVID diagnosis (66% women). Cumulative incidence of any cardiovascular event was higher in long COVID group (women 18.2%, men 20.6%) compared with control group (women 8.4%, men 11.1%). In a fully adjusted model, long COVID was associated with the composite cardiovascular outcome (women HR 2.06, 95% CI 1.92-2.22; men HR 1.33, 1.20-1.48), cardiac arrhythmia (women HR 3.11, 2.85-3.39; men HR 1.61, 1.41-1.85), and coronary artery disease (women HR 1.25, 1.04-1.52; men HR 1.26, 1.05-1.51). Heart failure incidence was elevated in women only (HR 1.25, 1.00-1.55), as also was peripheral artery disease (HR 1.25, 1.05-1.50). Long COVID was not associated with stroke in either sex. Interpretation: Long COVID is associated with increased risk of incident cardiovascular disease, particularly cardiac arrhythmias, heart failure, and coronary artery disease. These findings underscore the need for systematic follow-up and integration of long COVID into cardiovascular risk assessment. Funding: Region Stockholm and Heart Lung Foundation.

Indexed as

Cardiovascular disordersDiagnosisLong COVID cohort studyPrimary healthcareSigns and symptomsSomatic symptomsSymptom cluster

Identifiers

PMID42077647
PMCPMC13133534

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.