BACKGROUND AND PURPOSE:

• SARS-CoV-2 infection is known to increase the risk of acute myocardial infarction and stroke but other viral infections may also carry risk for future cardiovascular disease (CVD)
• Kawai et al. (Journal of the American Heart Association, 2025) examined the association between viral infections and risk of CVD

METHODS:

• Systematic review and meta-analysis
• Inclusion criteria
  • Cohort and case-control studies
  • Studies that examined the association of any viral infection with the risk of CVD
  • Excluded: Cross sectional studies
• Study design
  • Random effects models were used to estimate pooled adjusted risk ratio (aRR)
• Primary outcome
  • Cardiovascular disease, including coronary heart disease (CHD) and stroke

RESULTS:

• 155 studies
• HIV infection was consistently associated with an elevated risk of
  • CHD: pooled aRR 1.60 (95% CI, 1.38 to 1.85)
  • Stroke: aRR 1.45 (95% CI, 1.26 to 1.67)
• SARS-CoV-2 was associated with an increased risk of
  • CHD: aRR 1.74 (95% CI, 1.44 to 2.11)
  • Stroke aRR 1.69 (95% CI, 1.23 to 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 (IRR) 4.01 (95% CI, 2.66 to 6.05)
  • Stroke during the first month: IRR 5.01 (95% CI, 3.41 to 7.37)
• In cohort studies, hepatitis C virus infection was associated with a higher risk of
  • CHD: RR 1.27 (95% CI, 1.13 to 1.42)
  • Stroke: RR 1.23 (95% CI, 1.04 to 1.46)
• Herpes zoster was also associated with an elevated risk of
  • CHD: RR 1.12 (95% CI, 1.08 to 1.15)
  • Stroke: RR 1.18 (95% CI, 1.09 to 1.27)
• There is insufficient evidence to determine whether there is a link between cytomegalovirus and CVD
• There is limited evidence that there is an increased risk of CVD with
  • Hepatitis A virus
  • Herpes simplex virus type 1
  • Respiratory syncytial virus
  • Human papillomavirus
  • Dengue
  • Chikungunya

CONCLUSION:

• Several viral infections are associated with an increased risk of CVD, including coronary heart disease and stroke
  • Influenza
  • SARS-CoV-2
  • HIV
  • Hep C
  • Herpes zoster
• The authors suggest that vaccination may be an important method for preventing cardiovascular disease
• The authors state

Our study highlights the importance of integrated preventive measures, especially for adults with traditional risk factors for CVD

Learn More – Primary Sources:

Viral Infections and Risk of Cardiovascular Disease: Systematic Review and Meta‐Analysis