Protective effect of vaccination on the risk of cardiovascular disease after SARS-CoV-2 infection

Objective This study investigated the incidence of CVDs after COVID-19. Methods Data for 2,146,130 infected people were collected, including the vaccination status. COVID-19 patients were classified according to the number of the received vaccine doses: no, first, second, and ≥ third. To evaluate the short-term risk of CVDs after infection, adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were calculated by multivariable logistic regression analysis after adjustments for covariates. Results Compared to non-infected people, aORs [95% CIs; p value] for CVDs within a month after infection were 2.80 [2.64–2.97; < 0.001] in overall infected people and 4.62 [4.23–5.05; < 0.001], 4.20 [3.45–5.11; < 0.001], 2.79 [2.55–3.05; < 0.001], and 2.07 [1.91–2.24; < 0.001] in those who were infected after receiving no, first, second, and ≥ third vaccine doses, respectively. Among participants who received second doses of vaccine prior to contracting COVID-19, the aOR in those vaccinated with only the mRNA-based vaccine (BNT162b2 and mRNA-1273; Reference) was lower than those vaccinated with the virus-derived vaccine (ChAdOx1 nCov-19 and AD26.COV2-S; aOR 1.25 [1.06–1.48; < 0.01]). Conclusion Although COVID-19 increased the CVD risk, the inverse association in the risk of CVDs according to vaccine doses was significant in a dose–response manner. Our findings suggest that ≥ second doses of the COVID-19 vaccine prevent the risk of CVDs after SARS-CoV-2 infection. Graphical abstract In 2,146,130 infected adults (≥ 20 years), the inverse association in the short-term risk of cardiovascular diseases, including coronary heart disease and stroke, according to vaccine doses received was significant in a dose–response manner.