COVID-19 could be a powerful risk factor for heart attacks and strokes for as long as three years after an infection, a large new study suggests. The study was published Wednesday in the medical journal Atherosclerosis, Thrombosis, and Vascular Biology. It relied on medical records from roughly a quarter of a million people who were enrolled in a large database called the U.

K. Biobank. Within this dataset, researchers identified more than 11,000 people who had a positive lab test for COVID-19 documented in their medical records in 2020; nearly 3,000 of them had been hospitalized for their infections.

They compared these groups with more than 222,000 others in the same database who didn’t have a history of COVID-19 over the same time frame. People who caught COVID in 2020, before there were vaccines to blunt the infection, had twice the risk of a major cardiac event like a heart attack or stroke or death for almost three years after their illness, compared with the people who didn’t test positive, the study found. If a person had been hospitalized for their infection, pointing to a more severe case, the risk of a major heart event in was even greater – more than three times higher – than for people without COVID in their medical records.

What’s more, for people who needed to be hospitalized, COVID appeared to be as potent a risk factor for future heart attacks and strokes as diabetes or peripheral artery disease, or PAD. One study estimated that more than 3.5 million.