Rev Med Virol. 2026 Nov;36(6):e70219. doi: 10.1002/rmv.70219.
ABSTRACT
Cardiovascular diseases, such as acute myocardial infarction, heart failure, and arrhythmias, have been associated with SARS-CoV-2 infection, representing an important cause of long-term morbidity and mortality. In addition to preventing primary infection, COVID-19 vaccination has emerged as a protective factor against post-COVID cardiovascular outcomes. This study aims to analyse the evidence supporting a causal relationship between COVID-19 vaccination and the prevention of post-COVID cardiovascular conditions, based on classical and contemporary epidemiological criteria, including the Bradford Hill criteria (BHC) and the sufficient component cause (SCC) model. A qualitative synthesis of the evidence was performed according to the nine BHC and the SCC model. Scientific evidence indicates that COVID-19 vaccination meets four of the nine BHC as a protective factor against post-COVID cardiovascular conditions, namely strength of association, consistency, temporality, and biological gradient. Three criteria, biological plausibility, coherence, and analogy, were partially met. Specificity and experimental evidence were not supported by the available literature. The SCC model highlights the fundamental role of vaccination as a preventive causal component. It also contributes to two criteria, strength of association and temporality, while emphasising the limitation of specificity in causal inference. COVID-19 vaccination has proven effective beyond the acute phase of the disease, with protection extending to a reduced risk of post-COVID cardiovascular conditions. Comprehensive immunisation strategies and reinfection prevention are essential to mitigate the burden of post-COVID conditions. Additional studies are needed to explore the underlying biological mechanisms, interactions, and the role of COVID-19 vaccination in preventing post-COVID complications.
PMID:42858449 | DOI:10.1002/rmv.70219