Research project Viral Cardio (Viral Infections Research Assessment Linkage – Cardiovascular Complications) is an initiative funded by the Swedish Heart-Lung Foundation to uncover how infections (including COVID‑19, influenza, and Puumala virus) impact heart and vascular health. By combining registry data, biomarker analyses, and epidemiological methods, the project aims to identify individuals at risk and guide better prevention and treatment strategies.
Viral Cardio integrates nationwide data and advanced techniques to investigate cardiovascular complications triggered by various infections. Building on previously published findings—such as endothelial damage in hemorrhagic fever with renal syndrome (HFRS) and heightened risks of myocardial infarction, stroke, and bleeding after COVID‑19—this project addresses key knowledge gaps. Ultimately, it strives to pinpoint vulnerable patients, thereby improving clinical outcomes and guiding public health interventions.
Background
Viral infections can precipitate acute and long-term harm to blood vessels and the heart. Earlier research in hemorrhagic fever with renal syndrome (HFRS) performed by Fors Connolly during her postdoc with Prof Clas Ahlm highlighted the link between endothelial dysfunction—particularly glycocalyx degradation—and disease severity (Connolly-Andersen et al., OFID 2014). The endothelial glycocalyx is a protective, gel-like layer on the vessel surface that regulates coagulation, inflammation, and vascular permeability. Once this layer is damaged, be it by a viral infection, inflammation, trauma or other insult, it is likely that the risk of myocardial infarction, stroke, and bleeding can markedly rise. Fors Connolly found that HFRS was significantly associated with an increased risk of acute myocardial infarction and stroke (Connolly-Andersen et al., Circulation 2014) and venous thromboembolism (Connolly-Andersen et al., Clin Infect Dis 2018).
Furthermore, Fors Connolly and her research team identified SARS-CoV-2 as an independent risk factor for acute myocardial infarction, stroke (Katsoualaris et al., The Lancet, 2021), and thromboembolic and bleeding events (Katsoularis et al., The BMJ, 2022). These findings spotlight the urgent need for comprehensive analyses to better protect cardiovascular health in the face of viral threats.
Project
Viral Cardio utilizes the whole-population data from the VIRAL database to capture the association between infections and subsequent cardiovascular outcomes. Applying statistical methods—like self-controlled case series and matched cohort designs—Viral Cardio aims to quantify risk patterns for deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke, and bleeding across different patient subgroups.
A central focus is the role of endothelial glycocalyx disruption, offering potential biological markers for early detection.
