Post-acute sequelae of severe acute respiratory coronavirus 2 (SARS-CoV-2) infection continue to affect millions worldwide. Cognitive impairment and fatigue are among the most common lingering symptoms, with cognitive impairment impacting 70% of patients. The ongoing effects of COVID-19 are particularly pronounced in older adults, especially women, who face heightened vulnerability due to factors such as menopause and the resulting increase in cognitive challenges.

Dr. Monica Christmas, associate medical director for The Menopause Society, commented on the findings, noting, “As the authors highlight, post-acute sequelae of severe acute respiratory coronavirus 2 infection significantly affects quality of life, often leading to severe disability. This effect is particularly pronounced in women, who already experience higher rates of cognitive impairment after menopause.” By identifying early risk factors like white blood cell count, healthcare providers could better address the long-term challenges COVID-19 poses, especially for these at-risk groups.

The study, based on secondary analysis from the Women’s Health Initiative, sought to understand whether preexisting risk factors could predict more severe outcomes for older, postmenopausal women. Researchers found that leukocyte count, a common clinical marker of systemic inflammation, was significantly associated with the severity of COVID-19 symptoms.

This breakthrough supports the hypothesis that low-grade inflammation, signaled by white blood cell levels, might not only be an outcome of severe COVID-19 infection but could also serve as an early indicator of who might face more significant illness. The study’s results provide promising evidence that monitoring leukocyte count could offer a cost-effective and easily accessible way to identify those at risk.

While the study’s results are compelling, the researchers emphasize the need for further investigation into the relationship between leukocyte count and COVID-19 outcomes. Nevertheless, this study offers hope for better management and treatment of COVID-19, particularly for the vulnerable populations most impacted by the disease’s lingering effects.

As researchers continue to explore the long-term consequences of COVID-19, understanding the role of systemic inflammation could play a crucial part in mitigating the pandemic’s ongoing health effects.

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The study, published on January 22, 2025, reveals that individuals with greater amounts of fat embedded in their muscles are more likely to experience coronary microvascular dysfunction (CMD)—a condition where the tiny blood vessels in the heart become damaged. This dysfunction is closely linked to a higher risk of hospitalization or death due to heart attacks or heart failure.

While obesity is widely recognized as a major global health threat, the current reliance on BMI to assess cardiovascular risk may not be sufficient for all individuals, especially women. BMI has been shown to fail in accurately assessing the heart disease risks for those with higher muscle fat. In fact, for some people, particularly women, high BMI can reflect “benign” fat types that do not contribute to cardiovascular problems, Taqueti explained.

The research analyzed the muscle fat of 669 individuals, all of whom were undergoing evaluation for chest pain or shortness of breath at Brigham and Women’s Hospital. None of the participants had obstructive coronary artery disease. The study followed these patients for about six years, monitoring their heart health and hospitalizations for heart failure or heart attack. Those with higher amounts of intermuscular fat were more likely to develop CMD and subsequently experience severe heart-related events.

This groundbreaking study highlights the need for more precise measures of heart disease risk that go beyond traditional markers like BMI and waist circumference. It suggests that body composition, particularly fat within the muscles, plays a critical role in cardiovascular health, potentially offering new avenues for early detection and intervention.

Professor Taqueti’s team hopes these findings will lead to more personalized strategies for assessing and treating cardiovascular risks, especially for those whose BMI may not fully capture the dangers lurking beneath the surface.

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