The Indian Council of Medical Research (ICMR) and National Centre for Disease Control (NCDC) have conclusively established that there is no direct link between COVID-19 vaccination and the reports of sudden deaths of young people in the country. The report assumes significance in the light of concerns over 18 heart attack cases in Karnataka’s Hassan district within a one-month period, particularly among the young. The ICMR-NCDC studies affirm that COVID-19 vaccines are safe and effective with extremely rare instances of serious side effects. They say that COVID-19 vaccination does not appear to increase the risk and that the sudden cardiac deaths could have resulted from a wide range of factors, including genetics, lifestyle choices, and pre-existing conditions. Don’t overlook lifestyle triggers, especially smoking Dr Ranjan Shetty, lead cardiologist and medical director at Sparsh Hospitals, Bengaluru, says that of all the risk factors, smoking and high blood pressure because of work stress are mostly responsible. “Family history, cholesterol, obesity, diabetes, and alcohol are other triggers. Cigarette-smoking harms the entire cardiovascular system as it changes blood chemistry, thickens blood vessels. This causes the heart to race and the blood pressure to rise, accelerates blood clot and plaque formation. There is no benefit from cutting down cigarettes, you just have to give it up,” he says. He also warns that second-hand smoke poses the same risk to a non-smoker as it does to a smoker. The other big factors, he says, are poor sleep and high blood pressure. “The body doesn’t rest, the stress hormones are active, there is inflammation and high blood pressure. This in turn damages blood vessel walls, allowing for tears that dislodge unstable or even smaller plaques and encourage blood clots to form over them. To make matters worse, young people then subject their weakened arteries to gym workouts without proper sleep. That’s why we are hearing of young heart attacks more,” says Dr Shetty. What were the studies about? The ICMR and NCDC have been working together to understand the causes behind sudden unexplained deaths, especially in young adults between the ages of 18 and 45 years. To explore this, two complementary studies were undertaken using different research approaches—one based on past data and another involving real-time investigation. The first study, conducted by ICMR’s National Institute of Epidemiology (NIE), was carried out from May to August 2023 across 47 tertiary care hospitals in 19 states and Union Territories. It looked at individuals who appeared to be healthy but died suddenly between October 2021 and March 2023. The findings have conclusively shown that COVID-19 vaccination does not increase the risk of unexplained sudden death in young adults. The second study, titled “Establishing the cause in sudden unexplained deaths in young,” is currently being conducted by AIIMS, New Delhi in collaboration with ICMR. This is aimed at determining the common causes of sudden deaths in young adults. “Speculative claims without conclusive evidence risk undermining public confidence in vaccines, which have played a crucial role in saving millions of lives during the pandemic. Such unfounded reports and claims could strongly contribute to vaccine hesitancy in the country, thereby adversely impacting public health,” says the ICMR statement. So when should one do preventive tests? Dr Shetty says every young person with a family history should get tested in their early 20s and the rest definitely between 25 and 30. Apart from lipid profile and blood work, a calcium scoring test can map plaques while the high-sensitivity C-reactive protein (hsCRP), a blood component indicator of inflammation, can tell you if you are more prone to heart attacks. Then there is the treadmill test or TMT to map heart stress. Every diabetic should take a ten-year risk score.
