Follow TNM’s WhatsApp channel for news updates and story links.
The government panel appointed to study the link between the recent deaths allegedly due to cardiac events and COVID-19 vaccination could not find “any association” between the deaths and either the COVID-19 vaccine or infection. Instead, it found that lifestyle factors such as smoking and cholesterol levels were the “best explanation” for the rise in sudden heart attacks. The panel called for a public health strategy including a robust surveillance system for sudden cardiac deaths, particularly among young people.
The state government had appointed a panel on July 1, headed by Dr KS Ravindranath, director of Jayadeva Institute of Cardiovascular Sciences and Research in Bengaluru, to study several deaths attributed to the COVID-19 vaccines. The government had asked the panel to submit a report in 10 days. The Health Department released the report to the media on Saturday, July 5.
The state media has reported a sudden uptick in the deaths of young people in Hassan and other districts of Karnataka due to cardiac events, and that the deaths were linked to the COVID-19 vaccine. The Union government, which took note of the deaths in Karnataka, issued a statement on July 2, quoting ICMR studies which found no link between the COVID-19 vaccines and heart attacks.
Due to the public outcry, Chief Minister Siddaramaiah appointed a panel headed by Dr KS Ravindranath to study the issue. The panel, however, found no link between the two while noting several limitations of the study. The same panel had been asked by the state government in February this year to conduct a study into the deaths of young people in the state and whether it was linked to COVID-19 vaccines.
What the panel found
The panel studied 251 patients under the age of 45 admitted to Jayadeva Hospital between April 1 and May 31 this year. While several patients had other medical conditions such as diabetes, hypertension, cholesterol disorder, and a family history of heart disease, 77 or 26 % did not have any conventional risk factors.
Of the 251 patients, only 19 had contracted COVID-19, and 78% had received at least one vaccine dose.
To compare this group with a pre-COVID-19 group, the panel used patient data from 2019 from Jayadeva Hospital’s premature coronary artery disease registry (PCAD registry), which has been maintained for people under the age of 40. However, the study report does not mention the sample size of this group, even though it notes that they were matched for age and sex.
The study found that there had been a rise in the prevalence of risk factors from 2019 to 2025.
“Compared with the (Jayadeva) centre’s 2019 pre-COVID PCAD registry, diabetes, hypertension and dyslipidaemia (high cholesterol) were modestly but consistently more prevalent in 2025, suggesting that pandemic-related lifestyle disruptions or metabolic sequelae may have shifted the risk profile,” the report said. (Sequelae are conditions that are the consequence of a previous disease or injury.)
However, the panel said that there did not appear to be any single cause for the observed rise in sudden cardiac deaths. “Rather, it appears to be a multi-faceted issue, with behavioural, genetic and environmental risks. While in the immediate post-COVID-19 phase, there is an increase in the incidence of sudden cardiovascular events due to a pro-inflammatory state, the same cannot be held to be true in the long term (more than a year). It is three years since the end of the pandemic,” the report said.
The panel said that the current data did not support the belief that long Covid was responsible for the rise in sudden cardiac arrests among the young. “Rather, a rise in the prevalence of the common risk factors that lead to CVD (Example: hypertension, smoking, high cholesterol) is the best explanation for the rise in sudden cardiovascular events,” the report said.
Shortcomings of the study
The panel noted that one of the shortcomings of the study was that only 19 patients, or 7.6% of the total 251 patients chosen for the study, had had COVID-19 and that practically everyone had received at least one dose of a COVID-19 vaccine. This “limited meaningful between-group comparisons”, the report said, referring to the pre-COVID and post-COVID groups.
“Still, the sizeable minority of ‘risk-factor-negative’ events raises the possibility that residual inflammatory or pro-thrombotic pathways—whether post-viral or unrelated—may be amplifying premature coronary artery disease (CAD) presentations,” the report said.
Referring to the 26% of 251 people who had coronary artery disease but no other risk factors, the report said that residual inflammation or blood clots – either post-viral or unrelated to COVID-19 – may be leading to an overall rise in the incidence of premature coronary artery disease. (Incidence refers to new cases of a disease during a specific period.)
The panel also noted that the present study was a cross-sectional one (a study which analyses data from a population subset at a specific point in time) and confined to patients from just one hospital. So, it would not be able to establish the effects of the vaccine over time.
It also noted that a large multi-centre study (done at more than one hospital/location) with subjects who were not vaccinated, subjects with confirmed COVID-19 diagnoses and precise patient vaccination data would be needed “before attributing the observed uptick in young-onset CAD or sudden cardiac events to COVID-19 itself.”
For instance, 20 % of the subjects of the study could not remember whether they had received Covishield or Covaxin, and just 19 patients had had COVID-19, and finding subjects who had not been vaccinated would be a challenge since India now has near universal vaccination.
Sudden cardiac deaths
One of the reasons for public concern in the recent reported deaths was that many people who reportedly died due to heart attacks were in their 20s or 30s.
The panel made a special mention of sudden cardiac deaths among young people, calling for strong surveillance.
It recommended a screening system which would start at the school level at the age of 15 and check children for congenital heart diseases or structural abnormalities, inherited rhythm disorders, obesity, high blood pressure, cholesterol levels and insulin resistance.
The panel also recommended that a cardiac surveillance programme and a national registry for sudden cardiac deaths among young adults be set up. It also called for a registry of unexplained deaths in young adults and autopsy-based reporting.
It urged that the government carry out public health campaigns regarding heart diseases, their causes, risk factors, early detection and lifestyle changes, such as diet and exercise, increasing physical activity, quitting smoking, reducing screen time, reducing salt and sugar intake, and getting enough sleep.
The panel also called for large-scale prospective case-control clinical studies by agencies such as the Indian Council for Medical Research (ICMR) to study the long-term effects of both COVID-19 and vaccination.