**Executive Summary**
This document summarises the Indian government's response to a question in Lok Sabha (Unstarred Question No. 1021) regarding the increase in heart attack cases after COVID-19, to be answered on December 5, 2025. It details the findings of studies commissioned by the Indian Council of Medical Research (ICMR) and the response from AIIMS Delhi, including the effects of COVID-19 vaccines and infection on cardiovascular health. The document also highlights existing surveillance systems and vaccine adverse event reporting mechanisms.
**Key Points / Main Content**
* **ICMR Studies on Sudden Unexplained Deaths and Thrombotic Events:**
* ICMR commissioned two studies via the National Institute of Epidemiology (ICMR-NIE) to investigate sudden unexplained deaths and thrombotic events among young adults (18-45 years) in India.
* The first study (Oct 2021-Mar 2023) found that COVID-19 vaccines significantly reduce the risk of sudden unexplained death. Previous COVID-19 hospitalization, family history of sudden death, binge drinking, and vigorous physical activity before death were identified as risk factors.
* The second study identified that thrombotic events in young adults were mainly associated with comorbidities, prior thrombotic history, smoking, and previous hospitalization due to COVID-19. No definitive association was observed after one or two doses of Covishield or Covaxin.
* **AIIMS Delhi Findings:**
* AIIMS Delhi reported evidence of increased heart attacks, strokes, and other cardiovascular diseases post-COVID-19, especially among youth and children.
* COVID-19 infection increases risks of myocarditis, heart failure, arrhythmias, and hypertension.
* **Oxford-AstraZeneca Vaccine Blood Clots:**
* AIIMS Delhi noted reports of rare cases of unusual blood clots with low platelets following the Oxford-AstraZeneca COVID-19 vaccine.
* These side effects involved clots in the brain and abdomen, primarily in women under 60, usually within two weeks of vaccination.
* The European Medicines Agency (EMA) maintains the vaccine's benefits outweigh the risks.
* **Adverse Event Following Immunization (AEFI) Surveillance:**
* Adverse Event Following Immunization (AEFI) is reported through the AEFI surveillance system.
* AEFI are monitored through a well-structured system to establish a cause and effect relationship.
* **Disease Surveillance Programme:**
* The Integrated Disease Surveillance Programme (NCDC-IDSP) is strengthening a decentralized laboratory-based IT-enabled disease surveillance system.
* Since 2021, the Integrated Health Information Platform (IHIP) is being actively used for surveillance and monitoring of the COVID-19 pandemic.
**Impact Analysis**
* **Ministry of Health and Family Welfare**
**Impact**: Requires addressing concerns raised in Lok Sabha regarding post-COVID-19 health issues.
**Action Required**: The Ministry is expected to provide comprehensive answers to the questions posed.
* **Healthcare Professionals/Researchers (ICMR, AIIMS, NCDC)**
**Impact**: Needs to analyze and interpret data on post-COVID health outcomes and potential links to vaccination.
**Action Required**: Continue ongoing studies and surveillance to gather further evidence and refine prevention strategies.
* **General Public**
**Impact**: Affected by potential increased risk of heart attacks and strokes, especially post-COVID-19 infection, and need accurate information regarding vaccine safety.
**Action Required**: Follow public health guidelines for COVID-19 prevention, vaccination, and address risk factors such as smoking and alcohol. Monitor for AEFI and report them if noticed.
* **States/UTs**
**Impact**: Impacted by the need to report data on COVID i.e., cases, recovered and deaths
**Action Required**: States/UTs are expected to share information regarding Covid data.
Key Entities Referenced
MINISTRY OF HEALTH AND FAMILY WELFARE: The primary ministry responsible for answering the parliamentary question on heart attack cases after COVID-19.
COVID-19 vaccines: Vaccines used to prevent COVID-19, with a focus on their association with heart attacks and blood clots.
Indian Council of Medical Research (ICMR): The organization that commissioned studies on rising anecdotal reports of sudden unexplained deaths and thrombotic events following COVID-19.
All India Institute of Medical Sciences (AIIMS) Delhi: A medical institute providing information on the relationship between COVID-19, heart attacks, and blood clots.
Integrated Disease Surveillance Programme (NCDC-IDSP): A program under National Health Mission (NHM) to strengthen disease surveillance, involved in COVID-19 surveillance.
GOVERNMENTOFINDIA
MINISTRYOFHEALTH ANDFAMILYWELFARE
DEPARTMENTOFHEALTHRESEARCH
LOK SABHA
UNSTARREDQUESTION NO. 1021
TO BE ANSWEREDON 05THDECEMBER, 2025
INCREASING CASES OFHEARTATTACKAFTER COVID-19
†1021.SHRIDEVESH SHAKYA:
Will the Minister of HEALTHANDFAMILYWELFAREbe pleasedtostate:
(a) whether it is a fact that there has been a significant increase in the cases of heart attacks,
strokes and other serious diseases, especially among the youth, after COVID-19 and if so, the
detailsthereofandif not, the reasons therefor;
(b) the detailsof the findingsavailable national/international studies inthisregard;
(c) whether it is a fact that cases of a rare type of blood clots reported in some countries with
the Oxford-AstraZeneca vaccine andif so, the detailsthereof;
(d) the total number of such cases registered along with the number of deaths recorded in the
country;
(e) the corrective steps taken/proposed to be taken by the Government of India in the
vaccinationandsurveillance systems based onthese findings; and
(f) whether the Government is contemplating to implement any special surveillance program at
the national level to reduce the risk of post-COVID heart and myocardial infarction stroke in the
countryandif so, the detailsthereof?
ANSWER
THE MINISTER OFSTATEIN THE MINISTRYOFHEALTHAND FAMILYWELFARE
(SHRIPRATAPRAOJADHAV)
(a)and(b): IndianCouncil of Medical Research (ICMR) hasinformedthat it commissioned two
studies through National Institute of Epidemiology (ICMR-NIE) to investigate rising anecdotal
reports of sudden unexplained deaths and factors associated with thrombotic events among young
adultsin India.The first study was conductedamongapparently healthyadultsaged 18–45yearsin
India. The multicentric matched case–control study spanned 47 tertiary hospitals across India and
recruited 726 cases, including healthy adults with no known comorbidities who died suddenly
within 24 hours between 1 October 2021 and 31 March 2023. The study included four matched
controls per case by age, gender, and neighbourhood. Trained investigators collected detailed
information on recent COVID-19 vaccination (within 42 days), COVID-19 infection and post-
COVID conditions, family history of sudden death, smoking, recreational drug use, alcoholconsumption and binge drinking, and vigorous physical activity in the 48 hours preceding death or
interview. Key findingsof the study are givenbelow–
i. Receiving one or more doses of the COVID-19 vaccine was found to significantly reduce
the risk of unexplainedsudden death inyoungadults, with two doses offeringgreaterprotection.
ii. Previous hospitalization due to COVID-19 was linked to a higher risk of sudden
unexplaineddeathby four-fold.
iii. Other riskfactorsincludeda familyhistory ofsudden death,binge drinkingwithin 48hours,
andvigorousphysical activity shortly before death.
The study clearly shows that COVID-19 vaccines do not cause sudden unexplained deaths; rather,
theyare protective.
The second study was a multicentric hospital-based matched case–control study in 25 tertiary
hospitals across India to determine the association between COVID-19 vaccination, lifestyle,
medical risk factors and thrombotic events among young adults. This study included adults aged
18–45 yearshospitalized with new arterialor venousthrombotic events, with four hospital controls
per case matched by admission date. Among 292 cases (199 myocardial infarctions, 67 ischemic
strokes, and 26 venous events) and 1,168 controls, cases were mostly male and aged 31–45 years.
The keyfindingof thestudy arelisted below-
i. Thrombotic events in young adults were mainly associated with comorbidities, prior
thrombotic history,smoking,andprevioushospitalizationduetoCOVID-19.
ii. Nodefinitiveassociationbetweenthromboticeventswasobservedafteroneortwodosesof
Covishield™orCovaxin™.
iii. Inyoungadults,thromboticeventsweredrivenbytraditionalriskfactorsandpriorCOVID
19illness.
All India Institute of Medical Sciences (AIIMS) Delhi has informed that, there is evidence that
COVID-19 has caused an increase in heart attacks, strokes, and other serious cardiovascular
diseases, especially among the youth and children, with risks elevated regardless of prior health
status. Studies show COVID-19 infection increases risks of myocarditis, heart failure, arrhythmias,
and hypertension, with young people facing long-lasting heart and inflammatory complications
more frequently than before the pandemic. This rise in cardiovascular issues is linked to COVID-
19's inflammatory effects on blood vessels and the heart, as well as disruptions caused by the
pandemic.
(c): AIIMS Delhi hasfurther informed thatas peran internationalscientific report,rare cases of
unusual blood clots combined with low levels of blood platelets have been reported following
Oxford-AstraZeneca Covid-19 vaccine. These very rare side effects involved blood clots primarily
in the brain and abdomen, usually occurring within two weeks of vaccination, mostly in women
under 60 years of age. The European Medicines Agency (EMA) stated the overall benefits of the
vaccineoutweigh these rare risks.EMA’s scientific assessment underpinsthe safe and effective useof COVID-19 vaccines. The vaccine is effective at preventing COVID-19 and reducing
hospitalisations anddeaths.
(d) to(f): Adverse Event Following Immunization (AEFI) is any untoward medical
occurrence which follows immunization and which does not necessarily have a causal relationship
with the vaccine and vaccination. These are reported through the AEFI surveillance system.
Adverse Event Following Immunization are monitored through a well-structured & robust AEFI
surveillance system. Investigations and causality assessment help in establishing a cause and effect
relationship.
National Centre for Disease Control has informed that the, Integrated Disease Surveillance
Programme (NCDC-IDSP) is a programme under National Health Mission (NHM) with primary
mandate to strengthen & maintain a decentralized laboratory-based IT-enabled disease surveillance
system. It has transitioned to a near real-time, GIS-enabled platform – Integrated Health
Information Platform (IHIP) since 2021. Programme hasbeen actively involved in the surveillance
and monitoring of the COVID-19 pandemic. It plays a role in compiling the Covid data i.e. cases,
recoveredanddeathswhich are reportedbythe States/UTs.
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