Six-Month Cardiometabolic and Vascular Trajectories After COVID-19 Hospitalization: Exploratory Associations with Recorded Dietary and Omega-3 Management

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Background/Objectives: Post-COVID follow-up may provide an opportunity to reassess persistent and modifiable cardiometabolic risk. We characterized six-month cardiometabolic and vascular trajectories after COVID-19 hospitalization and explored associations with routinely documented dietary counseling and omega-3 recommendations. Methods: This single-center retrospective longitudinal cohort included 238 adults hospitalized with COVID-19 between March 2020 and December 2024. Patients were classified according to recorded post-discharge management as usual care (n = 64), dietary management (n = 60), omega-3 supplementation (n = 59), or combined management (n = 55). Outcomes were assessed at the index visit and at visits labeled approximately three and six months later. Longitudinal changes were estimated using generalized estimating equations; six-month associations were evaluated using baseline-adjusted ANCOVA with robust standard errors and Benjamini–Hochberg correction. Results: Mean age was 54.0 ± 10.6 years, 54.6% were women, 82.4% had hypertension, 40.8% had diabetes, and mean body mass index was 33.8 ± 4.6 kg/m2. At six months, endpoint-specific data were available for 182 participants for blood pressure, total cholesterol, triglycerides, and HDL-C; 180 for waist circumference; 179 for SCORE; 177 for LDL-C and bilateral carotid IMT analyses; 173 for HOMA-IR; and 164 for IL-6. Across the cohort, systolic and diastolic blood pressure decreased by 7.91 and 4.75 mmHg; several lipid, anthropometric, and insulin-resistance markers also improved. No omnibus group-by-time interaction was significant. After false-discovery-rate correction, only higher six-month HDL-C in the dietary and combined-management groups versus usual care remained statistically significant; all other between-group findings were nonsignificant after correction. Conclusions: Several cardiometabolic risk markers improved during follow-up, but no recorded management category showed consistent trajectory-level superiority. Because intervention content and adherence, time-updated medication use, acute COVID-19 severity, and lifestyle changes were not captured, the comparative findings are exploratory and noncausal. The isolated HDL-C associations should not be interpreted as evidence of cardiovascular benefit. No cardiac biomarkers, echocardiographic measures, incident heart failure, or cardiovascular events were assessed.

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