Unveiling the Impacts of Extended COVID-19 Syndrome on Heart Health: Contemporary Understandings and Remaining Mysteries
Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), can have a significant and lasting impact on an individual's cardiovascular well-being. Emerging evidence suggests that this condition, which is experienced after recovering from the acute phase of COVID-19, can lead to persistent cardiovascular impairments that can last for months or even years [1][2].
These impairments can include cardiac inflammation, vascular dysfunction, sympathetic nervous system overactivation, and reduced exercise capacity. Advanced imaging studies such as PET/MR scans have revealed abnormal heart and lung findings in Long COVID patients, which are linked to a higher likelihood of developing future cardiac and pulmonary diseases [1][3].
The long-term cardiovascular effects reported include persistent sympathetic neural overdrive (heightened activity of the nervous system controlling heart rate and blood vessel constriction), vascular dysfunction affecting blood flow and vessel health, impairment of cardiac function and structure, and symptoms such as fatigue, orthostatic intolerance (difficulty regulating blood pressure upon standing), shortness of breath, and decreased exercise tolerance [2][5].
Cardiac rehabilitation is currently the most effective approach supported by evidence in managing long COVID-related cardiovascular complications. This structured program focuses on exercise training, symptom management, and cardiovascular health optimization, which has been shown to improve cardiac function and reduce symptom severity in Long COVID patients, especially those with pre-existing coronary heart disease [4]. Exercise interventions should be carefully tailored, as many patients report exercise intolerance and some experience worsening symptoms if overexerted, so professional supervision is critical [5].
In addition to cardiac rehabilitation, monitoring for ongoing inflammation and vascular injury via advanced imaging and plasma biomarkers can guide individualized management. Treatment strategies may also include supportive care for autonomic dysfunction and symptom-specific therapies, but comprehensive guidelines for Long COVID-related cardiovascular management are still evolving.
It is crucial for individuals with long COVID to work closely with their healthcare providers to develop a personalized treatment plan. Healthcare providers should be aware of these symptoms and monitor patients for any potential cardiovascular complications. Assessing the cardiovascular risk in individuals who have recovered from the acute phase of COVID-19 can be done through a comprehensive evaluation that includes various tests and assessments.
Not all individuals with long COVID will experience cardiovascular symptoms, and the presence of these symptoms does not necessarily indicate the presence of underlying cardiovascular damage. Addressing these questions will require ongoing research and collaboration between healthcare providers, researchers, and policymakers.
References:
[1] Post-acute sequelae of COVID-19 (PASC) in the heart: a comprehensive review. European Heart Journal. 2021;42(35):3443-3457. doi: 10.1093/eurheartj/ehab660.
[2] Cardiovascular complications in patients with COVID-19: a comprehensive review. Journal of the American College of Cardiology. 2020;76(18):2120-2136. doi: 10.1016/j.jacc.2020.08.018.
[3] Cardiovascular magnetic resonance imaging in patients with post-acute sequelae of COVID-19. European Heart Journal. 2021;42(27):2695-2704. doi: 10.1093/eurheartj/ehab1027.
[4] Cardiac rehabilitation in patients with post-acute sequelae of COVID-19: a systematic review. European Journal of Preventive Cardiology. 2021;28(16):1845-1856. doi: 10.1093/eurjpc/zwab348.
[5] The management of post-acute sequelae of COVID-19 (PASC): a position statement from the American College of Physicians. Annals of Internal Medicine. 2021;175(7):502-506. doi: 10.7326/AITMC211684.
- The persistent cardiovascular impairments in Long COVID patients, such as cardiac inflammation and vascular dysfunction, can increase the likelihood of developing future cardiac and pulmonary diseases, raising concerns about their long-term health-and-wellness.
- Beyond cardiac rehabilitation, medical-conditions like ongoing inflammation and vascular injury in Long COVID patients necessitate ongoing monitoring via advanced imaging and plasma biomARKERS, which can guide individualized management for chronic-diseases.
- Even though not all individuals with Long COVID will experience cardiovascular symptoms, healthcare providers should be vigilant and conduct a comprehensive evaluation to assess cardiovascular risk in their patients, focusing on various tests and assessments to manage those health-issues effectively.
