TY - JOUR
T1 - Long COVID and the cardiovascular system - elucidating causes and cellular mechanisms in order to develop targeted diagnostic and therapeutic strategies
T2 - a joint Scientific Statement of the ESC Working Groups on Cellular Biology of the Heart and Myocardial and Pericardial Diseases
AU - Gyöngyösi, Mariann
AU - Alcaide, Pilar
AU - Asselbergs, Folkert W.
AU - Brundel, Bianca J.J.M.
AU - Camici, Giovanni G.
AU - Da Costa Martins, Paula
AU - Ferdinandy, Péter
AU - Fontana, Marianna
AU - Girao, Henrique
AU - Gnecchi, Massimiliano
AU - Gollmann-Tepeköylü, Can
AU - Kleinbongard, Petra
AU - Krieg, Thomas
AU - Madonna, Rosalinda
AU - Paillard, Melanie
AU - Pantazis, Antonis
AU - Perrino, Cinzia
AU - Pesce, Maurizio
AU - Schiattarella, Gabriele G.
AU - Sluijter, Joost P.G.
AU - Steffens, Sabine
AU - Tschöpe, Carsten
AU - Van Linthout, Sophie
AU - Davidson, Sean M.
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multiorgan symptoms that endure for weeks or months after SARS-CoV-2 infection has already subsided. This scientific document aims to provide insight into the possible causes and therapeutic options available for the cardiovascular manifestations of long COVID. In addition to chronic fatigue, which is a common symptom of long COVID, patients may present with chest pain, ECG abnormalities, postural orthostatic tachycardia, or newly developed supraventricular or ventricular arrhythmias. Imaging of the heart and vessels has provided evidence of chronic, post-infectious perimyocarditis with consequent left or right ventricular failure, arterial wall inflammation, or microthrombosis in certain patient populations. Better understanding of the underlying cellular and molecular mechanisms of long COVID will aid in the development of effective treatment strategies for its cardiovascular manifestations. A number of mechanisms have been proposed, including those involving direct effects on the myocardium, microthrombotic damage to vessels or endothelium, or persistent inflammation. Unfortunately, existing circulating biomarkers, coagulation, and inflammatory markers, are not highly predictive for either the presence or outcome of long COVID when measured 3 months after SARS-CoV-2 infection. Further studies are needed to understand underlying mechanisms, identify specific biomarkers, and guide future preventive strategies or treatments to address long COVID and its cardiovascular sequelae.
AB - Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multiorgan symptoms that endure for weeks or months after SARS-CoV-2 infection has already subsided. This scientific document aims to provide insight into the possible causes and therapeutic options available for the cardiovascular manifestations of long COVID. In addition to chronic fatigue, which is a common symptom of long COVID, patients may present with chest pain, ECG abnormalities, postural orthostatic tachycardia, or newly developed supraventricular or ventricular arrhythmias. Imaging of the heart and vessels has provided evidence of chronic, post-infectious perimyocarditis with consequent left or right ventricular failure, arterial wall inflammation, or microthrombosis in certain patient populations. Better understanding of the underlying cellular and molecular mechanisms of long COVID will aid in the development of effective treatment strategies for its cardiovascular manifestations. A number of mechanisms have been proposed, including those involving direct effects on the myocardium, microthrombotic damage to vessels or endothelium, or persistent inflammation. Unfortunately, existing circulating biomarkers, coagulation, and inflammatory markers, are not highly predictive for either the presence or outcome of long COVID when measured 3 months after SARS-CoV-2 infection. Further studies are needed to understand underlying mechanisms, identify specific biomarkers, and guide future preventive strategies or treatments to address long COVID and its cardiovascular sequelae.
KW - Cardiac
KW - Cardiovascular
KW - COVID-19
KW - Long COVID
KW - Post COVID
UR - http://www.scopus.com/inward/record.url?scp=85147705555&partnerID=8YFLogxK
U2 - 10.1093/cvr/cvac115
DO - 10.1093/cvr/cvac115
M3 - Review article
C2 - 35875883
AN - SCOPUS:85147705555
SN - 0008-6363
VL - 119
SP - 336
EP - 356
JO - Cardiovascular research
JF - Cardiovascular research
IS - 2
ER -