Journal article
Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus
- Abstract:
- Emerging as a new epidemic, long COVID or Post-Acute Sequelae of COVID-19 (PASC), a condition characterised by the persistence of COVID-19 symptoms beyond 4 weeks, is anticipated to substantially alter the lives of millions of people globally. Cardiopulmonary symptoms including chest pain, shortness of breath, fatigue and autonomic manifestations such as postural orthostatic tachycardia are common and associated with significant disability, heightened anxiety and public awareness. A range of cardiovascular abnormalities has been reported among patients beyond the acute phase and include myocardial inflammation, myocardial infarction, right ventricular dysfunction and arrhythmias. Pathophysiological mechanisms for delayed complications are still poorly understood, with a dissociation seen between ongoing symptoms and objective measures of cardiopulmonary health. COVID-19 is anticipated to alter the long term trajectory of many chronic cardiac diseases which are abundant in those at risk of severe disease. In this review, we discuss the definition of long COVID and its epidemiology, with an emphasis on cardiopulmonary symptoms. We further review the pathophysiological mechanisms underlying acute and chronic cardiovascular injury, the range of post-acute cardiovascular sequelae and impact of COVID-19 on multiorgan health. We propose a possible model for referral of post-COVID-19 patients to cardiac services and discuss future directions including research priorities and clinical trials that are currently underway to evaluate the efficacy of treatment strategies for long COVID and associated cardiovascular sequelae.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 1.2MB, Terms of use)
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- Publisher copy:
- 10.1093/eurheartj/ehac031
Authors
- Publisher:
- Oxford University Press
- Journal:
- European Heart Journal More from this journal
- Volume:
- 43
- Issue:
- 11
- Pages:
- 1157–1172
- Publication date:
- 2022-02-18
- Acceptance date:
- 2022-01-14
- DOI:
- EISSN:
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1522-9645
- ISSN:
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0195-668X
- Language:
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English
- Keywords:
- Pubs id:
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1233300
- Local pid:
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pubs:1233300
- Deposit date:
-
2022-01-25
Terms of use
- Copyright holder:
- Raman et al
- Copyright date:
- 2022
- Rights statement:
- © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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