• One-Year Adverse Outcomes Among US Adults With Post–COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database – “This case-control study leveraged a large commercial insurance database and found increased rates of adverse outcomes over a 1-year period for a PCC cohort surviving the acute phase of illness. The results indicate a need for continued monitoring for at-risk individuals, particularly in the area of cardiovascular and pulmonary management.”
  • One-year cardiovascular outcomes after coronavirus disease 2019: The cardiovascular COVID-19 registry – “At 1-year, patients with COVID-19 experienced an increased risk of all-cause death and adverse CV events, including ATE, VTE, and serious cardiac arrhythmias, but not CV death.”
  • Association of COVID-19 with short- and long-term risk of cardiovascular disease and mortality: a prospective cohort in UK Biobank – “COVID-19 infection, including long-COVID, is associated with increased short- and long-term risks of CVD and mortality. Ongoing monitoring of signs and symptoms of developing these cardiovascular complications post diagnosis and up till at least a year post recovery may benefit infected patients, especially those with severe disease.”
  • Cardiac Arrhythmias in Post-COVID Syndrome: Prevalence, Pathology, Diagnosis, and Treatment – “The spectrum of possible cardiac arrhythmias is broad, ranging from benign ventricular extrasystoles to atrial fibrillation and sudden cardiac death from ventricular arrhythmias. Thereby, the frequency of occurrence clearly correlates with cardiovascular comorbidities. However, cardiac arrhythmias can also affect previously healthy individuals or athletes. Together with other symptoms of the post-COVID condition, cardiac arrhythmias cause a further reduction in the quality of life.”
  • Long COVID Syndrome and Cardiovascular Manifestations: A Systematic Review and Meta-Analysis – “With ever-increasing COVID-19 cases, evidence of the association between COVID-19 pathology and cardiovascular manifestations is paramount. Considering this, our meta-analysis delineates that long COVID syndrome is associated with an increased burden of cardiovascular manifestations. Further this study emphasizes to conduct large-scale, multicenter researches to address the heterogeneity of post-COVID cardiovascular sequelae in different age groups and genders, as well as a pinpointing of the exact pathomechanism that can provide valuable evidence and aid in the identification of novel therapeutic targets to prevent the development of cardiovascular disease in COVID-19 patients.”
  • Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus – “Long COVID is emerging as a major public health issue. Our current understanding of pathophysiological mechanisms and treatment options remains limited; however, there is great optimism as several national and international research initiatives promise to disentangle the complexities of this disease. The high burden of cardiopulmonary symptoms along with other organ manifestations underscores the need for multispecialty input,274,275 a model that is likely to also profit other chronic diseases. Proactive screening and investigation, where appropriate, could allay fears and anxiety among patients. Considerable efforts to find the right balance between cost-effective investigations and benefit to patients are needed to ensure sustainable service provision in these challenging economic times. Finally, the vast inequalities43,276 in healthcare provision exposed by COVID-19 will continue to be magnified by long COVID, a problem that calls for global humanitarian efforts to promote and fund equitable access to healthcare, social and welfare support, and vaccines across the world.”
  • Long-term cardiac pathology in individuals with mild initial COVID-19 illness – “In summary, in the present cohort of individuals with mild initial COVID-19 illness, cardiac symptoms were related to subclinical inflammatory cardiac involvement, which may, at least in part, explain the pathophysiological background of persistent cardiac symptoms. Notably, profound myocardial injury or structural heart disease is not prerequisite for the presence of symptoms defying the classical definitions of viral myocarditis. Subclinical cardiovascular inflammation is increasingly recognized as a risk factor in chronic autoimmune systemic conditions, necessitating further research to establish long-term outcome in the context of post-COVID.”
  • Long-term cardiovascular outcomes of COVID-19 – “In summary, using a national cohort of people with COVID-19, we show that risk and 12-month burden of incident cardiovascular disease are substantial and span several cardiovascular disease categories (ischemic and non-ischemic heart disease, dysrhythmias and others). The risks and burdens of cardiovascular disease were evident even among those whose acute COVID-19 did not necessitate hospitalization. Care pathways of people who survived the acute episode of COVID-19 should include attention to cardiovascular health and disease.”
  • Autonomic dysfunction and postural orthostatic tachycardia syndrome in post-acute COVID-19 syndrome – “The post-acute sequelae of COVID-19 present major problems for many patients, their physicians and the health-care system. They are unrelated to the severity of the initial infection, are often highly symptomatic and can occur after vaccination. Many sequelae involve cardiovascular autonomic dysfunction, with postural orthostatic tachycardia syndrome in 30% of individuals. Prognosis is unknown, and treatment is still unsatisfactory.”
  • Cardiac pathology in COVID-19: a single center autopsy experience – “Cardiovascular comorbidities were prevalent, and pathologic changes associated with hypertensive and atherosclerotic cardiovascular disease were the most common findings. Despite markedly elevated inflammatory markers and cardiac enzymes, few patients exhibited inflammatory infiltrates or necrosis within cardiac myocytes. A unifying pathophysiologic mechanism behind myocardial injury in COVID-19 remains elusive, and additional autopsy studies are needed.”
  • Acute Cardiovascular Manifestations in 286 Children With Multisystem Inflammatory Syndrome Associated With COVID-19 Infection in Europe – “Cardiac involvement is common in children with multisystem inflammatory syndrome associated with the Covid-19 pandemic. The majority of children have significantly raised levels of N-terminal pro B-type natriuretic peptide, ferritin, D-dimers, and cardiac troponin in addition to high C-reactive protein and procalcitonin levels. In comparison with adults with COVID-19, mortality in children with multisystem inflammatory syndrome associated with COVID-19 is uncommon despite multisystem involvement, very elevated inflammatory markers, and the need for intensive care support.”
  • Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank – “Individuals hospitalised with COVID-19 have increased risk of incident cardiovascular events across a range of disease and mortality outcomes. The risk of most events is highest in the early postinfection period. Individuals not requiring hospitalisation have increased risk of VTE, but not of other cardiovascular-specific outcomes.”
  • Spectrum of Cardiac Manifestations in COVID-19 – “In COVID-19 infection, LV systolic function is preserved in the majority of patients, but LV diastolic function and RV function are impaired. Elevated troponin and poorer clinical grade are associated with worse RV function. In patients presenting with clinical deterioration at follow-up, acute RV dysfunction, with or without deep vein thrombosis, is more common, but acute LV systolic dysfunction was noted in ≈20%.”
  • Cardiovascular Injury Due to SARS-CoV-2 – “Data are emerging that highlight the extent of cardiovascular involvement in COVID-19 patients, including evidence that SARS-CoV-2 causes myocarditis and increases cardiac risk. The incidence of cardiac injury is much greater in patients with severe disease presentation and those in intensive care.”
  • Cardiovascular Magnetic Resonance for Patients With COVID-19 – “Public health guidelines and vaccine development are expected to result in fewer incident cases of COVID-19. However, the clinical spectrum of recovery after acute COVID-19 with regard to cardiovascular disease is unresolved. Reports to date have raised the potential of sustained cardiac injury in patients who have recovered from COVID-19. CMR is a key noninvasive clinical and research tool because of its comprehensive evaluation of myocardial function, structure, and tissue composition.”
  • Cardiovascular manifestations and treatment considerations in COVID-19 – “COVID-19 is similar to SARS and MERS with regard to host vulnerability, specifically in those with substantial cardiovascular comorbidities. Greater transmissibility of COVID-19 has resulted in a worldwide pandemic, a record number of infected individuals and an excess mortality that far exceeded previous coronavirus-related outbreaks. Myocardial injury is common in COVID-19 and portends a worse prognosis. Differentiating between the various causes of myocardial injury is crucial to determining the treatment course. The cardiovascular considerations for treatment, including anticoagulation, ACEI or ARB use, anti-arrhythmic management, immunosuppression/modulation, and haemodynamic support, are important and continue to evolve.”
  • Clinical presentation and management strategies of cardiovascular autonomic dysfunction following a COVID-19 infection – A systematic review – “There is evidence from the scientific literature about different types of cardiovascular autonomic dysfunction developing during and after COVID-19. More data about the prevalence of autonomic disorders associated with a SARS-CoV-2 infection are needed to quantify its impact on human health.”
  • Human Cardiac Pericytes Are Susceptible to SARS-CoV-2 Infection – “This study identifies human cardiac pericytes as a novel target of SARS-CoV-2. We demonstrate that pericyte infection leads to innate inflammatory response, NF-kB-dependent pericyte cell death, and production of soluble factors that activate endothelial cells. These findings position mural cell infection as a new mechanism contributing to the cardiovascular manifestations of COVID-19.”
  • Acute Pulmonary Embolism and COVID-19 – “In our study, we found a significant difference in C-reactive protein level and D-dimer value between PE-positive and PE-negative groups, which may suggest that patients with a positive COVID-19 test with higher levels of inflammation and D-dimer values are more susceptible to developing PE. In addition, we found that nonintubated patients who developed PE required more oxygen prior to pulmonary CT angiography evaluation than did their non-PE counterparts. We did not find a significant difference in ICU admissions, requirement for intubation, or duration of intubation between patients who developed PE and those who did not. In fact, 72% (52 of 72) of PEs were diagnosed in patients who did not require ICU-level care. This is in sharp contrast to a recently published study (5) highlighting PE to be associated with ICU admission and mechanical ventilation. Our results suggest that even patients who do not have severe enough illness to qualify for ICU care can develop acute PE.”
  • Myocarditis Associated With COVID-19 – “Myocarditis associated with COVID-19 has widely variable presentations, which range asymptomatic to life-threatening arrhythmias and hemodynamic compromise. A high index of suspicion is required to recognize the patient with cardiovascular manifestations of COVID-19 as there is evidence to show a negative impact on morbidity and mortality in such patients.”
  • SARS-CoV-2 Initiates Programmed Cell Death in Platelets – “Platelets internalize SARS-CoV-2 virions, directly or attached to microparticles, and viral internalization leads to rapid digestion, programmed cell death, and extracellular vesicle release. During COVID-19, platelets mediate a rapid response to SARS-CoV-2 and this response can contribute to dysregulated immunity and thrombosis.”
  • Human Cardiac Pericytes Are Susceptible to SARS-CoV-2 Infection – “This study identifies human cardiac pericytes as a novel target of SARS-CoV-2. We demonstrate that pericyte infection leads to innate inflammatory response, NF-kB-dependent pericyte cell death, and production of soluble factors that activate endothelial cells. These findings position mural cell infection as a new mechanism contributing to the cardiovascular manifestations of COVID-19.”
  • Transcriptomic profiling of cardiac tissues from SARS-CoV-2 patients identifies DNA damage – “In COVID-19 patients with adverse outcomes, cardiac troponin I and brain-type natriuretic peptide are elevated in ICU admission patients [62]. However, while biomarker changes are indicative of tissue damage, the mechanisms involved in cardiac injury have not been fully established. Recent studies have shown that myocarditis is prevalent in COVID-19, however, evidence for subclinical cardiac inflammation or mechanisms regulating this process has been limited.”