Cardiovascular disease as part of Long COVID: A systematic review

Vasiliki Tsampasian; Maria Bäck; Marco Bernardi; Elena Cavarretta; Maciej Dębski; Sabiha Gati; Dominique Hansen; Nicolle Kränkel; Konstantinos Koskinas; Josef Niebauer; Luigi Spadafora; Manuel Frias Vargas; Giuseppe Biondi-Zoccai; Vassilios S Vassiliou

doi:10.1093/eurjpc/zwae070

Cardiovascular disease as part of Long COVID: A systematic review

Eur J Prev Cardiol. 2024 Feb 21:zwae070. doi: 10.1093/eurjpc/zwae070. Online ahead of print.

Authors

Vasiliki Tsampasian¹, Maria Bäck^{2

3}, Marco Bernardi⁴, Elena Cavarretta^{5

6}, Maciej Dębski¹, Sabiha Gati⁷, Dominique Hansen⁸, Nicolle Kränkel⁹, Konstantinos Koskinas¹⁰, Josef Niebauer¹¹, Luigi Spadafora⁴, Manuel Frias Vargas^{12

13}, Giuseppe Biondi-Zoccai^{6

14}, Vassilios S Vassiliou^{1

15}

Affiliations

¹ Norwich Medical School, University of East Anglia, Norwich, UK.
² Institute of Medicine, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
³ Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden.
⁴ Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
⁵ Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
⁶ Mediterranea Cardiocentro, Naples, Italy.
⁷ Royal Brompton Hospital, UK and Imperial College London, UK.
⁸ Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium.
⁹ Deutsches Herzzentrum der Charité, Klinik für Kardiologie, Angiologie und Intensivmedizin, Campus Benjamin-Franklin (CBF), Charité University Medicine Berlin, 12203 Berlin, Germany.
¹⁰ Department of Cardiology, Bern University Hospital - INSELSPITAL, University of Bern, Switzerland.
¹¹ University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria.
¹² Department of Medicine, Faculty of Medicine, Complutense University of Madrid, Spain.
¹³ San Andres Primary Care Health Centre, Madrid, Spain.
¹⁴ Department of Medical - Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
¹⁵ Department of Cardiology, Norfolk and Norwich University Hospital, UK.

PMID: 38381595
DOI: 10.1093/eurjpc/zwae070

Abstract

Background: Long COVID syndrome has had a major impact on million patients' lives worldwide. The cardiovascular system is an important aspect of this multifaceted disease that may manifest in many ways. We have hereby performed a narrative review in order to identify the extent of the cardiovascular manifestations of the Long COVID syndrome.

Methods and results: An in-depth systematic search of the literature has been conducted for this narrative review. The systematic search of PubMed and Cochrane databases yielded 3,993, of which 629 underwent full text screening. A total of 78 studies were included in the final qualitative synthesis and data evaluation. The pathophysiology of the cardiovascular sequelae of Long COVID syndrome and the cardiac manifestations and complications of Long COVID syndrome are critically evaluated. In addition, potential cardiovascular risk factors are assessed, and preventive methods and treatment options are examined in this review.

Conclusions: This systematic review poignantly summarises the evidence from the available literature regarding the cardiovascular manifestations of Long COVID syndrome and reviews potential mechanistic pathways, diagnostic approaches, preventive measures and treatment options.