A Review of Long COVID With a Special Focus on Its Cardiovascular Manifestations

Yousif, Elamein; Premraj, Sarah

doi:10.7759/cureus.31933

Cited by 5 publications

(4 citation statements)

References 46 publications

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“…These findings suggest that COVID-19 increases systolic and diastolic BP and may cause new-onset HTN. Altogether, these findings and others regarding cardiovascular symptoms call into question our understanding of viral-mediated myocardial (and pericardial) involvement ( Halushka and Vander Heide, 2021 ; Hanneman et al, 2022 ; Pellegrini et al, 2021 ; Puntmann et al, 2020 ; Webster et al, 2021 ; Yousif and Premraj, 2022 ). They additionally raise inquiries about our poor knowledge of the pathophysiology of cardiovascular manifestations and predisposing risk factors associated with Long COVID/PASC whose long-term cardiovascular consequences remain unknown.…”

Section: Cardiovascular Diseases Associated With Covid-19—focus On Hy...mentioning

confidence: 95%

Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC)

Sherif

Gómez

Connors

et al. 2023

eLife

127

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COVID-19, with persistent and new onset of symptoms such as fatigue, post-exertional malaise, and cognitive dysfunction that last for months and impact everyday functioning, is referred to as Long COVID under the general category of post-acute sequelae of SARS-CoV-2 infection (PASC). PASC is highly heterogenous and may be associated with multisystem tissue damage/dysfunction including acute encephalitis, cardiopulmonary syndromes, fibrosis, hepatobiliary damages, gastrointestinal dysregulation, myocardial infarction, neuromuscular syndromes, neuropsychiatric disorders, pulmonary damage, renal failure, stroke, and vascular endothelial dysregulation. A better understanding of the pathophysiologic mechanisms underlying PASC is essential to guide prevention and treatment. This review addresses potential mechanisms and hypotheses that connect SARS-CoV-2 infection to long-term health consequences. Comparisons between PASC and other virus-initiated chronic syndromes such as myalgic encephalomyelitis/chronic fatigue syndrome and postural orthostatic tachycardia syndrome will be addressed. Aligning symptoms with other chronic syndromes and identifying potentially regulated common underlining pathways may be necessary for understanding the true nature of PASC. The discussed contributors to PASC symptoms include sequelae from acute SARS-CoV-2 injury to one or more organs, persistent reservoirs of the replicating virus or its remnants in several tissues, re-activation of latent pathogens such as Epstein–Barr and herpes viruses in COVID-19 immune-dysregulated tissue environment, SARS-CoV-2 interactions with host microbiome/virome communities, clotting/coagulation dysregulation, dysfunctional brainstem/vagus nerve signaling, dysautonomia or autonomic dysfunction, ongoing activity of primed immune cells, and autoimmunity due to molecular mimicry between pathogen and host proteins. The individualized nature of PASC symptoms suggests that different therapeutic approaches may be required to best manage specific patients.

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Section: Cardiovascular Diseases Associated With Covid-19—focus On Hy...mentioning

confidence: 95%

Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC)

Sherif

Gómez

Connors

et al. 2023

eLife

127

View full text Add to dashboard Cite

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“…Since 2019, SARS-CoV-2 infection appeared as a clinically heterogeneous disorder, ranging from a completely asymptomatic phase to mild or moderate respiratory symptoms, up to severe pneumonia, respiratory distress syndrome, multiorgan failure and death [ 14 , 15 ]. Extra-pulmonary manifestations and various types of long-term complications were also subsequently recognized [ 16 – 19 ]. Patients with MM or other hematology malignancies (HM) are at high risk for severe COVID-19, compared to the general (healthy and non-cancer) population [ 20 , 21 ] and possibly also to other cancer patients [ 22 – 24 ].…”

Section: Methodsmentioning

confidence: 99%

Management of patients with multiple myeloma and COVID-19 in the post pandemic era: a consensus paper from the European Myeloma Network (EMN)

et al. 2023

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In the post-pandemic COVID-19 period, human activities have returned to normal and COVID-19 cases are usually mild. However, patients with multiple myeloma (MM) present an increased risk for breakthrough infections and severe COVID-19 outcomes, including hospitalization and death. The European Myeloma Network has provided an expert consensus to guide patient management in this era. Vaccination with variant-specific booster vaccines, such as the bivalent vaccine for the ancestral Wuhan strain and the Omicron BA.4/5 strains, is essential as novel strains emerge and become dominant in the community. Boosters should be administered every 6–12 months after the last vaccine shot or documented COVID-19 infection (hybrid immunity). Booster shots seem to overcome the negative effect of anti-CD38 monoclonal antibodies on humoral responses; however, anti-BCMA treatment remains an adverse predictive factor for humoral immune response. Evaluation of the immune response after vaccination may identify a particularly vulnerable subset of patients who may need additional boosters, prophylactic therapies and prevention measures. Pre-exposure prophylaxis with tixagevimab/cilgavimab is not effective against the new dominant variants and thus is no longer recommended. Oral antivirals (nirmatrelvir/ritonavir and molnupiravir) and remdesivir are effective against Omicron subvariants BA.2.12.1, BA.4, BA.5, BQ.1.1 and/or XBB.1.5 and should be administered in MM patients at the time of a positive COVID-19 test or within 5 days post symptoms onset. Convalescent plasma seems to have low value in the post-pandemic era. Prevention measures during SARS-CoV-2 outbreaks, including mask wearing and avoiding crowded places, seem prudent to continue for MM patients.

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“…Emerging evidence demonstrates a significant burden on the CV system during the long COVID period (reviewed in [61]). Symptoms specific to the CV system involvement of long COVID include palpitations, chest pain, breathlessness, and postural dizziness with or without syncope [62]. Palpitations and chest pain are the most common findings of the long COVID period [63]; seemingly healthy individuals may experience dizziness and an increased heart rate while resting [64].…”

Section: Effect Of Long Covid On the Cardiovascular Systemmentioning

confidence: 99%

Persisting Shadows: Unraveling the Impact of Long COVID-19 on Respiratory, Cardiovascular, and Nervous Systems

Sideratou,

Papaneophytou

2023

Infectious Disease Reports

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The coronavirus disease 2019 (COVID-19), instigated by the zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), rapidly transformed from an outbreak in Wuhan, China, into a widespread global pandemic. A significant post-infection condition, known as ‘long- COVID-19′ (or simply ‘long- COVID’), emerges in a substantial subset of patients, manifesting with a constellation of over 200 reported symptoms that span multiple organ systems. This condition, also known as ‘post-acute sequelae of SARS-CoV-2 infection’ (PASC), presents a perplexing clinical picture with far-reaching implications, often persisting long after the acute phase. While initial research focused on the immediate pulmonary impact of the virus, the recognition of COVID-19 as a multiorgan disruptor has unveiled a gamut of protracted and severe health issues. This review summarizes the primary effects of long COVID on the respiratory, cardiovascular, and nervous systems. It also delves into the mechanisms underlying these impacts and underscores the critical need for a comprehensive understanding of long COVID’s pathogenesis.

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A Review of Long COVID With a Special Focus on Its Cardiovascular Manifestations

Cited by 5 publications

References 46 publications

Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC)

Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC)

Management of patients with multiple myeloma and COVID-19 in the post pandemic era: a consensus paper from the European Myeloma Network (EMN)

Persisting Shadows: Unraveling the Impact of Long COVID-19 on Respiratory, Cardiovascular, and Nervous Systems

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