Long COVID and the cardiovascular system - elucidating causes and cellular mechanisms in order to develop targeted diagnostic and therapeutic strategies: A joint Scientific Statement of the ESC Working Groups on Cellular Biology of the Heart and Myocardial & Pericardial Diseases
2022
Gyöngyösi, M. | Alcaide, P. | Asselbergs, F. W. | Brundel, Bjjm | Camici, G. G. | Costa Martins, P., Da | Ferdinandy, P. | Fontana, M. | Girao, H. | Gnecchi, M. | Gollmann-Tepeköylü, C. | Kleinbongard, P. | Krieg, T. | Madonna, R. | Paillard, M. | Pantazis, A. | Perrino, C. | Pesce, M. | Schiattarella, G. G. | Sluijter, J. P. G. | Steffens, S. | Tschöpe, C. | van Linthout, S. | Davidson, S. M. | Medizinische Universität Wien = Medical University of Vienna | Tufts University School of Medicine [Boston] | University Medical Center [Utrecht] | Utrecht University [Utrecht] | University College of London [London] (UCL) | Amsterdam UMC - Amsterdam University Medical Center | Vrije Universiteit Amsterdam [Amsterdam] (VU) | Universität Zürich [Zürich] = University of Zurich (UZH) | University hospital of Zurich [Zurich] | Maastricht University [Maastricht] | Semmelweis University [Budapest] | Pharmahungary Group [Szeged, Hungary] (PG) | University of Coimbra [Portugal] (UC) | Coimbra Institute for Clinical and Biomedical Research [Coimbra, Portugal] (iCBR - Faculty of Medicine) ; University of Coimbra [Portugal] (UC) | Università degli Studi di Pavia = University of Pavia (UNIPV) | Fondazione IRCCS Policlinico San Matteo [Pavia] ; Università degli Studi di Pavia = University of Pavia (UNIPV) | Innsbruck Medical University = Medizinische Universität Innsbruck (IMU) | Universitätsklinikum Essen [Universität Duisburg-Essen] (Uniklinik Essen) | Addenbrooke's Hospital ; Cambridge University NHS Trust | University of Pisa - Università di Pisa | Jefferson (Philadelphia University + Thomas Jefferson University) | Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN) ; Université Claude Bernard Lyon 1 (UCBL) ; Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) | Imperial College London | Royal Brompton and Harefield NHS Foundation Trust | University of Naples Federico II = Università degli studi di Napoli Federico II | Centro Cardiologico Monzino [Milano] ; Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO) ; Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) | Charité - UniversitätsMedizin = Charité - University Hospital [Berlin] | German Center for Cardiovascular Research (DZHK) ; Berlin Institute of Health (BIH) | Max Delbrück Center for Molecular Medicine [Berlin] (MDC) ; Helmholtz-Gemeinschaft = Helmholtz Association | Utrecht Brain Center [UMC] ; University Medical Center [Utrecht] | Ludwig-Maximilians-Universität München (LMU) | Berlin Institute of Health (BIH) | Charité Campus Virchow-Klinikum (CVK) | The Hatter Cardiovascular Institute (THCI) ; University College of London [London] (UCL)
International audience
Show more [+] Less [-]English. Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multi-organ 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 peri-myocarditis with consequent left or right ventricular failure, arterial wall inflammation or micro-thrombosis 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, micro-thrombotic 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.
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