TY - JOUR
T1 - Long COVID and the cardiovascular system - elucidating causes and cellular mechanisms in order to develop targeted diagnostic and therapeutic strategies
T2 - a joint Scientific Statement of the ESC Working Groups on Cellular Biology of the Heart and Myocardial and Pericardial Diseases
AU - Gyöngyösi, Mariann
AU - Alcaide, Pilar
AU - Asselbergs, Folkert W
AU - Brundel, Bianca J J M
AU - Camici, Giovanni G
AU - da Costa Martins, Paula
AU - Ferdinandy, Péter
AU - Fontana, Marianna
AU - Girao, Henrique
AU - Gnecchi, Massimiliano
AU - Gollmann-Tepeköylü, Can
AU - Kleinbongard, Petra
AU - Krieg, Thomas
AU - Madonna, Rosalinda
AU - Paillard, Melanie
AU - Pantazis, Antonis
AU - Perrino, Cinzia
AU - Pesce, Maurizio
AU - Schiattarella, Gabriele G
AU - Sluijter, Joost P G
AU - Steffens, Sabine
AU - Tschöpe, Carsten
AU - Van Linthout, Sophie
AU - Davidson, Sean M
N1 - Funding Information:
This work was supported by: University College London Hospitals Biomedical Research Centre to F.W.A. National Institutes of Health, Tufts University COVID19 seed funding (NIH-HL-144477) to P.A. Medizinisch-Wissenschaftlichen Fonds des Bürgermeisters der Bundeshauptstadt Wien, Project Nr: 21176, MUW AP21176BGM and KP21176BGM and Austrian Science Fund (FWF) Project Nr: KLI 1064-B to MG. The British Heart Foundation (PG/19/51/34493 and PG/16/85/32471) to S.M.D. Regione Lombardia (POR FESR 2014-2020-LINEA 2A COVID-grant no. 1850333) and CARDIO-COV project to M.P. Incyte s.r.l. and funds from Ministero dell'Istruzione, dell'Università e della Ricerca (549901_2020_Madonna: Ateneo) to R.M. Swiss Heart Foundation and Swiss National Science Foundation (310030_175546) to G.G.C., Alfred and Annemarie von Sick Grants for Translational and Clinical Research Cardiology and Oncology to G.G.C. H.H. Sheikh Khalifa bin Hamad Al Thani Foundation Assistant Professorship at the Faculty of Medicine, University of Zurich to G.G.C. The European Research Council [Project EVICARE (No. 725229)]to J.P.G.S. The National Research, Development and Innovation Office of Hungary (Research Excellence Program TKP within the framework of the Therapeutic Development thematic programme of the Semmelweis University; National Heart Laboratory; and 2020-1.1.6-JÖVO-2021-00013 - investment into the future) to P.F., and the EU Horizon 2020 project COVIRNA (101016072) to P.F. P.F. is a vice chair of the COST Cardioprotection action (CA16225) and an MC member of the COST CardioRNA project (CA17129). DZHK (German Centre for Cardiovascular Research) JRG to G.G.S. Dutch Cardiovascular Alliance (DCVA) awarded to the Phaedra consortium as well as the Impulse Grant 2018 awarded to the Phaedra IMPACT consortium (2012-08, 2014-11) to P.d.C.M. and by a Dutch Heart Foundation grant (NHS2015T066) to P.d.C.M. DHF and DZKH (DnAFix project 2020B003).
Publisher Copyright:
© The Author(s) 2022.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - 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.
AB - 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.
KW - Covid-19
KW - Cardiac
KW - Cardiovascular
KW - Long COVID
KW - Post COVID
U2 - 10.1093/cvr/cvac115
DO - 10.1093/cvr/cvac115
M3 - (Systematic) Review article
C2 - 35875883
SN - 0008-6363
VL - 119
SP - 336
EP - 356
JO - Cardiovascular Research
JF - Cardiovascular Research
IS - 2
M1 - cvac115
ER -