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 and Pericardial Diseases

Cardiovascular Research, Journal Year: 2022, Volume and Issue: 119(2), P. 336 - 356

Published: July 25, 2022

Abstract Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multiorgan symptoms that endure for weeks or months after SARS-CoV-2 infection already subsided. This scientific document aims to provide insight into the possible causes and therapeutic options available cardiovascular manifestations of long COVID. In addition chronic fatigue, which is common symptom COVID, patients may present with chest pain, ECG abnormalities, postural orthostatic tachycardia, newly developed supraventricular ventricular arrhythmias. Imaging heart vessels provided evidence chronic, post-infectious perimyocarditis consequent left right failure, arterial wall inflammation, microthrombosis in certain patient populations. Better understanding underlying cellular molecular mechanisms will aid development effective treatment strategies its manifestations. A number have been proposed, including those involving direct effects on myocardium, microthrombotic damage endothelium, persistent inflammation. Unfortunately, existing circulating biomarkers, coagulation, inflammatory markers, are not highly predictive either presence outcome when measured 3 infection. Further studies needed understand mechanisms, identify specific guide future preventive treatments address sequelae.

Language: Английский

---

Post-COVID dysautonomias: what we know and (mainly) what we don’t know

Nature Reviews Neurology, Journal Year: 2024, Volume and Issue: 20(2), P. 99 - 113

Published: Jan. 11, 2024

Language: Английский

---

Reshaping the healthcare world by AI-integrated wearable sensors following COVID-19

Chemical Engineering Journal, Journal Year: 2025, Volume and Issue: 505, P. 159478 - 159478

Published: Jan. 11, 2025

Language: Английский

---

Long COVID-19 and Postural Orthostatic Tachycardia Syndrome- Is Dysautonomia to Be Blamed?

Frontiers in Cardiovascular Medicine, Journal Year: 2022, Volume and Issue: 9

Published: March 9, 2022

While the increased arrhythmic tendency during acute COVID-19 infection is recognised, long-term cardiac electrophysiological complications are less well known. There a high number of patients reporting ongoing symptoms post-infection, termed long COVID. A recent hypothesis that COVID could be attributed to dysautonomia, defined as malfunction autonomic nervous system (ANS). The most prevalent cardiovascular dysautonomia amongst young people postural orthostatic tachycardia syndrome (POTS). Numerous reports have described development POTS part Possible underlying mechanisms, although not mutually exclusive or exhaustive, include hypovolaemia, neurotropism, inflammation and autoimmunity. Treatment options for other currently limited. Future research studies should aim elucidate mechanisms enable targeted therapies. Furthermore, it important educate healthcare professionals recognise conditions arising from COVID-19, such POTS, allow prompt diagnosis access early treatment.

Language: Английский

---

The potential role of ischaemia–reperfusion injury in chronic, relapsing diseases such as rheumatoid arthritis, Long COVID, and ME/CFS: evidence, mechanisms, and therapeutic implications

Biochemical Journal, Journal Year: 2022, Volume and Issue: 479(16), P. 1653 - 1708

Published: Aug. 31, 2022

Ischaemia-reperfusion (I-R) injury, initiated via bursts of reactive oxygen species produced during the reoxygenation phase following hypoxia, is well known in a variety acute circumstances. We argue here that I-R injury also underpins elements pathology chronic, inflammatory diseases, including rheumatoid arthritis, ME/CFS and, our chief focus and most proximally, Long COVID. Ischaemia may be fibrin amyloid microclot blockage capillaries, for instance as exercise started; reperfusion necessary corollary when it finishes. rehearse mechanistic evidence these occurrences here, terms their manifestation oxidative stress, hyperinflammation, mast cell activation, production marker metabolites related activities. Such microclot-based phenomena can explain both breathlessness/fatigue post-exertional malaise observed conditions, many other observables. The recognition processes implies, mechanistically, therapeutic benefit potentially to had from antioxidants, anti-inflammatories, iron chelators, suitable, safe fibrinolytics, and/or anti-clotting agents. review considerable existing consistent with this, biochemical mechanisms involved.

Language: Английский

---

Reduction of Cardiac Autonomic Modulation and Increased Sympathetic Activity by Heart Rate Variability in Patients With Long COVID

Frontiers in Cardiovascular Medicine, Journal Year: 2022, Volume and Issue: 9

Published: April 29, 2022

Although several clinical manifestations of persistent long coronavirus disease (COVID-19) have been documented, their effects on the cardiovascular and autonomic nervous system over term remain unclear. Thus, we examined presence alterations in cardiac functioning individuals with long-term manifestations. The study was conducted from October 2020 to May 2021, an assessment performed collect heart rate data for variability (HRV) analysis. participants were divided into COVID group, intragroup, which included patients who hospitalized, those not hospitalized symptomatic different periods (≤3, >3, ≤6, >6 months), without dyspnoea. control intergroup, comprised COVID-free individuals. Our results demonstrated that group showed reduced HRV compared COVID-19-uninfected group. Patients aged 23–59 years developed symptoms within 30 days after infection, whose diagnosis confirmed by serologic or reverse-transcription polymerase chain reaction (swab) tests, study. A total 155 [95 women (61.29%), mean age 43.88 ± 10.88 60 men (38.71%), 43.93 10.11 years] 94 controls [61 (64.89%), 40.83 6.31 33 (35.11%), 40.69 6.35 included. intragroup intergroup comparisons revealed a reduction global HRV, increased sympathetic modulation influence, decrease parasympathetic COVID. normal sympathovagal balance, while balance. findings indicate leads excitation influence reduction. can increase blood pressure predispose complications. Short-term analysis good reproducibility verify involvement.

Language: Английский

---

Long COVID Syndrome and Cardiovascular Manifestations: A Systematic Review and Meta-Analysis

Diagnostics, Journal Year: 2023, Volume and Issue: 13(3), P. 491 - 491

Published: Jan. 29, 2023

(1) Background: Long COVID syndrome is a significant cause of morbidity in COVID-19 patients who remain symptomatic with varied clinical presentations beyond three weeks. Furthermore, the relevance considering cardiovascular outcomes post-COVID-19 important current pandemic; (2) Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed this systematic review meta-analysis. searches conducted from multiple databases without language restrictions until October 8, 2022, to find studies evaluating such as arrhythmias, myocardium pericardium diseases, coronary vessel disease, thromboembolic disorders post-COVID cases. pooled odds ratio (OR), standard mean difference (SMD) their corresponding 95% confidence intervals (CI) computed association; (3) Results: Altogether, seven total 8,126,462 (cases: 1,321,305; controls: 6,805,157) participants included Pooled ratios significantly higher cases (OR > 1, p < 0.05) than controls. However, mortality (OR: 4.76, = 0.13), heart rate variability (SMD: −0.06, 0.91) between controls not statistically significant; (4) Conclusions: Significant sequelae long highlight importance careful cardiac monitoring phase address complications soon possible; larger-scale prospective are required accurate estimation.

Language: Английский

---

Cardiovascular autonomic dysfunction in “Long COVID”: pathophysiology, heart rate variability, and inflammatory markers

Frontiers in Cardiovascular Medicine, Journal Year: 2023, Volume and Issue: 10

Published: Sept. 1, 2023

Long COVID is characterized by persistent signs and symptoms that continue or develop for more than 4 weeks after acute COVID-19 infection. Patients with experience a cardiovascular autonomic imbalance known as dysautonomia. However, the underlying pathophysiological mechanisms behind this remain unclear. Current hypotheses include neurotropism, cytokine storms, inflammatory persistence. Certain immunological factors indicate autoimmune dysfunction, which can be used to identify patients at higher risk of COVID. Heart rate variability imbalances in individuals suffering from COVID, measurement non-invasive low-cost method assessing modulation. Additionally, biochemical markers are diagnosing monitoring These improve understanding driving response its effects on sympathetic parasympathetic pathways nervous system. Autonomic may result lower heart variability, impaired vagal activity, substantial sympathovagal imbalance. New research subject must encouraged enhance long-term risks cause

Language: Английский

---

Autoimmunity in Long Covid and POTS

Oxford Open Immunology, Journal Year: 2023, Volume and Issue: 4(1)

Published: Jan. 1, 2023

Abstract Orthostatic intolerance and other autonomic dysfunction syndromes are emerging as distinct symptom clusters in Long Covid. Often accompanying these common, multi-system constitutional features such fatigue, malaise skin rashes which can signify generalized immune dysregulation. At the same time, multiple autoantibodies identified both Covid-related disorders non-Covid disorders, implying a possible underlying autoimmune pathology. The lack of specificity findings precludes direct interpretations cause association, but their prevalence with its supporting evidence is compelling.

Language: Английский

---

Long-Term Impact of COVID-19 on Heart Rate Variability: A Systematic Review of Observational Studies

Healthcare, Journal Year: 2023, Volume and Issue: 11(8), P. 1095 - 1095

Published: April 11, 2023

Coronavirus disease 2019 (COVID-19) sequelae (or long COVID) has become a clinically significant concern. Several studies have reported the relationship between heart rate variability (HRV) parameters and COVID-19. This review investigates long-term association COVID-19 HRV parameters. Four electronic databases were searched up to 29 July 2022. We included observational comparing (measurement durations: 1 min or more) in participants with without history of used assessment tools developed by National Heart, Lung, Blood Institute group evaluate methodological quality studies. Eleven cross-sectional compared individuals who recovered from acute infection controls (n = 2197). Most standard deviation normal-to-normal intervals (SDNN) root mean square successive differences. The was not optimal. generally found decreased SDNN parasympathetic activity post-COVID-19 individuals. Compared controls, decreases observed had COVID. emphasized inhibition conditions. Due limitations measuring parameters, findings should be further validated robust prospective longitudinal

Language: Английский

---