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Current Atherosclerosis Reports

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01-07-2021 | Long-COVID Syndrome | Coronary Heart Disease (S. Virani and S. Naderi, Section Editors)

COVID and Cardiovascular Disease: What We Know in 2021

Authors: Michael Chilazi, Eamon Y. Duffy, Aarti Thakkar, Erin D. Michos

Published in: Current Atherosclerosis Reports | Issue 7/2021

Abstract

Purpose of Review

Coronavirus disease 2019 (COVID-19) has been the cause of significant global morbidity and mortality. Here, we review the literature to date of the short-term and long-term consequences of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection on the heart.

Recent Findings

Early case reports described a spectrum of cardiovascular manifestations of COVID-19, including myocarditis, stress cardiomyopathy, myocardial infarction, and arrhythmia. However, in most cases, myocardial injury in COVID-19 appears to be predominantly mediated by the severity of critical illness rather than direct injury to myocardium from viral particles. While cardiac magnetic resonance imaging remains a powerful tool for diagnosing acute myocarditis, it should be used judiciously in light of low baseline prevalence of myocarditis. Guiding an athletic patient through return to play (RTP) after COVID-19 infection is a challenging process. More recent data show RTP has been a safe endeavor using a screening protocol. “Long COVID” or post-acute sequelae of SARS-CoV-2 infection has also been described. The reported symptoms span a large breadth of cardiopulmonary and neurologic complaints including fatigue, palpitations, chest pain, breathlessness, brain fog, and dysautonomia including postural tachycardia syndrome (POTS). Management of POTS/dysautonomia primarily centers on education, exercise, and salt and fluid repletion.

Summary

Our understanding of the impact of COVID-19 on the cardiovascular system is constantly evolving. As we enter a new age of survivorship, additional research is needed to catalogue the burden of persistent cardiopulmonary symptoms. Research is also needed to learn how acute management may alter the likelihood and prevalence of this chronic syndrome.

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Title: COVID and Cardiovascular Disease: What We Know in 2021
Authors: Michael Chilazi
Eamon Y. Duffy
Aarti Thakkar
Erin D. Michos
Publication date: 01-07-2021
Publisher: Springer US
Keywords: Long-COVID Syndrome
Myocarditis
COVID-19
Published in: Current Atherosclerosis Reports / Issue 7/2021
Print ISSN: 1523-3804
Electronic ISSN: 1534-6242
DOI: https://doi.org/10.1007/s11883-021-00935-2

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COVID and Cardiovascular Disease: What We Know in 2021

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Abstract

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