Anticipating the long-term cardiovascular effects of COVID-19

Becker, Richard C.

doi:10.1007/s11239-020-02266-6

Cited by 94 publications

(85 citation statements)

References 57 publications

(64 reference statements)

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“…Nearly one-fourth of these individuals presented with ongoing myocardial inflammation three months after COVID-19 diagnosis. These excessive inflammatory responses are hypothesized to be a main contributing factor to deadly cases of COVID-19, where the immune system malfunctions and leads to fatal cardiovascular events ( 32 , 37 ).…”

Section: Pathophysiology Of Covid-19-related Cardiovascular Infectionmentioning

confidence: 99%

Impact of COVID-19 infection on the cardiovascular system: An evidence-based analysis of risk factors and outcomes

Kaye

Spence

Mayerle

et al. 2021

Best Practice & Research Clinical Anaesthesiology

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Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), also known as COVID-19 emerged in late 2019 in Wuhan, China and the World Health Organization declared the virus a pandemic on March 11, 2020. Disease progression from COVID-19 infection has increasingly shown significant symptom manifestations within organ systems beyond the respiratory system. In this regard, literature has shown increasing numbers of cardiovascular involvement during disease course and an associated increase in mortality among infected patients. Complications involving the cardiovascular system include myocardial infarction, arrhythmias, shock, and heart failure. In this evidence-based review, we discuss risk factors of cardiovascular involvement in COVID-19 infection, pathophysiology of COVID-19-related cardiovascular infection and injury, COVID-19 effects on the cardiovascular system and corresponding treatments, and hematologic effects of COVID-19 and COVID-19 in heart transplant patients. Clinicians managing COVID-19 patients should appreciate the potential cardiovascular effects related to the disease process.

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Section: Pathophysiology Of Covid-19-related Cardiovascular Infectionmentioning

confidence: 99%

Impact of COVID-19 infection on the cardiovascular system: An evidence-based analysis of risk factors and outcomes

Kaye

Spence

Mayerle

et al. 2021

Best Practice & Research Clinical Anaesthesiology

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“…In addition to the muscle loss in "long Covid", the extended time at bedrest can lead to postural hypotension (17). Also, vasculitis during COVID-19 can lead to baroceptor damage EDITORIAL COVID-19 -THE LONG ROAD TO RECOVERY resulting in autonomic dysregulation (18). Further, the increase in cytokines can damage the autonomic nervous system (19).…”

Section: Figurementioning

confidence: 99%

COVID-19 — The Long Road to Recovery

Morley

2020

J Nutr Health Aging

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Seems like it's been a long journey in the past two months of recovery. I'm making progress and starting to walk independently with a cane. A little at a time but getting there."-Carol Todecheene COVID-19 is a pandemic viral disease that has spread throughout the world in 2020 (1, 2). Nearly half of the persons with COVID-19 are asymptomatic. Older persons, persons with comorbidity and diabetes mellitus are particularly at risk of developing COVID-19. Severe cases of COVID-19 cause a viral pneumonia. In addition, COVID-19 can affect almost any organ in the body, as it enters cells through the angiotensin converting enzyme (ACE) 2 receptor (3). A subset of persons with COVID-19 appear to have a prolonged recovery period. This has been termed "long Covid" (4). The concept of a viral disease leading to a post viral syndrome usually with chronic fatigue, is well recognized (5). In one study where patients were followed after having one of three viral diseases (Epstein Barr virus, Coxiella burnetti or Ross fever virus), 12% were found to have a specific syndrome for 6 or more months. Acute recurrences of the illness occurred in the first 3 months and chronic fluctuating symptoms included fatigue, cognitive disturbances, dysphoria, anxiety and pains in the muscles. This syndrome has also been termed myalgic encephalomyelitis (6). After having had COVID-19, the Boston Red Sox pitcher, Eduardo Rodriguez was fatigued when throwing the ball and an MRI showed that he had myocarditis that will prevent him from pitching this year. There is now good evidence that the corona virus can invade myocardial cells and cause destruction of heart muscle (7). As is shown in Figure 1, myocarditis is not the only long-term side effect of COVID-19. These symptoms of "long Covid" include: fatigue, cough, dyspnea, loss of taste and smell, muscle weakness, muscle and joint pain, headache, confusion, conjunctivitis, chest pain, decreased mobility and falls (8, 9). It is important to recognize that persons who have severe pneumonia due to COVID-19 might take 6 months or longer to return their breathing to normal and that this is associated with decreased mobility. Elevated D-dimer levels are prognostic of poor lung function at 3 months (10).

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“…Ebenfalls zytokinassoziiert kann das autonome Nervensystem geschädigt werden [42]. Eine COVID-19-assoziierte Vaskulitis kann durch Schädigung des Barorezeptors zur autonomen Dysregulation beitragen [43].…”

Section: Langzeitfolgen Nach Covid-19unclassified

COVID-19: Intensivmedizinische Aspekte und Langzeitfolgen

Bruno

Wolff

Kelm

et al. 2020

Aktuelle Kardiologie

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ZusammenfassungEtwa 14% der COVID-19-Patienten weisen einen schwereren und ca. 5% einen kritischen Krankheitsverlauf auf. Besonders gefährdet sind ältere Personen, männliches Geschlecht, Raucher und stark adipöse Menschen. Wird der Patient invasiv oder nichtinvasiv beatmet, so steigt die Mortalität auf 53% respektive 50% an. In der Regel beträgt die Dauer vom Beginn der Symptome bis zur Aufnahme auf die Intensivstation 10 Tage. Die mittlere Verweildauer auf der Intensivstation beträgt 9 Tage. Für die Priorisierung sind die klinische Erfolgsaussicht einer intensivmedizinischen Behandlung sowie der Wunsch des Patienten maßgebend. Zentrale Kriterien für die Aufnahme auf die Intensivstation sind eine Hypoxämie (SpO2 < 90% unter 2 – 4 Liter Sauerstoff/min bei nicht vorbestehender Therapie), Dyspnoe, eine erhöhte Atemfrequenz (> 25 – 30/min) und ein systolischer Blutdruck ≤ 100 mmHg. Der Schutz des Personals genießt bei allen Maßnahmen Vorrang. Alle aerosolgenerierenden Prozeduren sollten nur mit großer Vorsicht erfolgen. Wird unter High Flow keine adäquate Oxygenierung erreicht (SpO2 ≥ 90% oder ein paO2 > 55 mmHg), sollte über eine Eskalation nachgedacht werden (NIV, invasive Beatmung). Die Patienten sollten lungenprotektiv beatmet werden. Die Intubation sollte als Rapid Sequence Induction erfolgen. Eine ECMO kann erwogen werden. Thrombembolische Komplikationen sind sehr häufig. Antibiotika sollten nicht routinemäßig gegeben werden. Die aktuell beste Datenlage liegt für Dexamethason vor. Remdesivir kann die Rekonvaleszenz beschleunigen. Langzeitfolgen nach COVID-19 sind sehr häufig. Kardiale, pulmonale und neurologische Probleme stehen dabei im Vordergrund.

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Anticipating the long-term cardiovascular effects of COVID-19

Cited by 94 publications

References 57 publications

Impact of COVID-19 infection on the cardiovascular system: An evidence-based analysis of risk factors and outcomes

Impact of COVID-19 infection on the cardiovascular system: An evidence-based analysis of risk factors and outcomes

COVID-19 — The Long Road to Recovery

COVID-19: Intensivmedizinische Aspekte und Langzeitfolgen

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