Cardiopulmonary disease as sequelae of long-term COVID-19: Current perspectives and challenges

Abstract

COVID-19 infection primarily targets the lungs, which in severe cases progresses to cytokine storm, acute respiratory distress syndrome, multiorgan dysfunction, and shock. Survivors are now presenting evidence of cardiopulmonary sequelae such as persistent right ventricular dysfunction, chronic thrombosis, lung fibrosis, and pulmonary hypertension. This review will summarize the current knowledge on long-term cardiopulmonary sequelae of COVID-19 and provide a framework for approaching the diagnosis and management of these entities. We will also identify research priorities to address areas of uncertainty and improve the quality of care provided to these patients.

Systematic review and meta-analysis of myocarditis and pericarditis in adolescents following COVID-19 BNT162b2 vaccination

“…This can be mediated by multisystem inflammatory syndrome in children (MIS-C), resulting in cardiac problems, which account for the majority of pediatric COVID-19 mortality 36 . Second, SARS-CoV-2 cardiovascular complications can negatively affect children and adolescents in settings with variable resources 37 , 38 . Third, the prognosis appears to be excellent in individuals with myocarditis caused by the COVID-19 vaccination.…”

Endothelial dysfunction in autoimmune, pulmonary, and kidney systems, and exercise tolerance following SARS-CoV-2 infection

“…In a meta-analysis of 9 studies including 464 individuals with long COVID symptoms and 359 without symptoms who completed CPET assessments, mean peak oxygen consumption (VO 2 ) was found to be 4.9 mL/kg/min lower in those with long COVID symptoms compared to those without symptoms (60). Several potential sites involved in the oxygen delivery and utilization pathway have been implicated in exercise intolerance in individuals previously infected with SARS-COV-2 and those experiencing long COVID (59,60,(76)(77)(78)(79)(80)(81)(82)(83)(84). Of note, impaired peripheral oxygen extraction has surfaced as one potential site of importance when considering limiting factors contributing to exercise intolerance in long COVID (see Figure 2) (59,60,78,82).…”