Features of post-COVID syndrome in patients who had COVID-19: effects on the cardiovascular system

Authors

  • T. M. Homeliuk I. Horbachevsky Ternopil National Medical University
  • D. V. Popovych I. Horbachevsky Ternopil National Medical University
  • M. I. Marushchak I. Horbachevsky Ternopil National Medical University

DOI:

https://doi.org/10.11603/bmbr.2706-6290.2021.4.12615

Keywords:

COVID-19, post-COVID syndrome, cardiovascular pathology

Abstract

Summary. At the beginning of the pandemic, COVID-19 was thought to be a short-lived disease. However, in the summer of 2020, the World Health Organization, using available data at the time, reported that some patients had symptoms of exhaustion for weeks or even months. Clinical studies of patients infected with SARS-CoV-2 have shown damage to many organs or systems, including the lungs, brain, kidneys and cardiovascular system. Despite extensive research into the cardiovascular complications of COVID-19 and its mechanisms, a number of unanswered questions remain unresolved. However, it is worth noting, that the study should also identify the target group, terms of screening after initial recovery from COVID-19 and tests, which will help in sorting people, who are at risk.

The aim of the study – to analyze modern literature sources on post-COVID syndrome in patients with comorbid COVID-19 and cardiovascular pathology.

Materials and Methods. The study examined the scientific publications of recent years, which are available on the Internet, key words "COVID-19", "SARS-CoV-2", key words "COVID-19","SARS-CoV-2", "post-COVID syndrome", "cardiovascular pathology".

Results. The presence of cardiovascular disease increases mortality in patients with COVID-19 and cardiovascular damage, including myocarditis, cardiac arrhythmias, endothelial cell lesions, thrombotic events and interstitial myocardial fibrosis, postural orthostatic tachycardia syndrome, observed in individual patients who underwent COVID-19. The main pathophysiology of cardiovascular complications associated with COVID-19, not fully studied, although direct myocardial viral infection and cytokine storm have been suggested as possible mechanisms.

Conclusions. The analysis of literature sources substantiates the relevance of the study of post-COVID syndrome in patients with comorbid course of COVID-19 and cardiovascular disease. Defining the role of COVID-19 in the development and progression of cardiovascular disease will pave the way for new approaches to the diagnosis, stratification, monitoring, prevention and treatment of this disease.

References

Han Zhu, June-Wha Rhee, Paul Cheng. Cardiovascular complications in patients with COVID-19: Consequences of viral toxicities and host immune respon. Current Cardiology Reports. 2020;32: 1-9.

Destin Groff, Ashley Sun, Anna E. Sentongo. Short-term and long-term rates of postacute sequelae of SARS-CoV-2 Infection. JAMA. 2021;4(10): 1-17.

Ani Nalbandian , Kartik Sehgal, Aakriti Gupta. Post-acute COVID-19 syndrome. Nature Medicine. 2021;21: 601-5.

Sophie A. M. van Kessel, Tim C. Olde Hartman, Cornelia H. M. van Jaarsveld Post-acute and long-COVID-19 symptoms in patients with mild diseases: a systematic review. Family Practice. 2021;20: 1-9. DOI:10.1093/fampra/cmab076

Shin Jie Yong. Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infectious Diseases. 2021;53(10); 737-54.

Weiyi Tan, Jamil Aboulhosn. The cardiovascular burden of coronavirus disease 2019 (COVID-19) with a focus on congenital heart disease. International Journal of Cardiolog. 2020;309: 70-7.

Hira Maab, Faryal Mustafa, Syeda Javeria Shabbir. Cardiovascular impact of COVID-19: an array of presentations. Acta Biomed. 2021;92(2): 1-10. DOI: 10.23750/abm.v92i2.10299

Shaobo Shi, Bo Shen, Tao Liu. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7): 802-10. DOI:10.1001/jamacardio.2020.0950

Mohammad Madjid, Payam Safavi-Naein, Scott D. Solomon. Potential effects of Coronaviruses on the cardiovascular system. A review. JAMA Cardiol. 2021;5(7): 831-40. DOI:10.1001/jamacardio.2020.1286

Claudia Carvalho-Schneider, Emeline Laurent, Adrien Lemaignen. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin. Microbiol. Infect. 20211;27(2): 258-63.

Chaolin Huang, Lixue Huang, Yeming Wang. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397: 220-32. DOI: 10.1016/S0140-6736(20)32656-8.

Stephanie M. Kochav, Ellie Coromilas, Ani Nalbandian Cardiac. Arrhythmias in COVID-19 Infection. Circ Arrhythm Electrophysio. 2020;13(60): e008719

Dawei Wang, Bo Hu, Chang Hu Clinical. Characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2021;323(11): 1061-9. DOI:10.1001/jama.2020.1585

Chad M. Colon, James G. Barrios, Joe W. Chiles. Atrial arrhythmias in COVID-19 patients. JACC Clin. Electrophysiol. 2020;6(9): 1189-90.

Zhou, Mi, Wong. Chun-Ka, Un, Ka-Chun. Cardiovascular sequalae in uncomplicated COVID-19 survivors. PLoS One. 2021;16(2): e0246732.

Enrico Guido Spinoni, Marco Mennuni, Andrea Rognon. Contribution of atrial аibrillation to in-hospital mortality in patients with COVID-19. Circ Arrhythm Electrophysiol. 2021;14(2): e009375. DOI: 10.1161/CIRCEP.120.009375

Blitshteyn S, Whitelaw S. Postural orthostatic tachycardia syndrome (POTS) and other autonomic disorders after COVID-19 infection: a case series of 20 patients. Immunol Res. 2021;69: 205-11.

Thomas F O’Connell, Christopher J Bradley, Amr E Abbas. Hydroxychloroquine/azithromycin therapy and QT prolongation in hospitalized patients with COVID-19. JACC Clin Electrophysiol. 2021;7(1): 16-25.

Ohad Oren, Eric H. Yang, Ty J. Gluckman. Use of chloroquine and hydroxychloroquine in COVID-19 and cardiovascular implications. Circ Arrhythm Electrophysiol. 2020;13(6): e008688.

Farnaz Farshidfar, Navid Koleini, Hossein Ardehalicorresponding. Cardiovascular complications of COVID-19. JCI Insight. 2021;6(13): e148980.

Jia Hui Zeng1, Ying Xia Liu2, Jing Yuan. First case of COVID 19 complicated with fulminant myocarditis: a case report and insights.Infection. 2020;10: 1-5. DOI: 10.1007/s15010-020-01424-5

Daniel S. Knight, Tushar Kotecha, Yousuf Razvi. COVID-19: Myocardial injury in survivors. Circulation. 2020;142(11): 1120-2. DOI: 10.1161/CIRCULATIONAHA.120.049252

Valentina O Puntmann, M Ludovica Carerj, Imke Wieters. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from Coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(11): 1265-73. DOI: 10.1001/jamacardio.2020.3557.

Qiurong Ruan , Kun Yang, Wenxia Wang. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5): 846-8. DOI: 10.1007/s00134-020-05991-x.

Leonardo Italia, Daniela Tomasoni, Stefano Bisegna, Edoardo Pancald. COVID-19 and heart failure: From epidemiology during the pandemic to myocardial injury, myocarditis, and heart failure sequelae. Front. Cardiovasc. 2021;8: 1-14.

Maarten Criel, Maarten Falter, Jasmien Jaeken. Venous thromboembolism in SARS-CoV-2 patients: only a problem in ventilated ICU patients, or is there more to it. Eur Respir. 2020;56(1): 2001201. DOI: 10.1183/13993003.01201-2020

Florian Bompard, Hippolyte Monnier, Ines Saab. Pulmonary embolism in patients with COVID-19 pneumonia. Eur. Respir. J. 2020;56(1): 2001365. DOI: 10.1183/13993003.01365-2020

Marisa Dolhnikoff, Amaro Nunes Duarte-Neto, Renata Aparecida de Almeida Monteiro. Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. J Thromb Haemost. 2020;18(6): 1517-9.

Gian Battista Danzi, Marco Loffi, Gianluca Galeazzi. Acute pulmonary embolism and COVID-19 pneumonia: a random association? Eur Heart J. 2020;41(19): 1858

Julien Poissy, Julien Goutay, Morgan Caplan. Pulmonary embolism in patients with COVID-19: Awareness of an increased prevalence. Circulation.2020;142(2): 184-6.

Waqas Ullah, Rehan Saeed, Usman Sarwar. COVID-19 Complicated by acute pulmonary embolism and right-sided heart failure. JACC Case Rep. 2020; 2(9): 1379-82.

Jean M. Connors, Jerrold H. Levy. COVID-19 and its implications for thrombosis and anticoagulation. The American Society of Hematology. 2020;135(23): 2033-40.

Richard C Becker. COVID-19 update: Covid-19-associated coagulopathy. J Thromb Thrombolysis. 2020;50(1): 54-67.

Zsuzsanna Varga, Andreas J Flammer, Peter Steiger. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234): 1417-8.

Maximilian Ackermann, Stijn E Verleden, Mark Kuehnel. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med. 2020;383(2): 120-8.

Neal M. Dixit, Austin Churchill & Ali Nsair. Post-acute COVID-19 syndrome and the cardiovascular system: What is known? Am Heart J Plus. 2021;5: 100025.

Swapna Mandal, Joseph Barnett, Simon E Brill. Long-COVID: A cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax. 2020;76(4): 396-8.

Rita Rubin. As their numbers grow, COVID-19 “Long Haulers” Stump Experts. JAMA. 2020;324(14): 1381-83.

Manuel Taboada, Esther Moreno, Agustín Cariñena. Quality of life, functional status, and persistent symptoms after intensive care of COVID-19 patient. Br J Anaesth. 2021;126(3): e110-3.

Maria Vincenza Polito, Angelo Silverio, Michele Bellino. Cardiovascular involvement in COVID-19: What sequelae should we expect. Cardiol Ther. 2021;10(2): 377-396.

Mei Zhou, Zhengrong Yin, Juanjuan Xu. Inflammatory profiles and clinical features of Coronavirus 2019 survivors 3 months after discharge in Wuhan, China. J Infect Dis. 2021;224(9): 1473-88.

Hisashi Kai, Mamiko Kai. Interactions of coronaviruses with ACE2, angiotensin II, and RAS inhibitors – xlessons from available evidence and insights into COVID-19.Hypertension Research volume. 2020;43: 648-54.

Markus Hoffmann, Hannah Kleine-Weber, Simon Schroeder. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2): 271-80.

Malvinder S. Parmar. An equally important protease as ACE2 in the pathogenicity of SARS-CoV-2 infection. Mayo Clin Proc. 2020;96(11): 2748-52.

Madeleine Johansson, Marcus Stahlberg, Michael Runold. Long-haul post-COVID-19 symptoms presenting as a variant of postural orthostatic tachycardia syndrome: The Swedish experience. JACC Case Rep. 2021;3(4): 573-80.

Qiutang Xiong, Ming Xu, Jiao Li. Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study. Clin Microbiol Infect. 2021;27(1): 89-95.

Meredith Bryarly, Lauren T Phillips, Qi Fu. Postural orthostatic tachycardia syndrome: JACC Focus Seminar. J Am Coll Cardiol. 2019;73(10): 1207-28

Fedorowski A. Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management. J Intern Med. 2019;285(4): 352-66.

David S Goldstein. The possible association between COVID-19 and postural tachycardia syndrome. Heart Rhythm. 2021;18(4): 508-9.

Khalil Kanjwal, Sameer Jamal, Asim Kichloo. New-onset postural orthostatic tachycardia syndrome following coronavirus disease 2019 infection. J Innov Card Rhythm Manag. 2020;11(11): 4302-4.

Published

2022-02-23

How to Cite

Homeliuk, T. M., Popovych, D. V., & Marushchak, M. I. (2022). Features of post-COVID syndrome in patients who had COVID-19: effects on the cardiovascular system. Bulletin of Medical and Biological Research, (4), 110–118. https://doi.org/10.11603/bmbr.2706-6290.2021.4.12615