The immediate, intermediate and long term effects of COVID-19 on cardiovascular health has received considerable attention since the COVID-19 pandemic unfolded in 2020. Fatal outcomes during the acute phase have been linked to cardiac involvement and thought to be the direct consequence of viral toxicity or immunothrombotic and/or vascular mechanisms inciting myocyte injury. The stark heterogeneity in prevalence estimates of cardiac abnormalities on autopsy studies versus high incidence of myocardial injury during severe illness raises questions about the various biases in reporting and the true prevalence of myocardial damage is still unknown. In the post-acute phase, symptoms suggestive of cardiopulmonary involvement are common, yet there is some dissociation between objective measures of health and ongoing symptoms highlighting the complexities in discerning underlying pathophysiological mechanisms. Studies evaluating interventions targeting cardiac complications and outcomes in the post-acute phase are also few and accompanied by considerable concerns that the pandemic will both, directly and indirectly, contribute to rising rates of major adverse cardiovascular events such as heart failure, arrhythmia and cardiovascular death. There is a need to better understand prevalence estimates of myocardial injury, examine the determinants of cardiopulmonary symptoms and underlying mechanisms, evaluate the yield of various diagnostic tests and investigate the role of specific treatments designed to alleviate ongoing symptoms and mitigate long term risks.
With over a quarter of billion people now infected with SARS-CoV-2, the aftermath of COVID-19 on cardiac health has been a topic of considerable interest and debate for the public. The epidemiological evidence base evaluating prevalence estimates of cardiovascular complications attributable to COVID-19 is weak and suffers from numerous biases. Our understanding of the determinants of post-COVID cardiac complications remains deficient, with a need for large-scale prospective studies evaluating long term cardiac injury in unselected patient cohorts (hospitalised and community). At a cellular and biochemical level, studies that interrogate the role of a dysfunctional immune system in dysregulating cardiac homeostasis, vascular mechanisms including endothelial dysfunction in the post-acute phase are needed. Clinical trials aimed at alleviating cardiopulmonary symptoms and mitigating long term major cardiovascular outcomes are also lacking. Novel non-invasive diagnostic tools with specificity for COVID-19 are also of potential interest given the challenges that exist in disaggregating causal effects of SARS-CoV-2 infection from associative relationships and highlight an area for further research. There is a lack of understanding of the prevalence of post-COVID-19 cardiac sequelae among pregnant women, children and people from low socioeconomic demographics which deserves further research.
The scope of this topic is to:
1) Build the epidemiological evidence base for post-COVID-19 cardiovascular complications.
2) Develop risk algorithms to identify long term cardiovascular risk and identify those in need for ongoing support.
3) Examine the determinants of cardiopulmonary manifestations post-COVID-19.
4) Evaluate potential molecular and cellular processes that underpin long term cardiac complications related to COVID-19 .
5) Raise awareness of the biases in reporting and contextualise this for the public and scientific communities.
6) Encourage intervention trials both in the acute and post-acute setting to evaluate therapies targeted at reducing medium and long term cardiac manifestations and outcomes.
7) Encourage investigations into COVID-19 associated cardiovascular complications among underrepresented communities (pregnant women, children, people from low sociodemographic areas).
8) Evaluate the indirect impact of the COVID-19 pandemic on cardiovascular health and obesity epidemic and investigate the impact of behavioural interventions on long term cardiac health.
The immediate, intermediate and long term effects of COVID-19 on cardiovascular health has received considerable attention since the COVID-19 pandemic unfolded in 2020. Fatal outcomes during the acute phase have been linked to cardiac involvement and thought to be the direct consequence of viral toxicity or immunothrombotic and/or vascular mechanisms inciting myocyte injury. The stark heterogeneity in prevalence estimates of cardiac abnormalities on autopsy studies versus high incidence of myocardial injury during severe illness raises questions about the various biases in reporting and the true prevalence of myocardial damage is still unknown. In the post-acute phase, symptoms suggestive of cardiopulmonary involvement are common, yet there is some dissociation between objective measures of health and ongoing symptoms highlighting the complexities in discerning underlying pathophysiological mechanisms. Studies evaluating interventions targeting cardiac complications and outcomes in the post-acute phase are also few and accompanied by considerable concerns that the pandemic will both, directly and indirectly, contribute to rising rates of major adverse cardiovascular events such as heart failure, arrhythmia and cardiovascular death. There is a need to better understand prevalence estimates of myocardial injury, examine the determinants of cardiopulmonary symptoms and underlying mechanisms, evaluate the yield of various diagnostic tests and investigate the role of specific treatments designed to alleviate ongoing symptoms and mitigate long term risks.
With over a quarter of billion people now infected with SARS-CoV-2, the aftermath of COVID-19 on cardiac health has been a topic of considerable interest and debate for the public. The epidemiological evidence base evaluating prevalence estimates of cardiovascular complications attributable to COVID-19 is weak and suffers from numerous biases. Our understanding of the determinants of post-COVID cardiac complications remains deficient, with a need for large-scale prospective studies evaluating long term cardiac injury in unselected patient cohorts (hospitalised and community). At a cellular and biochemical level, studies that interrogate the role of a dysfunctional immune system in dysregulating cardiac homeostasis, vascular mechanisms including endothelial dysfunction in the post-acute phase are needed. Clinical trials aimed at alleviating cardiopulmonary symptoms and mitigating long term major cardiovascular outcomes are also lacking. Novel non-invasive diagnostic tools with specificity for COVID-19 are also of potential interest given the challenges that exist in disaggregating causal effects of SARS-CoV-2 infection from associative relationships and highlight an area for further research. There is a lack of understanding of the prevalence of post-COVID-19 cardiac sequelae among pregnant women, children and people from low socioeconomic demographics which deserves further research.
The scope of this topic is to:
1) Build the epidemiological evidence base for post-COVID-19 cardiovascular complications.
2) Develop risk algorithms to identify long term cardiovascular risk and identify those in need for ongoing support.
3) Examine the determinants of cardiopulmonary manifestations post-COVID-19.
4) Evaluate potential molecular and cellular processes that underpin long term cardiac complications related to COVID-19 .
5) Raise awareness of the biases in reporting and contextualise this for the public and scientific communities.
6) Encourage intervention trials both in the acute and post-acute setting to evaluate therapies targeted at reducing medium and long term cardiac manifestations and outcomes.
7) Encourage investigations into COVID-19 associated cardiovascular complications among underrepresented communities (pregnant women, children, people from low sociodemographic areas).
8) Evaluate the indirect impact of the COVID-19 pandemic on cardiovascular health and obesity epidemic and investigate the impact of behavioural interventions on long term cardiac health.