Cardiovascular abnormalities of long-COVID syndrome: Pathogenic basis and potential strategy for treatment and rehabilitation

Abstract

Cardiac injury and sustained cardiovascular abnormalities in long-COVID syndrome, i.e. post-acute sequelae of coronavirus disease 2019 (COVID-19) have emerged as a debilitating health burden that has posed challenges for management of pre-existing cardiovascular conditions and other associated chronic comorbidities in the most vulnerable group of patients recovered from acute COVID-19. A clear and evidence-based guideline for treating cardiac issues of long-COVID syndrome is still lacking. In this review, we have summarized the common cardiac symptoms reported in the months after acute COVID-19 illness and further evaluated the possible pathogenic factors underlying the pathophysiology process of long-COVID. The mechanistic understanding of how Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) damages the heart and vasculatures is critical in developing targeted therapy and preventive measures for limiting the viral attacks. Despite the currently available therapeutic interventions, a considerable portion of patients recovered from severe COVID-19 have reported a reduced functional reserve due to deconditioning. Therefore, a rigorous and comprehensive cardiac rehabilitation program with individualized exercise protocols would be instrumental for the patients with long-COVID to regain the physical fitness levels comparable to their pre-illness baseline.

Keywords

Long-COVID syndrome / Cardiac rehabilitation / Exercise intolerance / Inflammation / Hypoxia inducible factor 1 / SARS-CoV-2 tropism

Conflict of interest

Lei Xi is an Editorial Board Member for Sports Medicine and Health Science and was not involved in the editorial review or the decision to publish this article. Otherwise, authors declare no conflict of interests in writing this review.

CRediT authorship contribution statement

Kainuo Wu: Writing - review & editing, Writing - original draft, Conceptualization. Jonathan Van Name: Writing - review & editing. Lei Xi: Writing - review & editing, Supervision, Conceptualization.

Special issue articles

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