Title : Cardiovascular alterations and clinical consequences of covid-19 infection

In addition to the typical pulmonary complications, COVID-19 infection is associated in 5%–20% of cases with cardiac abnormalities consistent with acute myocardial injury, which worsen the clinical course and prognosis of affected patients, including increased need for intensive care and higher mortality. Pre-existing comorbidities, such as cardiovascular disease, diabetes, chronic kidney disease, and other conditions, further increase the risk and adversely affect prognosis. The diagnostic criteria are those commonly used for cardiovascular diseases and include electrocardiography, cardiac biomarkers, and imaging techniques such as echocardiography and cardiac magnetic resonance imaging. The pathogenesis of myocardial injury is multifactorial and is secondary to hypoxia combined with increased myocardial oxygen demand, the massive release of inflammatory mediators through autoimmune mechanisms, including molecular mimicry, and a procoagulant state. In addition to this “direct” injury, the pandemic also caused indirect cardiovascular harm through the reduction and/or delay of care, diagnosis, follow-up, and cardiovascular prevention programs, thereby affecting cardiovascular management in many patients. The long-term effects of COVID-19 infection remain even less well investigated. The terms post-COVID and long COVID are used to describe persistent or delayed effects occurring 3–12 weeks after infection, including fatigue, dyspnea, and orthostatic intolerance, such as postural orthostatic tachycardia syndrome, as well as other less frequent symptoms listed by the World Health Organization. Vaccines have largely reduced cardiovascular complications and mortality itself in affected patients; conversely, they have led to only modest adverse events in a very small percentage of vaccinated individuals, including young people and children. However, clinical and instrumental follow-up of the clinical complications described after COVID infection should be intensified in order to reduce their impact on prognosis.

To be updated shortly..