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Medical Journal of Clinical Trials & Case Studies Research Article 4 min read

Post-Acute-COVID-19-Illness Cardiovascular Sequelae

Cheepsattayakorn A*, Cheepsattayakorn R and Siriwanarangsun P
* Corresponding author
ISSN: 2578-4838  10.23880/mjccs-16000296  Received: June 17, 2021  Published: July 13, 2021
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Abstract

At 60 days of the following-up, chest pain was present around 20 % of the COVID-19 survivors, whereas at 6 months following-up in the post-acute-COVID-19 Chinese study revealed ongoing chest pain and palpitations in 5 % and 9 % of the COVID-19 survivors, respectively

Editorial

At 60 days of the following-up, chest pain was present around 20 % of the COVID-19 survivors, whereas at 6 months following-up in the post-acute-COVID-19 Chinese study revealed ongoing chest pain and palpitations in 5 % and 9 % of the COVID-19 survivors, respectively [1, 2, 3]. Ongoing myocardial inflammation may occur at the rates as high as 60 % more than two months after the diagnosis by MRI [4]. The perpetuated mechanisms in post-acute- COVID-19-illness cardiovascular sequelae include SARS- CoV-2 (COVID-19) viral invasion, the immunologic response and inflammation affecting the structural integrity of the cardiac conduction system, pericardium, and myocardium, and downregulation of ACE 2. Autopsy studies in 39 COVID-19 cases (62.5 %) revealed SARS-CoV-2 (COVID-19) viral particles in the cardiac tissues that may contribute to the cardiomyocyte death and fibro-fatty displacement of desmosomal proteins that is critical for cell-to-cell adherence [5, 6, 7]. Persistently increased cardiometabolic demand may be occur in recovered COVID-19 patients that may be related to decreased cardiac reserve, dysregulation of the renin- angiotensin-aldosterone system (RAAS) [8]. SARS-CoV-2 (COVID-19) can induce heightened catecholaminergic state due to cytokine storming from cytokines, such as IL-1, IL-6, and TNF-α, that can prolong ventricular action potentials by modulating cardiomyocyte ion channel expression, in addition to the induction of resultant cardiomyopathy from SARS-CoV-2 (COVID-19) infection, and myocardial scarring or fibrosis that can contribute to re-entrant cardiac arrhythmias [9, 10]. After SARS-CoV-2 (COVID-19) illness, autonomic dysfunction can result in inappropriate sinus tachycardia and postural orthostatic tachycardia syndrome, that has been demonstrated as a resulting adrenergic modulation [11, 12]. Abstinence from aerobic activities or competitive sports for 3-6 months until resolution of myocardial inflammation by normalization of the troponin levels or cardiac MRI and serial echocardiogram, electrocardiogram, and cardiac MRI may be considered in competitive athletes with post-acute- COVID-19-related cardiovascular complications and in those with persistent cardiac symptoms [13, 14, 15, 16]. In a previously retrospective study among 3,080 COVID-19 patients revealed that withdrawal of cardiac-guidelines-directed medical treatment was related to higher mortality in the acute to post-acute-COVID-19 illness phases [17]. Potential harmfulness may be occurred in the abrupt cessation of the use of RAAS inhibitors [18]. A low-dose beta blocker for decreasing adrenergic activity and heart rate management and anti-arrhythmic drugs (such as amiodarone) is recommended with attention in post-acute-COVID-19-illness patients with postural orthostatic tachycardia syndrome and with pulmonary fibrotic changes following COVID-19 illness, respectively [19, 20]. In conclusion, more follow-up is needed to determine risk-over-time resolution, particularly cardiovascular risk in patients with pre-existing conditions due to sustained- and increased-clinical-sequelae risk is frequently identified from 4 weeks to 4 months after the acute-COVID-19- illness phase.

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@article{cheepsattayakorn2021,
  title   = {Post-Acute-COVID-19-Illness Cardiovascular Sequelae},
  author  = {Cheepsattayakorn A, Cheepsattayakorn R and Siriwanarangsun P},
  journal = {Medical Journal of Clinical Trials & Case Studies},
  year    = {2021},
  volume  = {5},
  number  = {4},
  doi     = {10.23880/mjccs-16000296}
}
Cheepsattayakorn A, Cheepsattayakorn R and Siriwanarangsun P (2021). Post-Acute-COVID-19-Illness Cardiovascular Sequelae. Medical Journal of Clinical Trials & Case Studies, 5(4). https://doi.org/10.23880/mjccs-16000296
TY  - JOUR
TI  - Post-Acute-COVID-19-Illness Cardiovascular Sequelae
AU  - Cheepsattayakorn A, Cheepsattayakorn R and Siriwanarangsun P
JO  - Medical Journal of Clinical Trials & Case Studies
PY  - 2021
VL  - 5
IS  - 4
DO  - 10.23880/mjccs-16000296
ER  -