☰ The beating heart... 70 studies & articles on SARS-CoV-2 and the cardiovascular system (2020–2023/2024)

C19.Life... et al • 28 February 2025

‘But even people who had not been hospitalized had increased risks of many conditions, ranging from an 8% increase in the rate of heart attacks to a 247% increase in the rate of heart inflammation.’

Nature (2 Aug 2022)

‘Either symptomatic or asymptomatic SARS-CoV-2 infection is associated with increased risk of late cardiovascular outcomes and has causal effect on all-cause mortality in a late post-COVID-19 period.’

The American Journal of Cardiology (15 Sep 2023)

📖 (2 Mar 2022 ~ JAMA) ‘The COVID Heart – One Year After SARS-CoV-2 Infection, Patients Have an Array of Increased Cardiovascular Risks’. ➲

‘Patients with COVID-19 were at increased risk of a broad range of cardiovascular disorders including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease.’

📖 (19 Mar 2024 ~ European Society of Cardiology: Cardiovascular Research) ‘Persistent increase of cardiovascular and cerebrovascular events in COVID-19 patients: a 3-year population-based analysis’. ➲

‘The increase of cardiovascular risk associated with COVID-19 might be extended for years and not limited to the acute phase of the infection.’

📖 (14 Mar 2022 ~ Johns Hopkins) ‘COVID and the Heart: It Spares No-One’. ➲

‘New evidence has revealed that anyone infected with COVID is at higher risk for heart issues – including clots, inflammation, and arrhythmias – a risk that persists even in relatively healthy people long after the illness has passed.’

📖 (23 Feb 2023 ~ Journal of Neurology) ‘Patterns of acute ischemic stroke and intracranial hemorrhage in patients with COVID-19’. ➲

‘220 patients (49.8%) presented with respiratory symptoms, and 167 (37.8%) presented with neurological symptoms first.

Acute ischemic stroke (AIS) was detected in 70 (15.8%), and intracranial hemorrhage (IH) in 48 (10.9%) patients.

There was no association between AIS or IH and the severity of COVID-19.’

📖 (22 Jun 2023 ~ British Heart Foundation) ‘Nearly 100,000 more deaths involving heart conditions and stroke than usual since pandemic began’. ➲

‘Nearly 100,000 more people with cardiovascular disease than expected have died since the start of the pandemic in England.’

📖 (4 Aug 2022 ~ Fortune) ‘Blood clots, heart problems, kidney failure: COVID creates a higher risk for rare pediatric health problems, new CDC study finds’. ➲

‘Children and teens who’ve had COVID are at greater risk for blood clots, heart problems, kidney failure, and Type 1 diabetes.’

📖 (2 Aug 2022 ~ Nature: News) ‘Heart disease after COVID: what the data say’. ➲

📖 (7 Feb 2022 ~ Nature: Medicine) ‘Long-term cardiovascular outcomes of COVID-19’. ➲

‘Our results provide evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial.’

📖 (3 Mar 2023 ~ JAMA) ‘One-Year Adverse Outcomes Among US Adults With Post-COVID-19 Condition vs Those Without COVID-19 in a Large Commercial Insurance Database’. ➲

‘Results from this study indicated a statistically significant increased risk for a range of cardiovascular conditions as well as mortality.

While these risks were heightened for individuals who experienced a more severe acute episode of COVID-19 (ie. requiring hospitalization), it is essential to note that most individuals (72.5%) in the cohort did not experience hospitalization during the acute phase.

Many of these conditions will have lasting effects on quality of life.’

📖 (10 Feb 2022 ~ Nature: News) ‘Heart-disease risk soars after COVID – even with a mild case’. ➲

‘Heart-disease risk soars after COVID – even with a mild case: Massive study shows a long-term, substantial rise in risk of cardiovascular disease, including heart attack and stroke, after a SARS-CoV-2 infection.’

📖 (24 Apr 2020 ~ The Washington Post / The Seattle Times) ‘Healthy people in their 30s and 40s, barely sick with COVID-19, are dying from strokes’. ➲

‘[Physician-researcher] Mocco, who has spent his career studying strokes and how to treat them, said he was “completely shocked” by the analysis.

He noted the link between COVID-19 and stroke “is one of the clearest and most profound correlations I’ve come across”.’

📖 (1 Nov 2021 ~ Harvard Medical School) ‘COVID-19 diagnosis raises risk of heart attack, stroke’. ➲

‘In the week after a COVID-19 diagnosis, the risk of a first heart attack increased by three to eight times.

The risk of a first stroke caused by a blood clot multiplied by three to six times.’

📖 (31 Jan 2022 ~ University of Utah) ‘COVID-19 Increasing Stroke Risks in People of All Ages’. ➲

‘“We are definitely seeing a huge increase in younger stroke survivors who are post-COVID diagnosis,” Kinzinger says. “We know that vascular complications go along with COVID infections, which can lead to strokes and other cardiovascular issues.”’

📖 (10 Jan 2023 ~ Frontiers in Cardiovascular Medicine) ‘SARS-CoV-2 infection predicts larger infarct volume in patients with acute ischemic stroke’. ➲

‘Hypercoagulation and microthrombosis represent the typical features of COVID-19 caused by SARS-CoV-2 [infection].

The pathogenic mechanisms are not yet fully understood, but multiple pathways are involved, including endothelialitis*.

The relative risk for the occurrence of AIS [acute ischemic stroke] is 3- to 4-fold greater compared to that of non-infected hospitalized historical or contemporary control cohorts, and since the outcome of AIS patients with COVID-19 appear worse both in terms of initial stroke severity and functional outcome/mortality, this subgroup of infected patients deserves particular attention.’

* Note: Endothelialitis refers to the inflammation of the endothelial cells that line the endothelium, which is the inner lining of blood vessels.

📖 (30 Aug 2022 ~ The Financial Times) ‘The growing evidence that Covid-19 is leaving people sicker: The potential impact on heart and brain disease poses challenges to healthcare systems globally’. ➲

‘Researchers found that rates of many conditions, such as heart failure and stroke, were substantially higher in people who had recovered from Covid than in similar people who had not been infected.

Although the evidence is still coming into focus, it is already becoming clearer to clinicians and health leaders in medical systems around the world that they are coping with a higher burden of disease in the population.’

📖 (4 Jun 2020 ~ Science Daily) ‘Coronavirus linked to stroke in otherwise healthy young people’. ➲

‘Young patients with no risk factors for stroke may have an increased risk if they have contracted COVID-19, whether or not they are showing symptoms of the disease.’

📖 (24 Aug 2022 ~ Nature: News) ‘Could tiny blood clots cause long COVID’s puzzling symptoms?’ ➲

‘Researchers already know that people with COVID-19, especially severe disease, are more likely to develop clots. The virus can infect cells lining the body’s 100,000 kilometres of blood vessels, causing inflammation and damage that triggers clotting.’

📖 (Sep 2020 ~ The Lancet) ‘COVID-19 related stroke in young individuals’. ➲

‘We believe that, in otherwise healthy, young patients who present with stroke during the pandemic, the diagnosis of COVID-19 should be thoroughly investigated.’

📖 (9 Feb 2022 ~ Science) ‘COVID-19 takes serious toll on heart health – a full year after recovery: Giant study shows striking rise in long-term heart and vessel disease’. ➲

‘The results are “stunning… worse than I expected, for sure,” says Eric Topol, a cardiologist at Scripps Research.

“All of these are very serious disorders… If anybody ever thought that COVID was like the ‘flu, this should be one of the most powerful data sets to point out that it’s not.”

“In the post-COVID era, COVID might become the highest risk factor for cardiovascular outcomes,” greater than well-documented risks such as smoking and obesity, says Larisa Tereshchenko, a cardiologist and biostatistician at the Cleveland Clinic.’

📖 (15 Sep 2023 ~ The American Journal of Cardiology) ‘Risk of Cardiovascular Events After COVID-19’. ➲

📖 (21 Feb 2022 ~ The Washington Post) ‘Five months post-covid, Nicole Murphy’s heart rate is still doing strange things’. ➲

‘Indeed, as the months since their infections have turned into years, people who initially had mild or even some asymptomatic coronavirus cases are pouring into cardiology practices across the country.’

📖 (1 Apr 2022 ~ Weill Cornell Medicine) ‘Are COVID-19-Linked Arrhythmias Caused by Viral Damage to the Heart’s Pacemaker Cells?’ ➲

‘The SARS-CoV-2 virus can infect specialized pacemaker cells that maintain the heart’s rhythmic beat, setting off a self-destruction process within the cells, according to a pre-clinical study.’

📖 (23 Sep 2020 ~ Science) ‘COVID-19 can affect the heart: COVID-19 has a spectrum of potential heart manifestations with diverse mechanisms’. ➲

‘Collectively, these young, healthy individuals had mild COVID-19 but were subsequently found to have unsuspected cardiac pathology.’

📖 (Updated: 12 May 2023 ~ The British Heart Foundation) ‘Is coronavirus a disease of the blood vessels?’ ➲

‘By triggering endothelial damage, coronavirus infection may cause abnormal blood clotting, ‘leaky’ vessels and reduced blood flow. These endothelial effects could have consequences from head to toe.

In the lungs, these effects can cause clots and fluid to accumulate, which means the lungs are less able to get oxygen into the body.

In the brain, damage to endothelial cells in the blood-brain barrier could lead to inflammation.

In the limbs, reduced blood flow could lead to “Covid toe”.’

📖 (17 Oct 2022 ~ Nature: Acta Pharmacologica Sinica) ‘Endothelial dysfunction in COVID-19: an overview of evidence, biomarkers, mechanisms and potential therapies’. ➲

‘It has been increasingly appreciated that COVID-19 is not only an infectious disease involving the lung; but also, a vascular disease affecting extrapulmonary organs.

Endothelial dysfunction-induced endotheliitis/endothelialitis/endotheliopathy following SARS-CoV-2 infection arises from a plethora of physiopathological mechanisms, including both direct mechanism or indirect mechanisms.’

📖 (7 Feb 2022 ~ Massachusetts General Hospital / Science Daily) ‘COVID-19-associated strokes link to higher disability and death risk, study finds’. ➲

‘The data suggest that patients from less affluent areas may have been at greater risk for serious complications such as stroke because of their inability to carry out protective measures such as social distancing or working at home.’

📖 (15 Mar 2022 ~ Thomas Jefferson University) ‘International Multi-Center Study Confirms Stroke Risk in Younger Healthier COVID-19 Patients’. ➲

‘The stroke patients who tested positive for COVID-19 were often younger, had multiple large vessels blocked, and often had worse outcomes than our usual patients. This international study confirms those early, alarming observations.’

📖 (16 Aug 2022 ~ Penn Medicine News) ‘People with Severe COVID-19 Face Increased Risk of Life-Threatening Blood Clots’. ➲

‘“Our research found this association both before and during vaccine availability, showing that the risk was not stemming from vaccination,” said Vincent Lo Re III, MD, MSCE, an associate professor of Infectious Diseases and Epidemiology at Penn.’

📖 (6 Apr 2022 ~ The Guardian) ‘Covid linked to 33-fold increase in risk of potentially fatal blood clot: Infection with virus also associated with fivefold increase in risk of deep vein thrombosis, data suggests’. ➲

‘Although the risks were highest in patients with more severe illness, even those with mild Covid had a threefold increased risk of DVT and a sevenfold increased risk of pulmonary embolism.’

📖 (Updated: 16 Dec 2024 ~ The British Heart Foundation) ‘How does Covid-19 affect your heart?’ ➲

‘Research suggests that Covid-19 can increase the risk of heart and circulatory conditions, like heart attack and stroke, after infection.

Damage can lead to abnormal blood clotting, ‘leaky’ blood vessels and reduced blood flow. Covid-19 can also lead to inflammation of the heart muscle (myocarditis) and heart lining (pericarditis).

Some research suggests that Covid-19 could be linked to an increased risk of developing high blood pressure (hypertension). This is a serious condition, as high blood pressure raises your chances of having a heart attack or stroke.’

📖 (8 Sep 2022 ~ MedPage Today) ‘Inflammation a Culprit in Long COVID Heart Problems: Prospective study illuminates mechanisms of lingering heart issues after mild COVID-19’. ➲

‘Their study included only patients without previously known cardiac conditions, comorbidities, or abnormal lung function tests at the baseline assessment and who had not been hospitalized for acute COVID-19 at any point.’

📖 (5 Sept 2022 ~ Nature: Medicine) ‘Long-term cardiac pathology in individuals with mild initial COVID-19 illness’. ➲

‘Baseline measurements from 346 individuals with COVID-19 (52% females) were obtained at a median of 109 days after infection, when 73% of participants reported cardiac symptoms, such as exertional dyspnea (62%), palpitations (28%), atypical chest pain (27%) and syncope (3%).

At follow-up (329 days after infection), 57% of participants had persistent cardiac symptoms.

Female gender and diffuse myocardial involvement on baseline imaging independently predicted the presence of cardiac symptoms at follow-up.’

📖 (26 Sep 2022 ~ Nature: Medicine) ‘Lingering cardiac involvement in previously well people after mild COVID-19’. ➲

‘In this article, the authors report a novel association between heart inflammation and prolonged shortness of breath, palpitations and chest pain, which are common after mild COVID-19.’

📖 (19 Sep 2022 ~ American Heart Association) ‘Association of COVID-19 With Major Arterial and Venous Thrombotic Diseases: A Population-Wide Cohort Study of 48 Million Adults in England and Wales’. ➲

‘Associations between COVID-19 and thrombotic events did not vary markedly by age or sex, but were greater in people of Black or Asian race than those of White race, and in people without than with a history of vascular events.’

📖 (28 Sep 2022 ~ Springer Nature) ‘Impaired left ventricular deformation and ventricular-arterial coupling in post-COVID-19: association with autonomic dysregulation’. ➲

‘Subjects in the post-acute COVID-19 phase present autonomic dysregulation… and impaired heart rate variability, which are associated with central aortic stiffness, ventricular-arterial impairment, and left ventricular function impairment.’

📖 (29 Sep 2022 ~ Brisbane Times) ‘Unlike flu, COVID-19 attacks DNA in the heart: new research’. ➲

‘Rather than extreme inflammation which they had expected to find, inflammation signals had been suppressed in the hearts of the COVID-19 patients, while markers for DNA damage and repair were much higher than in people who had died from the ’flu.

The way the DNA damage presented was similar to the way chronic diseases such as diabetes or even cancer presented, with the tissues of the heart putting out DNA damage signals.’

❦ Study: ‘Transcriptomic profiling of cardiac tissues from SARS-CoV-2 patients identifies DNA damage’ by Kulasinghe & Liu et al / Immunology (15 Sep 2022) ➲

📖 (6 Oct 2022 ~ Fortune) ‘Strokes, heart attacks, sudden deaths: Does America understand the long-term risks of catching COVID?’ ➲

‘Significantly, the risk of some of these complications is stronger in younger adults.

As the virus becomes more immune-evasive, our arsenal is shrinking, not expanding, despite what the CDC [the USA’s Centers for Disease Control] and political leaders may claim.’

📖 (21 Apr 2021 ~ American Heart Association) ‘SARS-CoV-2 and Stroke Characteristics: A Report From the Multinational COVID-19 Stroke Study Group’. ➲

‘36% of the AIS [Arterial Ischemic Stroke] patients in our study were less than 55 years of age, and 46% were less than 65 years of age.

These proportions are considerably higher than the population-based reports before the pandemic (12.9%–20.7%).’

📖 (4 Aug 2021 ~ The Journal of Applied Laboratory Medicine) ‘COVID-19: A Serious Vascular Disease with Primary Symptoms of a Respiratory Ailment’. ➲

‘[During SARS-CoV-2 infection,] endothelial cells encompassing the intima [the innermost layer] in arteries, capillaries, veins and the endocardium bind the viral particles via their ACE2 receptors, and consequently become severely inflamed, damaged, and/or destroyed.’

📖 (24 Oct 2022 ~ Medical Xpress) ‘COVID-19 surges linked to spike in heart attacks’. ➲

‘The spikes in heart attack deaths have tracked with surges of COVID-19 infection – even during the presumed less-severe Omicron phase of the pandemic.

Furthermore, the data showed the increase was most significant among individuals ages 25–44.’

📖 (29 Sep 2022 ~ Journal of Medical Virology) ‘Excess risk for acute myocardial infarction mortality during the COVID-19 pandemic’. ➲

‘The trend of mortality suggests that age and sex disparities have persisted even through the recent Omicron surge, with excess AMI*-associated mortality being most pronounced in younger-aged adults.’

* Note: AMI = Acute myocardial infarction, or heart attack.

📖 (24 Oct 2022 ~ Bloomberg UK) ‘Covid-19 Tied to Higher Risk of Deadly Blood Clots in Large Study’. ➲

‘Non-hospitalized Covid patients were 2.7 times more likely to develop dangerous clots called venous thromboembolisms and were more than 10 times more likely to die than individuals who avoided the disease.’

📖 (25 Oct 2022 ~ CNBC) ‘People who caught mild Covid had increased risk of blood clots, British study finds’. ➲

‘[P]atients hospitalized with Covid were 28 times more likely to develop blood clots, 22 times more likely to suffer heart failure, and 17 times more likely to have a stroke, according to the study.’

📖 (24 Oct 2022 ~ British Medical Journal: Heart) ‘Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank’. ➲

‘Overall, available evidence supports a distinct mechanistic role for COVID-19 in driving higher VTE* rates which occurs across disease severities and extends beyond the early post-infection phase.’

* Note: Venous thromboembolism (VTE) = refers to a blood clot that starts in a vein.

📖 (27 Apr 2021 ~ JACC: Basic to Translational Science) ‘SARS-CoV-2 Infects Human Engineered Heart Tissues and Models COVID-19 Myocarditis’. ➲

‘This study provides evidence that cardiomyocytes are a target of SARS-CoV-2 in the human heart, and support the conclusion that SARS-CoV-2 infection of cardiomyocytes and resultant… inflammation contribute to the cardiac manifestations of COVID-19.’

📖 (19 Nov 2022 ~ Pediatric Neurology) ‘SARS-CoV-2 Infection and Increased Risk for Pediatric Stroke’. ➲

‘COVID-19 infection can lead to a delayed hyperinflammatory response…

Based on epidemiologic data, we hypothesize that there is likely a delay of at least one month from the timing of initial COVID-19 infection to the development of stroke.

Our study suggests that prior COVID-19 infection, but not acute infection, is correlated with a risk for stroke in the pediatric population.

The risk for stroke appears to be distinct from the risk for [Multisystem Inflammatory Syndrome in Children/MIS-C].’

📖 (17 Oct 2022 ~ News Medical Life Sciences) ‘Asymptomatic COVID could potentially cause more complications in trauma patients’. ➲

‘Compared with similar trauma patients who tested negative for COVID, positive asymptomatic COVID trauma patients had higher rates of myocardial infarction and cardiac arrest (3.2% vs 0.9%).’

📖 (20 Jan 2022 ~ Science) ‘Nervous system consequences of COVID-19’. ➲

‘[High-field MRI] examination of brain tissue demonstrates microvascular damage in structures plausibly related to neurologic manifestations of COVID-19, consistent with endothelial activation and widespread vascular injury observed in other organs.’

📖 (12 Nov 2022 ~ Springer Nature) ‘Inflammation and vascular remodeling in COVID-19 hearts’. ➲

‘We conclude that cardiac involvement in COVID-19 is an angiocentric macrophage-driven inflammatory process, distinct from classical anti-viral inflammatory responses, and substantially underappreciated by conventional histopathologic analysis.

A systematic follow-up of non-fatal COVID-19 and long-COVID cases [would help detect] post-acute cardiac symptoms and fibrotic remodeling also in mild cases of disease due to the irreversible alterations of the cardiac vasculature.’

📖 (8 Jul 2022 ~ American Heart Association) ‘Thromboinflammation: From Atherosclerosis to COVID-19’. ➲

‘The activating interplay of thrombosis [blood clotting] and inflammation (thromboinflammation) has been established as a major underlying pathway, driving not only cardiovascular disease but also autoimmune disease and most recently, COVID-19.

Endothelial dysfunction and thromboinflammation have emerged early on as the key pathogenic mechanisms driving COVID-19 pathology…

COVID-19–specific coagulopathy is epitomized by elevated levels of [several glycoproteins involved in blood clotting].’

📖 (26 Dec 2022 ~ Nature: Communications) ‘Transcriptional reprogramming from innate immune functions to a pro-thrombotic signature by monocytes in COVID-19’. ➲

‘These results [reflect] hypercoagulability and acquired coagulopathies in patients with COVID-19, and suggest that monocytes from moderate COVID-19 patients upregulate a pro-thrombotic gene expression signature upon secondary SARS–CoV–2 sensing.’

📖 (2 Dec 2022 ~ Time) ‘Tiny Blood Clots May Be to Blame for Long COVID Symptoms, Some Researchers Say’. ➲

‘[Stellenbosch University Physiological Sciences’ Chair] posits that lingering viral remnants may damage the cells that line the blood vessels, prompting the formation of inflammation and microclots, which could in turn make the immune system attack itself.’

📖 (23 Aug 2021 ~ Springer Nature) ‘Persistent clotting protein pathology in Long COVID/Post-Acute Sequelae of COVID-19 (PASC) is accompanied by increased levels of antiplasmin’. ➲

‘Results presented in the current paper point to a significant failure in the fibrinolytic process [enzymatic breakdown of intravascular fibrin in blood clots] during COVID-19 and also in patients with lingering Long COVID/PASC symptoms.’

📖 (26 Dec 2022 ~ Journal of Clinical Medicine) ‘Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19’. ➲

‘60% of children who recovered from asymptomatic or mildly symptomatic COVID-19 still exhibit mild subclinical systolic cardiac impairment after an average follow-up of 148 ± 68 days from disease onset.’

📖 (13 Jan 2023 ~ Nature Reviews: Microbiology) ‘Long COVID: major findings, mechanisms and recommendations’. ➲

‘Cardiac MRI studies revealed cardiac impairment in 78% of 100 individuals who had a prior COVID-19 episode (investigated an average of 71 days after infection) and in 58% of participants with long COVID (studied 12 months after infection), reinforcing the durability of cardiac abnormalities.’

📖 (21 Jan 2023 ~ The Sydney Morning Herald) ‘Fatal heart attacks have surged in Australia. Here’s why’. ➲

‘“COVID-19 infection worsens pre-existing heart conditions, and increases the risk of developing more than 20 heart conditions including heart attack, blood clots, heart failure and stroke,” [Dr. Amanda Buttery, Heart Foundation of Australia] said.’

📖 (28 Nov 2022 ~ The Medical Journal of Australia) ‘Associations between COVID‐19 and hospitalisation with respiratory and non‐respiratory conditions: a record linkage study’. ➲

‘The incidence of hospitalisation with cerebral infarction [ischemic stroke] was twice as high after COVID‐19 onset as during the baseline period. Other investigators have estimated the risk of stroke to be 2–13 times as high for people with COVID‐19.

The pathophysiology of cerebrovascular involvement is unclear, but may be related to substantial endothelial disruption in highly vascularised organs such as the brain.’

📖 (19 Jan 2023 ~ European Society of Cardiology) ‘COVID-19 patients retain elevated risk of death for at least 18 months after infection’. ➲

‘COVID-19 is associated with higher risks of cardiovascular disease and death in the short- and long-term, according to a study in nearly 160,000 participants.

Compared to uninfected individuals, the likelihood of COVID-19 patients dying was up to 81 times higher in the first three weeks of infection and remained five times higher up to 18 months later.’

📖 (25 Jan 2023 ~ SciTech Daily / American Heart Association) ‘COVID Toll: Big Jump in Cardiovascular-Related Deaths Reported by American Heart Association’. ➲

‘COVID-19 has both direct and indirect impacts on cardiovascular health. As we learned, the virus is associated with new clotting and inflammation.’

📖 (13 Jan 2023 ~ Nature Reviews: Microbiology) ‘Long COVID: major findings, mechanisms and recommendations’. ➲

‘The narrative that COVID-19 had only respiratory sequelae led to a delayed realization of the neurological, cardiovascular and other multisystem impacts of COVID-19.’

📖 (2 Feb 2023 ~ Nature Communications) ‘High-depth sequencing characterization of viral dynamics across tissues in fatal COVID-19 reveals compartmentalized infection’. ➲

‘This lends credence to the hypothesis that direct infection may lead to the heart-related sequelae observed in some COVID-19 patients.

SARS-CoV-2 may establish a viral reservoir in these anatomical sites, leading to on-going tissue-specific pathology’

📖 (15 Feb 2023 ~ Journal of the American Heart Association) ‘Collagen‐Specific HSP47+ Myofibroblasts and CD163+ Macrophages Identify Profibrotic Phenotypes in Deceased Hearts With SARS‐CoV‐2 Infections’. ➲

‘Cardiac fibrosis complicates SARS-CoV-2 infections and has been linked to arrhythmic complications in survivors.

[Post-infection cardiac scarring may lead to] enhanced arrhythmogenesis, and even sudden cardiac death. As such, COVID‐19–induced cardiac fibrosis may have critical long‐term public health implications for healthcare systems and policy makers.’

📖 (8 Mar 2023 ~ Journal of Clinical Medicine) ‘Long-Term Adverse Effects of Mild COVID-19 Disease on Arterial Stiffness, and Systemic and Central Hemodynamics: A Pre-Post Study’. ➲

‘The finding that the longer the period from COVID-19 infection the worse the vascular impairment was surprising, as we expected inflammation burden associated with COVID-19 to decrease with time.’

📖 (19 May 2023 ~ EurekAlert) ‘International COVID-19 Registry uncovers increased incidence of clotting in heart attack patients with COVID-19’. ➲

‘COVID-19 is a pro-inflammatory, clot-forming disease and we now see its effect in the coronary arteries…

These new insights point to the need for clinicians to be meticulous with blood thinning strategies, early interventions and patient follow-up.’

📖 (10 Aug 2023 ~ Associated Press) ‘COVID-19 took a toll on heart health and doctors are still grappling with how to help’. ➲

‘Long COVID patients were about twice as likely to seek care for cardiovascular problems like blood clots, abnormal heartbeats or stroke in the year after infection, compared to similar patients who’d avoided COVID-19. — U.S. insurance database analysis.’

📖 (21 Aug 2023 ~ American Heart Association / Medical Xpress) ‘Analysis finds COVID-19 may trigger new-onset high blood pressure’. ➲

‘An analysis of electronic medical records for more than 45,000 people found that COVID-19 infection was significantly associated with the development of high blood pressure, according to new research published in Hypertension.’

📖 (28 Sep 2023 ~ National Institutes of Health) ‘SARS-CoV-2 infects coronary arteries, increases plaque inflammation’. ➲

‘SARS-CoV-2, the virus that causes COVID-19, can directly infect the arteries of the heart and cause the fatty plaque inside arteries to become highly inflamed, increasing the risk of heart attack and stroke, according to a study funded by the NIH.’

📖 (28 Sep 2023 ~ Nature: Cardiovascular Research) ‘SARS-CoV-2 infection triggers pro-atherogenic inflammatory responses in human coronary vessels’. ➲

‘Our data establish that SARS-CoV-2 infects coronary vessels, inducing plaque inflammation that could trigger acute cardiovascular complications and increase the long-term cardiovascular risk.’

📖 (18 Oct 2023 ~ Nature: Cardiovascular Research) ‘SARS-CoV-2 infection boosts inflammation in atherosclerotic plaques’. ➲

‘A post-mortem study reported that severe vascular injury, including microthrombosis, was nine times more prevalent in COVID-19 lungs than inpatients with influenza.’

📖 (18 Oct 2023 ~ Nature: Cardiovascular Research) ‘SARS-CoV-2 infection boosts inflammation in atherosclerotic plaques (Fig. 1: SARS-CoV-2 infects coronary vessel lesions)’. ➲

‘SARS-CoV-2 induces a strong pro-atherogenic inflammatory response… This pro-inflammatory response may contribute to the instability of atherosclerotic plaques and the increased incidence of ischemic cardiovascular complications in patients.’

📖 (9 Nov 2023 ~ European Heart Journal) ‘Prior COVID-19 infection is associated with persistent and higher thrombus burden in acute coronary syndromes’. ➲

‘Our findings suggest that COVID-19 infection may lead to persistent endothelial dysfunction and hypercoagulability, portending increased severity of coronary artery ectasia and coronary thrombosis even after recovery from the initial infection.’

📖 (18 May 2022 ~ American Medical Association) ‘3 tips for doctors trying to manage long COVID’s cardiac symptoms’. ➲

‘As many as 10% to 30% may develop long COVID following SARS-CoV-2 infection. In these individuals, symptoms such as chest pain, shortness of breath, and palpitations draw attention to the cardiovascular system.

Patients with long COVID may experience other cardiac symptoms such as elevated blood pressure, tachycardia out of proportion to that expected for effort, and drops in oxygen saturation.

There is also a lack of data to help guide diagnosis, treatment and prognosis.

That is why a systematic approach to assist in the evaluation and management of long COVID is needed, especially since the evidence base is likely to evolve over time.

Patient-centered models of care are needed to address long COVID.

This requires co-ordination by multi-disciplinary teams that include primary care physicians, sub-specialists such as pulmonologists, cardiologists, and neurologists, along with social workers, psychologists, and physical therapists.’

More... Cardiovascular System

📖 Prevalence of cardiovascular symptoms in post-acute COVID-19 syndrome: a meta-analysis

by Huang et al / BMC Medicine • 6 February 2025

‘The proportions of PACS [PASC/Long Covid] patients experiencing chest pain, palpitation, and hypertension as sequelae were 22%, 18%, and 19% respectively.’

📖 Clinical and functional assessment of SARS-CoV-2 sequelae among young marines – a panel study

by Porter et al / The Lancet: Regional Health (Americas) • 23 October 2024

❦ ‘In this population of healthy young adult US Marines with mostly either asymptomatic or mild acute COVID-19, one fourth reported physical , cognitive , or psychiatric long-term sequelae of infection. The Marines affected with PASC [Post-Acute Sequelae of COVID-19 / Post-COVID-19 Complications / ‘Long Covid’] showed evidence of long-term decrease in functional performance suggesting that SARS-CoV-2 infection may negatively affect health for a significant proportion of young adults .’ ❂ ‘Among the 899 participants, 88.8% had a SARS-CoV-2 infection. Almost a quarter (24.7%) of these individuals had at least one COVID-19 symptom that lasted for at least 4 weeks meeting the a priori definition of PASC established for this study. Among those with PASC, 10 had no acute SARS-CoV-2 symptoms after PCR-confirmed infection suggesting that PASC can occur among asymptomatic individuals. Many participants reported that lingering symptoms impaired their productivity at work, caused them to miss work, and/or limited their ability to perform normal duty/activities. Marines with PASC had significantly decreased physical fitness test scores up to approximately one year post-infection with a three-mile run time that averaged in the 65th percentile of the reference cohort. [ PASC was associated with a significantly increased 3-mile run time on the standard Marine fitness test. PASC participants ran 25.1 seconds slower than a pre-pandemic reference cohort composed of 22,612 Marine recruits from 2016 to 2019. A three-mile run evaluates aerobic exercise , overhead lifting of an ammunition can and pull-ups evaluate strength , and shooting a rifle evaluates fine-motor skills .] Scores for events evaluating upper body (pull-ups, crunches, and ammo-can lift) were not significantly reduced by PASC; however, overall physical fitness scores were reduced. ‘The poorer run times and overall scores among PASC participants are indicative of on-going functional effects.’ Standardized health-based assessments for somatization, depression, and anxiety further highlighted the detrimental health effects of PASC. Almost 10% of participants with PASC had PHQ-8 scores ≥10. Increased somatization * has been associated with increased stress, depression, and problems with emotions. * [ Somatization / Somatisation = Medical symptoms caused by psychological stress.] Additionally, PASC participants had higher GAD-7 scores suggesting increased anxiety in a population with unique inherent occupational stressors associated with higher rates of anxiety, depression, and post-traumatic stress disorder. ‘Increased severity of anxiety among those with PASC, combined with greater rates of mental health disorders in general, could portend an ominous combination and should be closely followed.’ Like others, we identified cardiopulmonary symptoms as some of the most prevalent. The high prevalence of symptoms like shortness of breath, difficulty breathing, cough, and fatigue is particularly notable when combined with decreased objective measures of aerobic performance such as running. These results suggest pathology in the cardiopulmonary system. In contrast we observed no reduction in scores assessing strength and marksmanship suggesting the lack of detectable pathology in the neuro-musculoskeletal system. We have previously found in this same cohort that SARS-CoV-2 infection causes prolonged dysregulation of immune cell epigenetic patterns like auto-immune diseases. Based on the reported PASC symptoms, the potential current and future public health implications in this population could be substantial. ‘Chronic health complications from PASC, especially in a young and previously healthy population with a long life expectancy, could decrease work productivity and increase healthcare costs.’ Significant changes in the Years-of-Life lived with a disability can disproportionally increase disability-adjusted life-years, and should be considered when allocating resources and designing policy.’ ❂ 📖 (23 Oct 2024 ~ The Lancet: Regional Health/America) Clinical and functional assessment of SARS-CoV-2 sequelae among young marines – a panel study ➤ © 2024 The Lancet .

On unseen costs, refrigerator trucks, and the train coming down the tunnel

by Dr. David Joffe PhD / FRACP (Respiratory Physician) • 27 January 2024

❦ “It’s really not in the interest of the virus to kill us quickly. That’s why it has mutated to immune escape. That way it enters silently, and then eats you slowly whilst you’re still a spreading vector. Refrigerator trucks are long gone. That’s all the political class wanted. The unseen costs of CVD [cardiovascular disease] , DM [diabetes mellitus] , and both dementia and Parkinson’s Disease are the train coming down the tunnel. The economists are catching up. The actuaries are already there. Politicians and most people? Not yet...” ❂ © 2024 Dr. David Joffe PhD / FRACP (Respiratory Physician) ➲

📖 Immune damage in Long Covid

by Wolfram Ruf / Science • 18 January 2024

❦ ‘Acute infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause a respiratory illness that can be associated with systemic immune cell activation and inflammation , widespread multi-organ dysfunction , and thrombosis . Not everyone fully recovers from COVID-19, leading to Long Covid, the treatment of which is a major unmet clinical need. Long Covid can affect people of all ages , follows severe as well as mild disease , and involves multiple organs . Patients with Long Covid display signs of immune dysfunction and exhaustion , persistent immune cell activation , and autoimmune antibody production , which are also pathological features of acute COVID-19. The complement system is crucial for innate immune defense by effecting lytic destruction of invading micro-organisms, but when uncontrolled, it causes cell and vascular damage . The complement cascade is activated by antigen–antibody complexes in the classical pathways or in the lectin pathway by multimeric proteins (lectins) that recognize specific carbohydrate structures, which are also found on the SARS-CoV-2 spike protein that facilitates host cell entry. Both pathways may contribute to the pronounced complement activation in acute COVID-19. Long Covid symptoms include a postexertional exhaustion reminiscent of other post-viral illnesses , such as myalgic encephalomyelitis ( ME ) – chronic fatigue syndrome ( MECFS ) with suspected latent viral reactivation . Antibody titer changes in Long Covid patients indicate an association of fatigue with reactivation of latent Epstein-Barr virus ( EBV ) infections , and Cervia-Hasler et al found that the severity of Long Covid symptoms is associated with cytomegalovirus ( CMV ) reactivation . A better understanding of the connections between viral reactivation, persistent interferon signaling, and autoimmune pathologies promises to yield new insights into the thromboinflammation associated with Long Covid. Although therapeutic interventions with coagulation and complement inhibitors in acute COVID-19 produced mixed results, the pathological features specific for Long Covid suggest potential interventions for clinical testing. Microclots are also observed in ME-CFS patients , indicating crucial interactions between complement, vWF, and coagulation-mediated fibrin formation in post-viral syndromes. A better definition of these interactions in preclinical and clinical settings will be crucial for the translation of new therapeutic concepts in chronic thromboinflammatory diseases .’ ❂ 📖 (18 Jan 2024 ~ Science) Immune damage in Long Covid ➤ © 2024 Wolfram Ruf / Science .

📖 Beyond breathing: How COVID-19 affects your heart, brain and other organs

by Michael Merschel / American Heart Association • 16 January 2024

“I would argue that COVID-19 is not a disease of the lungs at all. It seems most likely that it is what we call a vascular and neurologic infection, affecting both nerve endings and our cardiovascular system.”

📖 Excess mortality in England post Covid-19 pandemic: implications for secondary prevention

by Pearson-Stuttard et al / The Lancet (Regional Health Europe) • 1 December 2023

❦ 'For middle-aged adults ( 50–64 ) in this period [June 2022 – June 2023 ], the relative excess for almost all causes of death examined was higher than that seen for all ages .' ➲ ‘Since July 2020, the Office for Health Improvement and Disparities (OHID) has published estimates of excess mortality. In the period from week ending 3rd June 2022 to 30th June 2023 , excess deaths for all causes were relatively greatest for 50–64 year olds ( 15% higher than expected ), compared with 11% higher for 25–49 and < 25 year olds , and about 9% higher for over 65 year old groups. Several causes, including cardiovascular diseases , show a relative excess greater than that seen in deaths from all-causes ( 9% ) over the same period (week ending 3rd June 2022–30th June 2023), namely: all cardiovascular diseases ( 12% ), heart failure ( 20% ), ischaemic heart diseases ( 15% ), liver diseases ( 19%) , acute respiratory infections ( 14% ), and diabetes ( 13% ). For middle-aged adults (50–64) in this 13-month period, the relative excess for almost all causes of death examined was higher than that seen for all ages . Deaths involving cardiovascular diseases were 33% higher than expected, while for specific cardiovascular diseases, deaths involving ischaemic heart diseases were 44% higher , cerebrovascular diseases 40% higher and heart failure 39% higher . Deaths involving acute respiratory infections were 43% higher than expected and for diabetes , deaths were 35% higher . Deaths involving liver diseases were 19% higher than expected for those aged 50–64 , the same as for deaths at all ages. Looking at place of death, from 3rd June 2022 to 30th June 2023 there were 22% more deaths in private homes than expected compared with 10% more in hospitals . The greatest numbers of excess deaths in the acute phase of the pandemic were in older adults. The pattern now is one of persisting excess deaths which are most prominent in relative terms in middle-aged and younger adults , with deaths from CVD [cardiovascular] causes and deaths in private homes being most affected.’ ❂ ➲ [C19.Life Note ] : Considering their findings and conclusion, I’m not sure why the authors would choose to use the term ‘post-pandemic’ in this title – when their evidence points to an on-going pandemic, fueled by continuing high rates of infection, that is now simply killing younger age-groups than previously seen.] ❂ 📖 (1 Dec 2023 ~ The Lancet (Regional Health Europe) Excess mortality in England post Covid-19 pandemic: implications for secondary prevention ➤ © 2023 Pearson-Stuttard et al / The Lancet (Regional Health Europe) .

📖 Status of major hemostatic components in the setting of COVID-19: the effect on endothelium, platelets, coagulation factors, fibrinolytic system, and complement

by Sayyadi et al / Annals of Hematology • 19 April 2023

❦ ‘COVID-19 patients have a hypercoagulability state, and thrombosis is a life-threatening complication of them.’ ✻ Hypercoagulability , also known as thrombophilia , is a condition in which there is an abnormally increased tendency towards blood clotting . ‘From the early days of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak to the present, clinical and basic studies have indicated that coronavirus disease 2019 (COVID-19) may be associated with coagulopathy ( CAC ), which is involved in its related morbidity and mortality. Deep vein thrombosis ( DVT ) and pulmonary embolism ( PE ) are common in COVID-19 patients and are remarkably high in the intensive care unit (ICU)–admitted patients. CAC can lead to the formation of circulating microthrombi and macrothrombi which can involve multiple sites, including the lungs , brain , heart , and visceral organs like kidneys and spleen . There is a close relationship between the immune system and coagulation. The components of the hemostatic system play a role in the body’s immunity, and the activation of the immune system strongly influences the hemostatic system. Abnormal activation of the immune system may promote the growth of pathologies associated with thrombosis. COVID-19 is accompanied by an immune-cell hyperactivation and excessive production of proinflammatory cytokines , known as “ cytokine storm ”. CAC is theorized to result from dysregulated interactions between the immune and coagulation systems .’ ❂ 📖 (19 Apr 2023 ~ Annals of Hematology) Status of major hemostatic components in the setting of COVID-19: the effect on endothelium, platelets, coagulation factors, fibrinolytic system, and complement ➤ © 2023 Annals of Hematology .

📖 Human Endogenous Retrovirus, SARS-CoV-2, and HIV Promote PAH via Inflammation and Growth Stimulation

by Wang et al / International Journal of Molecular Sciences • 18 April 2023

❦ ‘Pulmonary arterial hypertension (PAH) is a pulmonary vascular disease characterized by the progressive elevation of pulmonary arterial pressures.’ Pulmonary Arterial Hypertension ( PAH ) is a progressive lung disease that affects the heart and lungs . It is caused when the tiny arteries in the lungs become thickened and narrowed , causing abnormally high blood pressure in the pulmonary artery . Symptoms include shortness of breath during exercise, fainting spells , dizziness , swelling of the ankles or legs , chest pain , and a racing pulse . ‘It is becoming increasingly apparent that inflammation contributes to the pathogenesis and progression of PAH. Several viruses are known to cause pulmonary arterial hypertension (PAH) , such as SARS-CoV-2 , Human Endogenous Retrovirus K (HERV-K), and Human Immunodeficiency Virus ( HIV ), in part due to acute and chronic inflammation .’ ❂ 📖 (18 Apr 2023 ~ International Journal of Molecular Sciences) Human Endogenous Retrovirus, SARS-CoV-2, and HIV Promote PAH via Inflammation and Growth Stimulation ➤ © 2023 International Journal of Molecular Sciences .

📖 SARS-CoV-2 infection predicts larger infarct volume in patients with acute ischemic stroke

by De Michele et al / Frontiers in Cardiovascular Medicine • 18 January 2023

❦ ‘Acute ischemic stroke (AIS) is a fearful complication of Coronavirus Disease-2019 (COVID-19). SARS-CoV-2 infection seems to play a major role in endothelium activation and infarct volume extension during AIS.’ ❂ 📖 (10 Jan 2023 ~ Frontiers in Cardiovascular Medicine) SARS-CoV-2 infection predicts larger infarct volume in patients with acute ischemic stroke ➤ © 2023 Frontiers in Cardiovascular Medicine .

📖 Long COVID: major findings, mechanisms and recommendations

by Davis et al / Nature Reviews: Microbiology • 13 January 2023

‘The narrative that COVID-19 had only respiratory sequelae led to a delayed realization of the neurological, cardiovascular and other multi-system impacts of COVID-19.’

📖 Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19

by Sabatino et al / Journal of Clinical Medicine • 26 December 2022

❦ ‘Our findings shed new light on the cardiac impact of COVID-19 in paediatric age. 60% of children who recovered from asymptomatic or mildly symptomatic COVID-19 still exhibit mild subclinical systolic cardiac impairment after an average follow-up.’ ❂ 📖 (26 Dec 2022 ~ Journal of Clinical Medicine) Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19 ➤ © 2022 Journal of Clinical Medicine .

📖 Analysis of thrombogenicity under flow reveals new insights into the prothrombotic state of patients with post-COVID syndrome

by Constantinescu-Bercu et al / Journal of Thrombosis and Haemostosis • 12 December 2022

❦ ‘Post-COVID syndrome (PCS) is an emerging condition linked to an uncharacterized prothrombotic state. Post-COVID syndrome can lead to increased platelet recruitment and larger thrombi under flow. The median time of 23 months from symptom onset suggests potential long-term thrombogenicity .’ ❂ 📖 (12 Dec 2022 ~ Journal of Thrombosis and Haemostosis) Analysis of thrombogenicity under flow reveals new insights into the prothrombotic state of patients with post-COVID syndrome ➤ © 2022 Journal of Thrombosis and Haemostosis .

📖 Long-term cardiac pathology in individuals with mild initial COVID-19 illness

by Puntmann et al / Nature: Medicine • 5 September 2022

‘At follow-up (329 days after infection), 57% of participants had persistent cardiac symptoms.’

📖 Covid-19: Even mild infections can cause long-term heart problems, large study finds

by Janice Hopkins Tanne / The British Medical Journal • 14 February 2022

❦ ‘ Infection with SARS-CoV-2 can cause cardiovascular problems for up to a year , not just during the acute phase, a large study has found. One year after covid-19 infection people were at higher risk of cardiovascular disease , including cerebrovascular disorders , dysrhythmias , ischaemic and non-ischaemic heart disease , pericarditis , myocarditis , heart failure , and thromboembolic disease . Even those who had not been admitted to hospital with covid-19 were at risk of these problems , but the risk increased with the severity of the infection, from people not admitted to hospital to those admitted to intensive care. Those who had had covid-19 had a 72% increased risk of heart failure , 63% increased risk of heart attack , and 52% increased risk of stroke compared with controls. The researchers wrote that the increased risks “were evident regardless of age , race , sex , and other cardiovascular risk factors , including obesity, hypertension, diabetes, chronic kidney disease, and hyperlipidemia; they were also evident in people without any cardiovascular disease before exposure to covid-19 , providing evidence that these risks might manifest even in people at low risk of cardiovascular disease.” The researchers said that the risk of cardiovascular disease in people who have had covid-19 is substantial . While the best way to prevent cardiovascular problems is to prevent infection in the first place , governments and health systems must prepare to deal with possible big problems in future. The cardiovascular problems seen in some people who have had covid-19 are chronic and may have long-lasting consequences for the individual and for health systems , economic productivity , and life expectancy , the researchers say.’ ❂ 📖 (7 Feb 2022 ~ Nature: Medicine) Long-term cardiovascular outcomes of COVID-19 ➤ 📖 (14 Feb 2022 ~ The BMJ) Covid-19: Even mild infections can cause long term heart problems, large study finds ➤ Related: 📖 (10 Feb 2022 ~ Nature: News) Heart-disease risk soars - even with a mild case ➤ © 2022 The British Medical Journal .

📖 Left ventricular longitudinal strain alterations in asymptomatic or mildly symptomatic paediatric patients with SARS-CoV-2 infection

by Sirico et al / European Heart Journal: Cardiovascular Imaging • 5 July 2021

❦ ‘SARS-CoV-2 infection may affect left ventricular deformation in 26% of children despite an asymptomatic or only mildly symptomatic acute illness. A follow-up is needed to verify the reversibility of these alterations and their impact on long-term outcomes.’ ❂ 📖 (5 July 2021 ~ European Heart Journal: Cardiovascular Imaging) Left ventricular longitudinal strain alterations in asymptomatic or mildly symptomatic paediatric patients with SARS-CoV-2 infection ➤ © 2021 Sirico et al / European Heart Journal: Cardiovascular Imaging.

📖 Acute Cardiovascular Manifestations in 286 Children With Multisystem Inflammatory Syndrome Associated With COVID-19 Infection in Europe

by Valverde et al / Circulation • 9 November 2020

❦ ‘A total of 286 children from 55 centers in 17 European countries were included. The median age was 8.4 years (interquartile range, 3.8-12.4 years) and 67% were boys. The most common cardiovascular complications were shock, cardiac arrhythmias, pericardial effusion, and coronary artery dilatation. Cardiac involvement is common in children with multisystem inflammatory syndrome associated with the Covid-19 pandemic.’ ❂ 📖 (9 Nov 2020 ~ Circulation) Acute Cardiovascular Manifestations in 286 Children With Multisystem Inflammatory Syndrome Associated With COVID-19 Infection in Europe ➤ © 2020 Valverde et al / Circulation.

☰ The beating heart... 70 studies & articles on SARS-CoV-2 and the cardiovascular system (2020–2023/2024)

📖 Prevalence of cardiovascular symptoms in post-acute COVID-19 syndrome: a meta-analysis

📖 Clinical and functional assessment of SARS-CoV-2 sequelae among young marines – a panel study

On unseen costs, refrigerator trucks, and the train coming down the tunnel

📖 Immune damage in Long Covid

📖 Beyond breathing: How COVID-19 affects your heart, brain and other organs

📖 Excess mortality in England post Covid-19 pandemic: implications for secondary prevention

📖 Status of major hemostatic components in the setting of COVID-19: the effect on endothelium, platelets, coagulation factors, fibrinolytic system, and complement

📖 Human Endogenous Retrovirus, SARS-CoV-2, and HIV Promote PAH via Inflammation and Growth Stimulation

📖 SARS-CoV-2 infection predicts larger infarct volume in patients with acute ischemic stroke

📖 Long COVID: major findings, mechanisms and recommendations

📖 Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19

📖 Analysis of thrombogenicity under flow reveals new insights into the prothrombotic state of patients with post-COVID syndrome

📖 Long-term cardiac pathology in individuals with mild initial COVID-19 illness

📖 Covid-19: Even mild infections can cause long-term heart problems, large study finds

📖 Left ventricular longitudinal strain alterations in asymptomatic or mildly symptomatic paediatric patients with SARS-CoV-2 infection

📖 Acute Cardiovascular Manifestations in 286 Children With Multisystem Inflammatory Syndrome Associated With COVID-19 Infection in Europe

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☰ 14 studies & articles on... SARS-CoV-2 (COVID-19) reinfections, cumulative damage, and increased risk of all-cause mortality