COVID and Cardiovascular Disease: What We Know in 2021

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has led to significant global health issues.
• Early observations noted diverse cardiovascular manifestations, including myocarditis, stress cardiomyopathy, myocardial infarction, and arrhythmias.

Purpose of the Study:

• To review the current literature on the short-term and long-term cardiovascular consequences of SARS-CoV-2 infection.
• To discuss the management of cardiovascular issues in the context of critical illness and athlete recovery.

Main Methods:

• Literature review of studies on SARS-CoV-2 and cardiovascular effects.
• Analysis of findings related to acute cardiac injury, myocarditis diagnosis, and return-to-play protocols.
• Examination of emerging data on "Long COVID" and its cardiopulmonary and neurological symptoms.

Main Results:

• Myocardial injury in COVID-19 is often linked to critical illness severity rather than direct viral cardiac damage.
• Cardiac magnetic resonance imaging is valuable for myocarditis but should be used judiciously.
• Return-to-play protocols have proven safe for athletes after COVID-19 infection.
• "Long COVID" presents with a wide range of symptoms, including fatigue, palpitations, chest pain, and dysautonomia like Postural Orthostatic Tachycardia Syndrome (POTS).

Conclusions:

• Cardiovascular manifestations of SARS-CoV-2 infection are varied, with injury often secondary to critical illness.
• Effective screening protocols support safe return-to-play for athletes.
• Management of "Long COVID" symptoms like POTS involves education, exercise, and fluid/salt repletion.
• Further research is crucial to understand the long-term cardiovascular burden and the impact of acute management on chronic sequelae.