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Long-COVID Syndrome and the Cardiovascular System: A Review of Neurocardiologic Effects on Multiple Systems

Nicholas L DePace1,2,3, Joe Colombo4,5,6

  • 1Franklin Cardiovascular Associates, PA - Autonomic Dysfunction and POTS Center, Sicklerville, NJ, USA.

Current Cardiology Reports
|September 30, 2022
PubMed

Insights

Long-COVID syndrome, a multi-organ disorder, involves neuro-cardiac issues stemming from SARS-CoV-2 infection. Therapies targeting autonomic dysfunction, inflammation, and oxidative stress are key to managing these persistent symptoms.

Area of Science:

  • Neuroscience
  • Cardiology
  • Infectious Diseases

Background:

  • Long-COVID syndrome is a complex, multi-organ disorder persisting over 12 weeks post-SARS-CoV-2 infection.
  • Neuro-cardiac involvement is a significant feature, influenced by viral entry via angiotensin-converting enzyme 2 receptors, inflammation, and oxidative stress.

Purpose of the Study:

  • To define Long-COVID syndrome.
  • To explore the neuro-cardiac manifestations of Long-COVID.
  • To discuss therapeutic strategies targeting autonomic dysfunction, inflammation, and oxidative stress.

Main Methods:

  • Review of existing literature on Long-COVID.
  • Analysis of the impact of SARS-CoV-2 on neuro-cardiac systems.
  • Discussion of diagnostic approaches including noninvasive cardiac workup and autonomic nervous system assessment.
  • Evaluation of therapeutic interventions for autonomic dysfunction.

Main Results:

  • Long-COVID can lead to a spectrum of cardio-neuro effects, including myocardial injury, arrhythmias, and autonomic dysfunction.
  • Autonomic dysfunction (parasympathetic and sympathetic activity) is frequently linked to Long-COVID symptoms.
  • Objective assessment is crucial to differentiate cardiac from neural etiologies of symptoms like dyspnea, chest pain, and palpitations.

Conclusions:

  • Effective management of Long-COVID requires addressing underlying autonomic dysfunction, chronic inflammation, and oxidative stress.
  • Targeting autonomic dysfunction can alleviate cardiac symptoms associated with Long-COVID.
  • Comprehensive assessment of both cardiac and autonomic function is recommended for accurate diagnosis and treatment planning.
Abstract

Keywords:
Autonomic dysfunctionInflammationLong-COVIDNeuro-cardiovascular effectsOxidative stressQuality of lifeSymptomsTreatment

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