Acute and Post-Acute COVID-19 Cardiovascular Complications: A Comprehensive Review

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• SARS-CoV-2 infection poses a significant risk for acute and long-term cardiovascular complications.
• Patients with COVID-19 face increased mortality and a wide spectrum of post-acute cardiac issues.
• Understanding these complications is vital for effective patient management.

Purpose of the Study:

• To provide an updated clinical overview of diagnosing and treating cardiovascular manifestations of COVID-19.
• To review current evidence on acute and post-acute cardiovascular complications, symptomatology, and pathophysiology.
• To discuss therapeutic strategies and identify at-risk populations.

Main Methods:

• Comprehensive literature review of clinical studies on COVID-19 and cardiovascular complications.
• Analysis of diagnostic and treatment approaches for acute and long-term cardiovascular sequelae.
• Identification of patient populations at higher risk for adverse outcomes.

Main Results:

• COVID-19 is associated with increased myocardial injury, heart failure, dysrhythmias, and coagulation abnormalities.
• Cardiovascular complications persist beyond 30 days post-infection, regardless of comorbidities, but high-risk groups (elderly, hypertensive, diabetic) experience worse outcomes.
• Low-dose propranolol may manage tachycardia, ACE inhibitors/ARBs should not be withdrawn, and extended thromboprophylaxis with rivaroxaban improved outcomes in high-risk patients.

Conclusions:

• COVID-19 leads to significant cardiovascular complications during both acute and long-term phases.
• Prompt diagnosis and tailored management, including potential use of propranolol and rivaroxaban, are essential.
• Older patients with pre-existing conditions are particularly vulnerable and require focused attention.