High prevalence of persistent cardiovascular symptoms in COVID-19 recovered patients according to new study

Scientists from the USA and Australia have recently conducted a study on community-dwelling adults to determine the prevalence and risk factors of long-term cardiovascular symptoms in coronavirus disease 2019 (COVID-19) recovered individuals. The study is currently available on the medRxiv* preprint server.

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen of COVID-19, is a deadly beta-coronavirus that primarily infects the human respiratory tract. Besides inducing acute respiratory symptoms, the virus also infects other vital organs and causes long-term complications, which is commonly known as long-COVID. The long-COVID symptoms can persist for several weeks after the resolution of acute infection.

Among various long-COVID symptoms, a considerably high prevalence of cardiovascular complications has been observed in COVID-19 recovered individuals. Studies have shown that cardiovascular symptoms can persist for about 6 months in COVID-recovered individuals who had been hospitalized during the acute infection phase.

Besides persistent symptoms, new-onset cardiovascular complications have also been noticed in both hospitalized and non-hospitalized COVID-recovered individuals. These observations highlight the risk of cardiovascular morbidity and disability among patients with long-COVID.

In the current study, the scientists have determined the prevalence and risk factors of long-term cardiovascular symptoms in community-dwelling adults with prior SARS-CoV-2 infection.      

Study design

The study population included a total of 442 adults who previously had laboratory-confirmed SARS-CoV-2 infection.

Self-reported surveys were conducted to collect baseline information on sociodemographic factors, COVID-19-related parameters, pre-existing health conditions, persistent cardiovascular symptoms, new-onset cardiovascular complications, fatigue, and overall wellbeing.

The primary outcome of the study was self-reported cardiovascular symptoms that were present three weeks after a positive COVID-19 test as well as at the time of survey enrollment. In addition, self-reported information on new-onset cardiovascular complications was collected from the participants.

Important observations

The prior-COVID medical history of the participants (mean age: 45 years) showed that about 46%, 23%, and 4% had pre-existing health conditions, cardiovascular risk factors, and cardiovascular disease, respectively.

Prevalence of post-acute cardiovascular symptoms

The prevalence of post-acute cardiovascular symptoms was estimated to be 43% in the study population. Among these participants, only 12% reported being hospitalized during the acute phase of SARS-CoV-2 infection. The average duration of symptom continuance since the detection of primary infection was 12 months.

Among long-term cardiovascular symptoms, the most frequent was heart palpitation, followed by tachycardia, feeling faint, persistent chest pain, and sharp chest pain. Regarding other general symptoms, the most common symptom was fatigue, followed by joint pain, muscle pain, breathing difficulty, and activity intolerance.

Fatigue was more commonly observed among participants with post-acute cardiovascular symptoms. Similarly, a lower functioning of mental and physical health was observed in these participants. 

New-onset cardiovascular complications were observed in about 27% of participants after recovery from acute infection. The most prevalent complication was tachycardia, followed by hypertension and postural orthostatic tachycardia syndrome.  

A relatively higher prevalence of tachycardia and myocarditis was observed among participants who had recovered from COVID-19 more than 18 months ago.

Risk factors for post-acute cardiovascular symptoms

The participants with pre-existing cardiovascular disease or other health conditions showed a significantly higher risk of developing long-term post-COVID cardiovascular symptoms. In addition, increasing age and COVID-19-related hospitalization were identified as potent risk factors for long-COVID.

Study significance

The study reveals a high prevalence (43%) of long-term cardiovascular symptoms in community-dwelling adults with previous SARS-CoV-2 infection. The prevalence of new-onset cardiovascular complications including hypertension and tachycardia was 27% in the study population.

Furthermore, the study identifies that pre-existing cardiovascular disease or other health conditions, older age, and COVID-19-related hospitalization serve as potent risk factors for post-acute cardiovascular symptoms.

However, all symptoms analyzed in the study were self-reported by the participants. None of the symptoms were medically confirmed. Considering this limitation, the scientists further aim to reevaluate the findings based on the data collected from electronic medical reports of the participants.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Written by

Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.