Long COVID: New review highlights impact on cardiovascular system

The wide-ranging effects of Long COVID and the associated issues for healthcare providers have been revealed in a new review of the major studies into the condition, co-authored by a consultant cardiologist at Royal Brompton and Harefield hospitals.

Published in the European Heart Journal, the review specifically highlights the impact of Long COVID on the cardiovascular system. 

According to one of its co-authors, Professor Thomas Lüscher, Director of Research, Education and Development at Royal Brompton and Harefield Clinical Group, this is “the first review to summarise the diverse evidence on Long COVID and provide a balanced picture of this important issue.”

Professor Lüscher said: “The pandemic brought not only acute illness and death, it became a chronic disease of many organs, not just the lungs, but the heart, brain and kidney, among others.”

“Long COVID is, besides its huge impact for the affected individual, of great societal and economic importance as it leads to leave of absence from work, reduced work performance and hence unforeseen costs.”

The review was conducted by researchers from the University of Oxford, the University of Wisconsin School of Medicine and Public Health, Royal Brompton Hospital and Imperial College, London, and the University of Zurich, Switzerland.

The review spans each step from a patient’s original coronavirus infection and the direct impacts, such as myocardial infarction or inflammatory myocarditis, to the long-term impacts on aspects of wellbeing such as mental health and fatigue.

The researchers also concluded that current evidence for the treatment of Long COVID is lacking and that our current understanding of pathophysiological mechanisms and treatment options remains limited. They also found that the vast inequalities in healthcare provision exposed by COVID-19 continue to be magnified by Long COVID, a problem that calls for global humanitarian efforts to promote and fund equitable access to healthcare, social and welfare support and vaccines across the world.

Dr Betty Raman, of Oxford’s Radcliffe Department of Medicine, said: “Long COVID is emerging as a major public health issue, which makes it important that we better understand the long-term effects of COVID-19 to improve our treatment of it.

“This review highlights the wide range of short and long-term health impacts and the mechanisms behind them, which is key to providing treatment and ongoing care.”

Professor Stefan Neubauer, Head of the Division of Cardiovascular Medicine, Radcliffe Department of Medicine, said: “Long COVID is a huge medical challenge. This review gives a comprehensive update on its effect on the cardiovascular system and will also be important in guiding future research into the condition and for finding new treatments.”

Dr Betty Raman is leading one of the first randomised, double-blind, placebo-controlled studies in the UK. The team’s work is supported by the NIHR Oxford Biomedical Research Centre, a partnership between Oxford University Hospitals NHS Foundation Trust and the University of Oxford. Other trials to date have been open-label or non-random assignment of therapy.