Long-term impact of COVID-19 on the cardiovascular system

Long-COVID, also known as post-acute COVID-19 syndrome (PACS), post-COVID-19 condition, post-COVID-19 syndrome, or chronic COVID syndrome (CCS), encompasses persistent symptoms and complications following recovery from an acute phase of SARS-CoV-2 infection and includes ongoing symptomatic COVID-19 and post-COVID-19 syndrome. One concern about long-COVID is its impact on the cardiovascular (CV) system (CVS). Survivors of acute COVID-19 are at substantial risk of developing CV disease (CVD), and the burden of these pathologies may persist for at least 1 year. COVID-19 can cause acute cardiac injury, myocarditis, thromboembolic complications, arrhythmias, and other CVD complications. The increased risk of CVD extends beyond the acute phase of COVID-19, with patients still displaying an increased risk of developing major adverse CVD events 1 year after COVID-19. This chapter provides insights into the long-term impact and the connection of SARS-CoV-2 infection on the CVS and development of long-COVID syndrome. We explore post-acute sequelae of SARS-CoV-2 infection, post-COVID syndrome in hospitalized individuals, autonomic dysfunction in long-COVID syndrome, vascular aging after COVID-19, and CV sequelae in severe COVID-19 survivors.