May 2022 - Cardiology
This is a new literature review updated in May 2022. In case some essential information is missing, please contact us at: : rafael@hcuge.ch.
Long-term cardiovascular outcomes of COVID-19
Xie Y, Xu E, Bowe B, Al-Aly Z.. Nat Med. 2022 Mar;28(3):583-590. doi: 10.1038/s41591-022-01689-3. Epub 2022 Feb 7. PMID: 35132265.
The cardiovascular complications of acute coronavirus disease 2019 (COVID-19) are well described, but the post-acute cardiovascular manifestations of COVID-19 have not yet been comprehensively characterized. Here the authors used national healthcare databases from the US Department of Veterans Affairs to build a cohort of 153,760 individuals with COVID-19, as well as two sets of control cohorts with 5,637,647 (contemporary controls) and 5,859,411 (historical controls) individuals, to estimate risks and 1-year burdens of a set of pre-specified incident cardiovascular outcomes. The authors show that, beyond the first 30 d after infection, individuals with COVID-19 are at increased risk of incident cardiovascular disease spanning several categories, including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure and thromboembolic disease. These risks and burdens were evident even among individuals who were not hospitalized during the acute phase of the infection and increased in a graded fashion according to the care setting during the acute phase (non-hospitalized, hospitalized and admitted to intensive care).
Link to study : Long-term cardiovascular outcomes of COVID-19
Heart rate variability and cardiac autonomic functions in post-COVID period
Asarcikli LD, Hayiroglu Mİ, Osken A, Keskin K, Kolak Z, Aksu T.. J Interv Card Electrophysiol. 2022 Feb 1:1–7. doi: 10.1007/s10840-022-01138-8. Epub ahead of print. PMID: 35106678; PMCID: PMC8806134.
In this retrospective study, 60 consecutive patients treated COVID-19 between March 2020 and March 2021, and 33 age-matched healthy controls were enrolled. Study group consisted of consecutive post-COVID patients evaluated in the outpatient clinic who had 24-h Holter monitoring for the indication of palpitations, within 12 to 26 weeks following the diagnosis of COVID-19. Control group consisted of consecutive subjects with palpitations, no known autonomic imbalance, cardiovascular diseases or risk factors, who had 24-h Holter monitors. Time domain indices of heart rate variability (HRV) analysis (standard deviation of normal RR intervals in 24 h (SDNN 24 h) and root mean square of successive RR interval differences (RMSSD)) were significantly higher in post-COVID patients (p < 0.05 for all). Among frequency domain indices, high frequency and low frequency/high frequency ratio was significantly higher in post-COVID patients (p = 0.037 and p = 0.010, respectively). SDNN >60 ms [36 (60.0%) vs. 12 (36.4%), p = 0.028)] and RMSSD >40 ms [31 (51.7%) vs. 7 (21.2%), p = 0.003)] were more prevalent in post-COVID patients. Logistic regression models were created to evaluate parasympathetic overtone in terms of SDNN >60 ms and RMSSD >40 ms. After covariate adjustment, post-COVID patients were more likely to have SDNN >60 msn (OR: 2.4, 95% CI:1.2–12.8) and RMSSD >40 ms (OR: 2.5, 95% CI: 1.4–9.2). This study revealed parasympathetic overtone and increased HRV in patients with history of COVID-19. This may explain the unresolved orthostatic symptoms occurring in post-COVID period which may be associated with autonomic imbalance.
Link to study : Heart rate variability and cardiac autonomic functions in post-COVID period
Inappropriate sinus tachycardia in post-COVID-19 syndrome
Aranyó J, Bazan V, Lladós G, Dominguez MJ, Bisbal F, Massanella M, Sarrias A, Adeliño R, Riverola A, Paredes R, Clotet B, Bayés-Genís A, Mateu L, Villuendas R. Sci Rep. 2022 Jan 7;12(1):298. doi: 10.1038/s41598-021-03831-6. PMID: 34996973; PMCID: PMC8741896.
To assess cardiac autonomic function, a 2:1:1 comparative sub-analysis was conducted against both fully recovered patients with previous SARS-CoV-2 infection and individuals without prior SARS-CoV-2 infection. Among 200 patients with post-COVID-19 syndrome, 40 (20%) fulfilled the diagnostic criteria for inappropriate sinus tachycardia (IST) (average age of 40.1 ± 10 years, 85% women, 83% mild COVID-19). No underlying structural heart disease, pro-inflammatory state, myocyte injury, or hypoxia were identified. IST was accompanied by a decrease in most heart rate variability parameters, especially those related to cardiovagal tone: pNN50 (cases 3.2 ± 3 vs. recovered 10.5 ± 8 vs. non-infected 17.3 ± 10; p < 0.001) and HF band (246 ± 179 vs. 463 ± 295 vs. 1048 ± 570, respectively; p < 0.001). IST is prevalent condition among PCS patients. Cardiac autonomic nervous system imbalance with decreased parasympathetic activity may explain this phenomenon.
Link to study : Inappropriate sinus tachycardia in post-COVID-19 syndrome
Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus
Raman B, Bluemke DA, Lüscher TF, Neubauer S. Eur Heart J 2022;43:1157–1172.
Link to study : Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus
Cardiovascular complications in the Post-Acute COVID-19 syndrome (PACS)
Elseidy SA, Awad AK, Vorla M, Fatima A, Elbadawy MA, Mandal D, Mohamad T. Int J Cardiol Heart Vasc. 2022 Mar 28;40:101012. doi: 10.1016/j.ijcha.2022.101012. PMID: 35355927; PMCID: PMC8958273.
Link to study : Cardiovascular complications in the Post-Acute COVID-19 syndrome
Long-Lasting Myocardial and Skeletal Muscle Damage Evidenced by Serial CMR During the First Year in COVID-19 Patients From the First Wave
Filippetti L, Pace N, Louis JS, Mandry D, Goehringer F, Rocher MS, Jay N, Selton-Suty C, Hossu G, Huttin O, Marie PY. Front Cardiovasc Med. 2022 Mar 9;9:831580. doi: 10.3389/fcvm.2022.831580. PMID: 35355964; PMCID: PMC8959613.
Long COVID-19 and Postural Orthostatic Tachycardia Syndrome- Is Dysautonomia to Be Blamed ?
Chadda KR, Blakey EE, Huang CL, Jeevaratnam K. Front Cardiovasc Med. 2022 Mar 9;9:860198. doi: 10.3389/fcvm.2022.860198. PMID: 35355961; PMCID: PMC8959615.
Link to study : Long COVID-19 and Postural Orthostatic Tachycardia Syndrome- Is Dysautonomia to Be Blamed ?
Orthostatic Intolerance in Adults Reporting Long COVID Symptoms Was Not Associated With Postural Orthostatic Tachycardia Syndrome
Monaghan A, Jennings G, Xue F, Byrne L, Duggan E, Romero-Ortuno R. Front Physiol. 2022 Mar 4;13:833650. doi: 10.3389/fphys.2022.833650. PMID: 35309052; PMCID: PMC8931464.
Link to study : Orthostatic Intolerance in Adults Reporting Long COVID Symptoms Was Not Associated With Postural Orthostatic Tachycardia Syndrome
