Secondo una ricerca della Washington University, chi è stato colpito duramente dal virus SARS-CoV-2 nel primo anno dopo la malattia rischia di subire ischemia miocardica, aritmie di vario grado, pericardite o miocardite

Il cuore è sicuramente coinvolto nella patologia del Long-COVID con complicazioni quali l'ischemia miocardica acuta o cronica, aritmie di vario grado e pericolosità, disautonomia, con possibile tachicardia al passaggio da una posizione supina a quella eretta, ed inoltre eventi tromboembolici o anche infiammatori quali la pericardite o la miocardite.

Il rischio di tali patologie si può prolungare durante il primo anno post-Covid, specialmente nei soggetti in cui l'infezione virale è stata in forma grave o in quelli con precedenti patologie croniche come diabete, obesità, malattie renali.

Long COVID and its cardiovascular implications

Long COVID represents the constellation of post-acute and long-term health effects of severe acute respiratory syndrome coronavirus ( SARS-CoV-2 ) infection which can affect nearly every organ including the cardiovascular system. Long COVID can affect people across race, ethnicity, sex, gender, and age groups. While the risk of long COVID is highest among those who had severe acute COVID-19 disease, the risk is non-trivial among people with mild COVID-19. It is estimated that at least 65 million people worldwide are impacted by long COVID.

Definition of long COVID

Long COVID is the umbrella term that encompasses all the post-acute and long-term sequelae ( including cardiovascular conditions ) of SARS-CoV-2 infection ( i.e. the health conditions that are causally driven by SARS-CoV-2 infection and develop or persist after the acute phase ).

Long-term cardiovascular sequelae of COVID-19

Long COVID may impact the cardiovascular system with sequelae including ischaemic heart disease, dysrhythmias, dysautonomia ( including postural orthostatic tachycardia syndrome ), thromboembolic events, and myocarditis. The risk of some cardiovascular sequelae may extend beyond the first year of infection, especially among those with severe acute COVID-19 illness that necessitated hospitalization. The elevated risk is evident even in people without pre-existing commodities and across various demographic groups and in people who had mild COVID-19 but increases according to the severity of acute infection.

COVID-19 and proximal risk factors for heart disease

Infection with SARS-CoV-2 also heightens the risk of proximal risk factors for heart disease, including obesity, hypertension, diabetes, hyperlipidaemia, kidney disease, and neuropsychiatric disorders.

Effect of reinfection

People around the world are getting reinfected with SARS-CoV-2, which may be the inevitability that we all will face. Evidence shows that reinfection may contribute additional risks of long COVID including additional risks of cardiovascular sequelae ( i.e. the adverse health effects of two infections are worse than one and three infections are worse than two ).

Source: Ziyad Al-Aly, European Heart Journal 2023