Article Impact Level: HIGH Data Quality: STRONG Summary of European Journal of Preventive Cardiology, https://doi.org/10.1093/eurjpc/zwaf540 Dr. Vassilios S Vassiliou et al.
Points
- COVID-19 can trigger and worsen cardiovascular complications during both acute and post-acute phases of infection.
- Over 20% of Long COVID patients experience cardiac symptoms, with 2–5% of all infected individuals potentially developing Cardiac Long COVID.
- Early patient education, managing modifiable risk factors, and vaccination are crucial for cardiovascular prevention post-COVID-19.
- Routine prophylactic aspirin or anticoagulation is not advised without specific clinical indications due to lack of evidence.
- Cardiac rehabilitation is essential for patients with cardiovascular complications or chronic fatigue following SARS-CoV-2 infection.
Summary
This clinical consensus statement, issued by multiple associations of the European Society of Cardiology, addresses the critical challenges of cardiovascular disease prevention and management in the context of the COVID-19 pandemic. It highlights the complex interplay between SARS-CoV-2 infection and cardiovascular complications, which can manifest during acute infection, in the post-acute phase as Long COVID, and potentially from reinfection or vaccine adverse reactions. The document’s primary objective is to furnish clinicians with comprehensive guidance to optimize cardiovascular outcomes across the entire spectrum of COVID-19 disease.
The statement emphasizes the substantial global impact of COVID-19, with over 10 million deaths and nearly 1 billion documented cases, likely underestimating the true burden. Cardiovascular complications are a common sequela, with >20% of Long COVID patients experiencing cardiac symptoms, suggesting that 2–5% of all infected individuals may develop Cardiac Long COVID. These complications range from inflammatory conditions like myocarditis and pericarditis to thrombotic events, arrhythmias, and heart failure. Despite the benefits of treatments such as corticosteroids in acute hospitalized patients, adverse effects on cardiac physiology can occur, regardless of vaccination status, although vaccines significantly reduce morbidity and mortality.
Key recommendations include early patient education on potential Cardiac Long COVID symptoms, prompt management of modifiable cardiovascular risk factors (e.g., hypertension, hyperlipidaemia, hyperglycaemia), and encouraging vaccination and booster doses, particularly for high-risk individuals, as these may reduce Long COVID and COVID-19-related cardiovascular complications. Prophylactic aspirin or anticoagulation without specific clinical indications is not currently advised due to a lack of supporting evidence and bleeding risks. Structured cardiac rehabilitation is deemed crucial for patients experiencing cardiovascular complications or chronic fatigue post-infection to restore cardiopulmonary function and improve exercise capacity.
Link to the article: https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwaf540/8255559?login=false
References
Vassiliou, V. S., Tsampasian, V., Luchian, M. L., D’Ascenzi, F., D’Ascenzo, F., Dweck, M. R., Escaned, J., Gati, S., Halle, M., Koskinas, K. C., Neubeck, L., Papadakis, M., Petersen, S. E., Ristic, A., Metra, M., & Biondi-Zoccai, G. (2025). Cardiovascular disease prevention and management in covid-19: A clinical consensus statement of the european association of preventive cardiology, the european association of cardiovascular imaging, the association of cardiovascular nursing & allied professions, the european association of percutaneous cardiovascular interventions, and the heart failure association of the esc. European Journal of Preventive Cardiology, zwaf540. https://doi.org/10.1093/eurjpc/zwaf540
