Long-Term Cardiovascular Symptoms of Mild COVID-19

Muscle weakness, fatigue, difficulty sleeping, anxiety, depression, and severely impacted pulmonary diffusion capacities are all common complaints six months post-infection [2]. However, many of the studies examining the long-term effects of COVID-19 have focused primarily on patients who were previously hospitalized [2]. While these individuals have likely experienced the most severe symptoms, only 5.5% of all COVID cases in the United States have resulted in hospitalization, underlining the need for additional research on the long-term effects of mild COVID [3].

Follow-up assessments were performed at a median of 329 days after COVID-19 diagnosis. Although 20% of the cohort were asymptomatic at follow-up, 53% of subjects remained symptomatic, and an additional 5% of previously asymptomatic participants had developed new cardiac symptoms. Compared to men, women were more likely to experience continued cardiac symptoms with the most commonly reported being shortness of breath, palpitations, and chest pains. Shortness of breath was often related to an exaggerated tachycardic response and fatigue following exercise. Many participants also experienced some level of exercise intolerance; those most affected often refrained from leaving their homes due to the sudden onset of physical weakness, dizziness, or in rare cases, blackouts. 

Although myocardial mapping values generally improved across the entire cohort, native T2 values remained higher in individuals with persistent cardiac symptoms. Participants who were previously infected with SARS-CoV-2 exhibited higher mapping measurements, increased pericardial involvement, and more non-ischemic scarring compared to controls. These findings suggest that cardiac inflammation may be shared among individuals with COVID-19, regardless of the presence of cardiac symptoms. Although the mechanisms responsible were not examined in this study, the patterns of cardiac symptoms identified may help guide future COVID-19 research.

While this research provides further insight into post-COVID cardiovascular symptoms, the long-term effects of this virus remain unknown. In comparison with the global incidence of the disease, a relatively small number of participants (346 participants, 95 control) were pooled for this study, and replication is required to confirm these findings. Furthermore, while myocardial mapping can provide valuable pathophysiological insights, this technique is not immediately transferable to clinical practice due to a lack of standardization. Nevertheless, these results could prove helpful in characterizing long-term COVID-19 symptoms in the general population, as most studies to date have focused on hospitalized individuals without screening for existing comorbidities or cardiac diagnoses. As we approach the third year of the pandemic, one thing remains clear: there is still much to learn about the effects of long COVID.

Jasmin Skinner is an undergraduate student at the University of Western Ontario completing a Specialization in Biology and a Minor in Chemistry, with focused interest in applying these concepts to environmental conservation. As a lover of the outdoors and the arts, much of her time is spent in nature and within the local London art community, creating and connecting with all walks of life. After graduating, she hopes to continue her passion of finding unconventional solutions to environmental issues by working with nature, not against it.