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 Table of Contents    
Year : 2023  |  Volume : 55  |  Issue : 5  |  Page : 343-344

Long coronavirus disease: Consequences of COVID-19 infection and vaccine on cardiovascular diseases

Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Date of Submission05-Aug-2023
Date of Decision02-Sep-2023
Date of Acceptance04-Sep-2023
Date of Web Publication02-Nov-2023

Correspondence Address:
Shoban Babu Varthya
Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur - 342 005, Rajasthan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijp.ijp_512_23

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How to cite this article:
Tiwari K, Saravanan A, Anil A, Singh S, Varthya SB. Long coronavirus disease: Consequences of COVID-19 infection and vaccine on cardiovascular diseases. Indian J Pharmacol 2023;55:343-4

How to cite this URL:
Tiwari K, Saravanan A, Anil A, Singh S, Varthya SB. Long coronavirus disease: Consequences of COVID-19 infection and vaccine on cardiovascular diseases. Indian J Pharmacol [serial online] 2023 [cited 2023 Nov 28];55:343-4. Available from: https://www.ijp-online.com/text.asp?2023/55/5/343/389238

Dear Editor,

The coronavirus disease-19 (COVID-19) pandemic has exerted a major impact on global health, with millions of people getting infected and thousands of deaths. In addition to the immediate effects of the virus, there is growing evidence that COVID-19 can also have long-term consequences. Long-COVID-19 patients are individuals experiencing persistent COVID-19 symptoms lasting beyond 4 weeks from their initial infection. Despite fatigue being the most common long–COVID-19 symptom, the range of abnormalities caused by the infection is vast, including cardiovascular diseases (CVD). The presence of angiotensin-converting enzyme 2 receptors in the heart offers a direct pathway for SARS-CoV-2 virus, triggering an intense local immune response within the infected cardiomyocytes. Endothelial damage and microthrombosis contribute to coagulation disorders, while chronic hypoxia elevating the likelihood of cardiac injury in those infected with COVID-19. In addition, sustained immune activation can induce fibrosis, resulting in arrhythmias.[1] As vaccination efforts continue to ramp up, it is essential to understand the potential consequences of both virus and vaccines on CVD, thereby improving the cardiovascular assessment in COVID-19-infected individuals.

The prevalence of acute cardiovascular events has increased since the COVID-19 pandemic. Kunal et al. undertook a study involving symptomatic individuals afflicted by COVID-19. Their study unveiled instances of cardiovascular complications, including acute cardiac injury, cardiogenic shock, heart failure, acute coronary syndrome, and potential myocarditis.[2] Along with acute complications, people surviving COVID-19 also developed long-term complications. In the research conducted by Wang et al., utilizing data from the United States (US) Department of Veterans Affairs databases, higher incidences of heart failure, cerebrovascular disorders, ischemic heart disease, arrhythmia, and thrombotic disorders in the COVID-19 afflicted group compared to control cohorts were found, between 30 days and 12 months after infection. A retrospective study conducted using TriNetX US collaborative networks unveiled a significant risk of developing cardiovascular conditions within a 12-month period following COVID-19 recovery, when compared to a control group without a history of COVID-19. Among the male survivors of COVID-19, the most common cardiovascular risks were myocarditis, ischemic cardiomyopathy, and pulmonary embolism, whereas myocarditis, ischemic cardiomyopathy, atrial fibrillation, and atrial flutter were the most common risks among female COVID-19 survivors.[3] Therefore, understanding the acute cardiovascular effects and long-COVID-19 complications due to COVID-19 infection can guide health-care providers in the early detection and management of CVD.

While the vaccines against COVID-19 are being associated with some cardiovascular complications, Watson et al. observed that vaccines have significantly reduced COVID-19 mortality and have prevented millions of deaths worldwide, thus outweighing the risks.[4] Despite the benefits, an abrupt increase in the incidence of cardiac mortality among younger individuals since the COVID-19 pandemic is also evident. A cohort study by Diaz et al. among two million individuals conducted across 40 different hospitals in the US found that there were 20 reported cases of vaccine-related myocarditis, translating to a rate of 1.0 case per 100,000 vaccine doses administered. In addition, the study identified 37 cases of pericarditis linked to the vaccine, corresponding to a rate of 1.8 cases per 100,000 doses of the vaccine administered.[5]

In conclusion, the critical role of cardiovascular assessment in COVID-19-infected individuals is essential as there is evidence as mentioned above for the association between COVID-19 and CVD. Early detection and management of cardiovascular complications can significantly impact patient outcomes, reducing the burden of CVD and enhancing overall health-care efficacy. Thus, timely intervention, based on thorough assessment, is imperative in the battle against the devastating impacts of the COVID-19 virus on the cardiovascular system.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Crook H, Raza S, Nowell J, Young M, Edison P. Long COVID-mechanisms, risk factors, and management. BMJ 2021;374:n1648.  Back to cited text no. 1
Kunal S, Sharma SM, Sharma SK, Gautam D, Bhatia H, Mahla H, et al. Cardiovascular complications and its impact on outcomes in COVID-19. Indian Heart J 2020;72:593-8.  Back to cited text no. 2
Wang W, Wang CY, Wang SI, Wei JC. Long-term cardiovascular outcomes in COVID-19 survivors among non-vaccinated population: A retrospective cohort study from the TriNetX US collaborative networks. EClinicalMedicine 2022;53:101619.  Back to cited text no. 3
Watson OJ, Barnsley G, Toor J, Hogan AB, Winskill P, Ghani AC. Global impact of the first year of COVID-19 vaccination: A mathematical modelling study. Lancet Infect Dis 2022;22:1293-302.  Back to cited text no. 4
Diaz GA, Parsons GT, Gering SK, Meier AR, Hutchinson IV, Robicsek A. Myocarditis and pericarditis after vaccination for COVID-19. JAMA 2021;326:1210-2.  Back to cited text no. 5


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