A meta-analysis of 37 studies involving 3 million people suggests that those with long COVID are much more likely to experience chest pain, heart palpitations, and high blood pressure than their uninfected counterparts.
For the analysis, published late last week in BMC Medicine, researchers from Central South University in Hunan, China, systematically reviewed literature on high blood pressure, palpitations, and chest pain published up to March 17, 2024. Study sample sizes ranged from 60 to 2.4 million, with follow-up periods of 3 to 12 months.
"Emerging evidence indicates that COVID-19 may lead to post-acute COVID-19 syndrome (PACS) with cardiovascular implications, potentially driven by factors such as ACE2 interaction with viruses, systemic inflammation, and endothelial dysfunction," the researchers wrote. "However, there remains a limited amount of research on the cardiovascular manifestations of PACS, which may delay the development of optimal treatment strategies for affected patients."
Need for regular follow-up of recovering patients
Nearly 15% of long-COVID patients experienced cardiovascular complications. Among the case-control studies, relative to uninfected controls, the odds ratios (ORs) of experiencing chest pain among COVID-19 patients was 4.0, while they were 3.4 and 1.7 for palpitations and high blood pressure, respectively. The percentages of PACS patients experiencing chest pain, palpitations, and high blood pressure were 22%, 18%, and 19%, respectively.
More intensive monitoring of individuals with pre-existing cardiovascular risk factors, such as hyperglycemia, using advanced technologies like artificial intelligence, may help detect early signs of cardiovascular dysfunction and improve long-term outcomes.
The case-series studies identified chest pain as the most common cardiovascular symptom among long-COVID patients (22%), followed by high blood pressure (19%) and palpitations (18%).
"Clinicians should maintain vigilance in monitoring cardiovascular symptoms, even in patients without a prior history of cardiovascular disease, as cardiovascular sequelae can emerge in previously healthy individuals following COVID-19," the study authors wrote. "More intensive monitoring of individuals with pre-existing cardiovascular risk factors, such as hyperglycemia, using advanced technologies like artificial intelligence, may help detect early signs of cardiovascular dysfunction and improve long-term outcomes."
The study authors said that the results highlight the substantial cardiovascular burden among COVID-19 survivors, but the high heterogeneity seen in the chest pain and palpitations analysis suggests the need for further research.
"Future research should focus on the long-term follow-up of COVID-19 patients to explore the enduring impact of sequelae on patient health and inform medical decision-making to optimize patient outcomes," they concluded.
