Cardiovascular (CV) sequelae occur frequently during the first six months after Covid infection, 30-50% more often than after viral pneumonia, whereby the severity of the acute illness determines the occurrence rate. Hospitalized patients show a doubling of cardiovascular complications compared to outpatients. Symptoms include dyspnea, chest pain during physical exercise, and exercise-induced tachycardia. Post-Covid hypertension is only slightly more common than in influenza pneumonia.
Exercise ECG and echocardiography are recommended for functional testing.
An MRI only appears to be indicated in the case of pre-existing CV diseases.
include fatigue, concentration and memory disorders, headache and muscle pain, odor, and taste disorders, autonomic dysregulations and cognitive deficits.
A specialist should be consulted for the diagnostic work-up and treatment.
are also dealt with in detail in the S1 Guideline. The forms of complaint are similar to adults with fatigue, exercise intolerance, etc. However, persistent lung function impairments are less common and more dependent on existing pulmonary diseases.
A guideline [NICE], made available in the UK, is comparable to the German S1 guideline, but laid out in more general terms, containing less specific diagnostic or therapeutic recommendations. Nonetheless, it indicates the immense urge for research for validation of procedures and interventions. In addition to the basic diagnostic procedures, only exercise tests (6-min walk test) are postulated in the cardiovascular context. In an editorial on the NICE Guidelines [Venkatesan], the above-mentioned prevalence of long Covid is also confirmed in the UK population.
Other Covid Associated Complications
In addition to many other authors, Ramayami [Ramayami] from the Univ. of Miami, reports on Post-Covid Erectile Dysfunction, linking it to Endothelial Dysfunction.
Radin [Radin] from Scribbs Clinic, CA, USA evaluated lifestyle data collected from about 37,000 participants using activity and lifestyle trackers. From this pool, data of 875 people reporting acute respiratory complaints were selected, of which 234 (26,7%) tested positive for Covid and 641 tested negative. The two groups were compared in terms of resting heart rate (RHR), activity and sleep behavior. The Covid-positive group needed a longer time to return to baseline values (before the onset of the complaints) than the Covid-negative group. The most pronounced difference was in the resting heart rate, initially showing a short period of bradycardia, but changing into tachycardia which persisted for an average of 79 days before returning to baseline. The number of steps and the duration of sleep required 32 and 24 days, respectively, until initial values were reached. A subgroup of those who tested positive (13.7%) even took an average of 133 days to return to their baseline heart rate.