Long COVID has become a world-wide, non-communicable epidemic, caused by long-lasting multi-organ symptoms that endure for weeks or months after SARS-CoV-2 infection has already subsided. This scientific document aims to provide insight into the possible causes and therapeutic options available for the cardiovascular manifestations of long COVID. In addition to chronic fatigue, which is a common symptom of long COVID, patients may present with chest pain, ECG abnormalities, postural orthostatic tachycardia, or newly developed supraventricular or ventricular arrhythmias. Imaging of the heart and vessels has provided evidence of chronic, post-infectious peri-myocarditis with consequent left or right ventricular failure, arterial wall inflammation or micro-thrombosis in certain patient populations. Better understanding of the underlying cellular and molecular mechanisms of long COVID will aid in the development of effective treatment strategies for its cardiovascular manifestations. A number of mechanisms have been proposed, including those involving direct effects on the myocardium, micro-thrombotic damage to vessels or endothelium, or persistent inflammation. Unfortunately, existing circulating biomarkers, coagulation and inflammatory markers, are not highly predictive for either the presence or outcome of long COVID when measured 3 months after SARS-CoV-2 infection. Further studies are needed to understand underlying mechanisms, identify specific biomarkers and guide future preventive strategies or treatments to address long COVID and its cardiovascular sequelae.

中文翻译：

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Long COVID 和心血管系统——阐明原因和细胞机制以制定有针对性的诊断和治疗策略：ESC 心脏和心肌及心包疾病细胞生物学工作组的联合科学声明

Long COVID 已成为世界范围内的非传染性流行病，由持续数周或数月的持久多器官症状引起，在 SARS-CoV-2 感染已经消退后。这份科学文件旨在深入了解长 COVID 的心血管表现的可能原因和可用的治疗方案。除了长期 COVID 的常见症状慢性疲劳外，患者还可能出现胸痛、心电图异常、体位性心动过速或新发的室上性或室性心律失常。心脏和血管成像提供了慢性、感染后心肌炎的证据，并在某些患者群体中导致左心室或右心室衰竭、动脉壁炎症或微血栓形成。更好地了解长 COVID 的潜在细胞和分子机制将有助于为其心血管表现制定有效的治疗策略。已经提出了许多机制，包括涉及对心肌的直接影响、对血管或内皮的微血栓形成损伤或持续性炎症的机制。不幸的是，在 SARS-CoV-2 感染后 3 个月进行测量时，现有的循环生物标志物、凝血和炎症标志物并不能高度预测长期 COVID 的存在或结果。需要进一步的研究来了解潜在的机制，确定特定的生物标志物并指导未来的预防策略或治疗，以解决长期 COVID 及其心血管后遗症。