Tackling the growing problem of cardiovascular complications from Covid-19 infection and long Covid is the subject of a new clinical consensus statement published by affiliated associations of the European Society of Cardiology (ESC).
This ‘major new report’, authored by a group of experts from across Europe, sets out how to confront the ‘profound and lasting impact’ of Covid-19 on cardiovascular health.
The authors noted a lack of clear guidance on how to approach the diagnosis, treatment, rehabilitation and prevention of Covid-19’s damaging cardiovascular effects, which has led to uncertainty for clinicians and some patients seeking unproven and unsafe treatments.
This underlined ‘the urgent need for tailored, comprehensive cardiovascular prevention strategies for patients at risk, with recent or prior infection’, they said.
Optimising cardiovascular outcomes in Covid-19
To address this, the authors reviewed all the existing research on Covid-19 and cardiovascular disease, including the effects of an acute infection, long Covid and Covid vaccination.
They then established a set of recommendations on how to treat or prevent these complications, aiming to equip clinicians with a practical tool to optimise cardiovascular outcomes for patients with acute or prior Covid-19 infection.
Their key recommendations included the continuation of vaccination programmes to reduce the cardiac risks of Covid-19 and the creation of structured cardiac rehabilitation programmes, including specialised physiotherapy, to prevent long-term complications and aid recovery.
Advice for the diagnosis and treatment of cardiac symptoms brought on by Covid, including lifestyle modifications and personalised therapeutic approaches to enhance patient outcomes, were also outlined.
‘Multidisciplinary care and personalised treatment plans are fundamental to improving outcomes,’ the authors said.
‘Unified, practical recommendations’
Professor Vassilios Vassiliou, a clinical professor in cardiac medicine at the University of East Anglia and honorary consultant cardiologist at the Norfolk and Norwich University Hospital, Norwich, UK, led the work on behalf of the ESC.
He said: ‘This statement provides unified, practical recommendations for prevention, rehabilitation, and long-term care, while also identifying critical research gaps to ensure strategies continue to evolve with emerging evidence.’
He highlighted the need for equal access to rehabilitation services, noting significant regional variation and that capacity ‘across much of Europe is insufficient to accommodate both conventional cardiac patients and those with cardiac long Covid’.
Professor Vassiliou added: ‘Unfortunately, even now, cardiac long Covid continues to affect the quality of life for many patients. We need to ensure patients have equitable access to rehabilitation services, support primary prevention through vaccination and lifestyle programmes, and fund research into long Covid and cardiovascular outcomes. Health systems must be prepared for the ongoing burden, not just the acute infection.’
Prioritise prevention
Nearly one billion people are known to have been infected with Covid-19 worldwide, although the real number is believed to be much higher. Researchers estimate that around 100 million people are currently living with long Covid, with approximately five million of these having cardiac long Covid and experiencing symptoms such as angina, breathlessness, arrhythmia, heart failure, fatigue and dizziness.
Covid patients, particularly those who have been hospitalised, have a higher risk of cardiovascular disease, including heart attack, stroke and cardiac-related death. And patients with existing heart disease are at increased risk of serious complications immediately and long after Covid-19 infection.
The ESC consensus statement authors concluded: ‘Future studies should prioritise the individualisation of preventive measures for diverse populations, refine rehabilitation strategies, and advance long-term cardiovascular care, ensuring that evidence-based practices continue to evolve alongside emerging data.’
The clinical consensus statement is jointly published by the European Association of Preventive Cardiology, the European Association of Cardiovascular Imaging, the Association of Cardiovascular Nursing and Allied Professions, the European Association of Percutaneous Cardiovascular Interventions, and the Heart Failure Association of the ESC.