Skip to main content
SpringerLink
Log in

Post COVID-19 Conditions: The New Challenge to Mankind

  • Chapter
  • First Online:
Frontiers of COVID-19

  • 475 Accesses

Abstract

After the waves of acute COVID-19 that swept mankind in 2020 and 2021, now we are confronted with the challenge of post COVID-19 conditions. According to the definition, post COVID-19 conditions comprise all signs and symptoms of COVID-19 that persist after the acute phase (3–4 weeks), without an upper limit of duration (as for the present state of knowledge). The symptoms of post COVID-19 conditions are highly variable, could affect every system, often overlap, and typically fluctuate and change over time.

In regard to this disease and its long-term burden, the Bulgarian Cardiac Institute initiated a campaign “Life after COVID-19” and the data we gathered showed that a substantial proportion of patients having suffered from COVID-19 continue to have persistent symptoms that require special medical attention. Our biggest concern was the acute vascular manifestations of post COVID-19 conditions, such as acute coronary syndromes and acute pulmonary embolism, and for these we shared our personal experience.

Post COVID-19 conditions have and will have a major significance for the healthcare and economic systems in the upcoming years. This derives from the simple facts that it is highly prevalent, affects people regardless of age (including young and active people) or severity of the acute illness (even asymptomatic cases), and that we still must learn a lot about its pathogenesis, natural history, treatment, and prognosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. COVID-19 rapid guideline: managing the long-term effects of COVID-19. NICE guideline [NG188]. 18 Dec 2020. https://www.nice.org.uk/guidance/ng188

  2. Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat Med. 2021;27:601–15. https://doi.org/10.1038/s41591-021-01283-z.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Logue JK, Franko NM, McCulloch DJ, et al. Sequelae in adults at 6 months after COVID-19 infection. JAMA Netw Open. 2021;4(2):e210830. https://doi.org/10.1001/jamanetworkopen.2021.0830.

    Article  PubMed  PubMed Central  Google Scholar 

  4. McNamara D. Infectious COVID-19 can persist in gut for weeks, September 11, 2020, MedScape.

    Google Scholar 

  5. World Health Organization (WHO). COVID-19 clinical management living guidance. WHO; 2021. 25 January 2021.

    Google Scholar 

  6. Mason RJ. Pathogenesis of COVID-19 from a cell biology perspective. Eur Respir J. 2020;55:2000607. https://doi.org/10.1183/13993003.00607-2020.

    Article  CAS  PubMed  Google Scholar 

  7. Yeoh YK, Zuo T, Lui GC, et al. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19. Gut. 2021;70:698–706.

    Article  CAS  Google Scholar 

  8. Murthy S, Lee TC. IL-6 blockade for COVID-19: a global scientific call to arms. Lancet Respir Med. 2021;9(5):438–40. https://doi.org/10.1016/S2213-2600(21)00127-2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Huang C, Huang L, Wang Y. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220–32. https://doi.org/10.1016/S0140-6736(20)326568.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. CDC. Post-COVID conditions, centers for disease control and prevention, vol. 2021. CDC; 2021. https://www.cdc.gov/.

    Google Scholar 

  11. Bansal M. Cardiovascular disease and COVID-19. Diabetes Metab Syndr. 2020;14(3):247–50.

    Article  Google Scholar 

  12. Napoli C, Tritto I, Benincasa G, Mansueto G, Ambrosioc G. Cardiovascular involvement during COVID-19 and clinical implications in elderly patients. A review. Ann Med Surg. 2020;57:236–43. https://doi.org/10.1016/j.amsu.2020.07.054.

    Article  Google Scholar 

  13. Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(271–80):e8.

    Google Scholar 

  14. Sattar Y, Ullah W, Rauf H, Virk H-u-H, Yadav S, Chowdhury M, Connerney M, Mamtani S, Pahuja M, Patel RD, Mir T, Almas T, Pacha HM, Alraiesg MC. COVID-19 cardiovascular epidemiology, cellular pathogenesis, clinical manifestations and management. Int J Cardiol Heart Vasc. 2020;29:100589. https://doi.org/10.1016/j.ijcha.2020.100589.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ksiazek TG, Erdman D, Goldsmith CS, et al. A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med. 2003;348:1953–66.

    Article  CAS  Google Scholar 

  16. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. J Am Med Assoc. 2020;323:1061–9. https://doi.org/10.1001/jama.2020.1585.

    Article  CAS  Google Scholar 

  17. Huang C, Wang Y, Li X. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. https://doi.org/10.1016/S0140-6736(20)30183-5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–13. https://doi.org/10.1016/S0140-6736(20)30211-7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Li B, Yang J, Zhao F. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109(5):531–8.

    Article  CAS  Google Scholar 

  20. Zhou F, Yu T, Du R. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;

    Google Scholar 

  21. Mihatov N, Januzzi JL, Gaggin HK. Type 2 myocardial infarction due to supply-demand mismatch. Trends Cardiovasc Med. 2017;27(6):408–17.

    Article  Google Scholar 

  22. Asrress KN, Williams R, Lockie T, Khawaja MZ, De Silva K, Lumley M, Patterson T, Arri S, Ihsan S, Ellis H, Guilcher A, Clapp B, Chowienczyk PJ, Plein S, Perera D, Marber MS, Redwood SR. Physiology of angina and its alleviation with nitroglycerin: insights from invasive catheter laboratory measurements during exercise. Circulation. 2017;136(1):24–34.

    Article  CAS  Google Scholar 

  23. Xiong TY, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long-term implications. Eur Heart J. 2020;41(19):1798–800.

    Article  CAS  Google Scholar 

  24. Chen D, Li X, Song Q, Hu C, Su F, Dai J. Hypokalemia and clinical implications in patients with coronavirus disease 2019 (COVID-19). medRxiv. 2020. https://doi.org/10.1101/2020.02.27.20028530.

  25. Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(11):1265–73.

    Article  Google Scholar 

  26. Hua A, O’Gallagher K, Sado D, Byrne J. Life-threatening cardiac tamponade complicating myo-pericarditis in COVID-19. Eur Heart J. 2020;41(22):2130.

    Article  CAS  Google Scholar 

  27. Gómez-Mesa JE, Galindo-Coral S, Montes MC, Muñoz Martin AJ. Thrombosis and coagulopathy in COVID-19. Curr Probl Cardiol. 2021;46(3):100742. https://doi.org/10.1016/j.cpcardiol.2020.100742.

    Article  PubMed  Google Scholar 

  28. Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemostasis. 2020;18(4):844–7.

    Article  CAS  Google Scholar 

  29. Knight DS, Kotecha T, Razvi Y, Chacko L, Brown JT, Jeetley PS. COVID-19: myocardial injury in survivors. Circulation. 2020;142(11):1120–2.

    Article  CAS  Google Scholar 

  30. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(7):811–8.

    Article  Google Scholar 

  31. Sala S, Peretto G, Gramegna M, Palmisano A, Villatore A, Vignale D. Acute myocarditis presenting as a reverse Tako-Tsubo syndrome in a patient with SARS-CoV-2 respiratory infection. Eur Heart J. 2020;41(19):1861–2.

    Article  CAS  Google Scholar 

  32. Manka R, Karolyi M, Polacin M, Holy EW, Nemeth J, Steiger P. Myocardial edema in COVID-19 on cardiac MRI. J Heart Lung Transplant. 2020;39(7):730–2.

    Article  Google Scholar 

  33. Zhang L, Wang B, Zhou J, Kirkpatrick J, Xie M, Johri AM. Bedside focused cardiac ultrasound in COVID-19 from the Wuhan epicenter: the role of cardiac point-of-care ultrasound, limited transthoracic echocardiography, and critical care echocardiography. J Am Soc Echocardiogr. 2020;33(6):676–82.

    Article  Google Scholar 

  34. Skulstad H, Cosyns B, Popescu BA, Galderisi M, Salvo GD, Donal E. COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel. Eur Heart J Cardiovasc Imaging. 2020;21(6):592–8.

    Article  Google Scholar 

  35. Cosyns B, Lochy S, Luchian ML, Gimelli A, Pontone G, Allard SD. The role of cardiovascular imaging for myocardial injury in hospitalized COVID-19 patients. Eur Heart J Cardiovasc Imaging. 2020;21(7):709–14.

    Article  Google Scholar 

  36. Motwani M, Kidambi A, Greenwood JP, Plein S. Advances in cardiovascular magnetic resonance in ischaemic heart disease and non-ischaemic cardiomyopathies. Heart. 2014;100(21):1722–33.

    Article  Google Scholar 

  37. Citro R, Pontone G, Bellino M, Silverio A, Iuliano G, Baggiano A, Manka R, Iesu S, Vecchione C, Asch FM, Ghadri JR, Templinf C. Role of multimodality imaging in evaluation of cardiovascular involvement in COVID-19. Trends Cardiovasc Med. 2021;31(1):8–16. https://doi.org/10.1016/j.tcm.2020.10.001.

    Article  CAS  PubMed  Google Scholar 

  38. Tam CF, Cheung KS, Lam S. Impact of coronavirus disease 2019 (COVID-19) outbreak on ST-segment-elevation myocardial infarction care in Hong Kong, China. Circ Cardiovasc Qual Outcomes. 2020;13:CIRCOUTCOMES120006631.

    Article  Google Scholar 

  39. Karlsen S, Dahlslett T, Grenne B, Sjøli B, Smiseth O, Edvardsen T, Karlsen HB, et al. Global longitudinal strain is a more reproducible measure of left ventricular function than ejection fraction regardless of echocardiographic training. Cardiovasc Ultrasound. 2019;17:18.

    Article  Google Scholar 

  40. Li R, Wang H, Ma F, et al. Widespread myocardial dysfunction in COVID-19 patients detected by myocardial strain imaging using 2-D speckle-tracking echocardiography. Acta Pharmacol Sin. 2021;42:1–8.

    Article  Google Scholar 

  41. Li SS, Cheng CW, Fu CL, et al. Left ventricular performance in patients with severe acute respiratory syndrome: a 30-day echocardiographic follow-up study. Circulation. 2003;108(15):1798–803.

    Article  Google Scholar 

  42. Shmueli H, Shah M, Ebinger J, et al. Left ventricular global longitudinal strain in identifying subclinical myocardial dysfunction among patients hospitalized with COVID-19. Int J Cardiol Heart Vasc. 2021;32:100719.

    PubMed  PubMed Central  Google Scholar 

  43. St S, Richter S, Seige M. Echocardiographic characteristics of patients with SARS-CoV-2 infection. Clin Res Cardiol. 2020;109:1549–66.

    Article  Google Scholar 

  44. Huang L, Zhao P, Tang D, et al. Cardiac involvement in recovered COVID-19 patients identified by magnetic resonance imaging. JACC Cardiovasc Imaging. 2020;13(11):2330–9. https://doi.org/10.1016/j.jcmg.2020.05.004.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Rattka M, Dreyhaupt J, Winsauer C, et al. Effect of the COVID-19 pandemic on mortality of patients with STEMI: a systematic review and meta-analysis. Heart. 2021;107:482–7.

    Article  CAS  Google Scholar 

  46. Samidurai A, Das A. Cardiovascular complications associated with COVID-19 and potential therapeutic strategies. Int J Mol Sci. 2020;21(18):6790. https://doi.org/10.3390/ijms21186790.

    Article  CAS  PubMed Central  Google Scholar 

  47. ZsuzsannaVarga AJ, Flammer PS, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395(10234):1417–8. https://doi.org/10.1016/S0140-6736(20)30937-5. Epub 2020 Apr 21.

    Article  Google Scholar 

  48. Lowenstein CJ, Solomon SD. Severe COVID-19 is a microvascular disease. Circulation. 2020;142:1609–11.

    Article  CAS  Google Scholar 

  49. Kasal DA, De Lorenzo A, Tibiriçá E. COVID-19 and microvascular disease: pathophysiology of SARS-CoV-2 infection with focus on the renin- angiotensin system. Heart Lung Circ. 2020;29(11):1596–602. https://doi.org/10.1016/j.hlc.2020.08.010.

    Article  PubMed  PubMed Central  Google Scholar 

  50. McFadyen JD, Stevens H, Peter K. The emerging threat of (micro)thrombosis in COVID-19 and its therapeutic implications. Circ Res. 2020;127:571–87. https://doi.org/10.1161/CIRCRESAHA.120.317447.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Asakura H, Ogawa H. COVID-19-associated coagulopathy and disseminated intravascular coagulation. Int J Hematol. 2021;113:45–57. https://doi.org/10.1007/s12185-020-03029-y.

    Article  CAS  PubMed  Google Scholar 

  52. Schiavone M, Gobbi C, Biondi-Zoccai G, et al. Acute coronary syndromes and Covid-19: exploring the uncertainties. J Clin Med. 2020;9(6):1683. https://doi.org/10.3390/jcm9061683.

    Article  CAS  PubMed Central  Google Scholar 

  53. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD, ESC Scientific Document Group. Fourth universal definition of myocardial infarction (2018). Eur Heart J. 2019;40(3):237–69. https://doi.org/10.1093/eurheartj/ehy462.

    Article  PubMed  Google Scholar 

  54. Sakr Y, Giovini M, Leone M, et al. Pulmonary embolism in patients with coronavirus disease-2019 (COVID-19) pneumonia: a narrative review. Ann Intensive Care. 2020;10:124.

    Article  Google Scholar 

  55. Rouhezamin MR, Haseli S. Diagnosing pulmonary thromboembolism in COVID-19: a stepwise clinical and imaging approach. Acad Radiol. 2020;27(6):896–7.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Heart and Brain Centre of Excellence, Pleven, Bulgaria

    Iana Simova, Denis Nikolov, Denislava Hristova, Hristina Tzanovska, Anyuta Ivanova, Maria-Magdalena Pintova & Diliana Iakova

  2. Bulgarian Cardiac Institute, Sofia, Bulgaria

    Iana Simova & Toni Vekov

  3. Medical University, Pleven, Bulgaria

    Iana Simova, Diliana Iakova & Toni Vekov

  4. Heart and Brain Centre of Excellence, Burgas, Bulgaria

    Vladimir Kornovski

  5. Medical University, Sofia, Bulgaria

    Todor Kundurzhiev

Authors
  1. Iana Simova
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Denis Nikolov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Denislava Hristova
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hristina Tzanovska
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anyuta Ivanova
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria-Magdalena Pintova
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Diliana Iakova
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Vladimir Kornovski
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Todor Kundurzhiev
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Toni Vekov
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. School of Information Technology, Deakin University, Melbourne, VIC, Australia

    Sasan Adibi

  2. School of Medicine, University of Queensland, Brisbane, QLD, Australia

    Paul Griffin

  3. Clinical - Vaccines, Clover Biopharmaceuticals, Zürich, Switzerland

    Melvin Sanicas

  4. Inflammation Division, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia

    Maryam Rashidi

  5. Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy

    Francesco Lanfranchi

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Simova, I. et al. (2022). Post COVID-19 Conditions: The New Challenge to Mankind. In: Adibi, S., Griffin, P., Sanicas, M., Rashidi, M., Lanfranchi, F. (eds) Frontiers of COVID-19. Springer, Cham. https://doi.org/10.1007/978-3-031-08045-6_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-08045-6_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-08044-9

  • Online ISBN: 978-3-031-08045-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation