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Long COVID and Cardiovascular Health: Clinical Perspectives on Risk and...
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Long COVID and Cardiovascular Health: Clinical Perspectives on Risk and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 20 July 2025 | Viewed by 850

Special Issue Editors

Dr. Mariana Tudoran

E-Mail Website
Guest Editor
Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy "Victor Babes" Timisoara, 300041 Timisoara, Romania
Interests: hypertension; heart failure; atherosclerosis; echocardiography; atrial fibrillation; clinical cardiology; chronic heart failure
Dr. Cristina Tudoran

E-Mail Website
Guest Editor
1. Department VII, Internal Medicine II, Discipline of Cardiology, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
2. Centre of Molecular Research in Nephrology and Vascular Disease, University of Medicine and Pharmacy “Vic-tor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
3. County Emergency Hospital “Pius Brinzeu”, L. Rebreanu, Nr. 156, 300723 Timisoara, Romania
Interests: pulmonary hypertension; heart failure; heart rate variability; myocarditis; pericarditis; COVID-19 and post-acute COVID-19 syndrome
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Since the first cases of COVID-19 were diagnosed in November 2019 in China, massive efforts have been invested in encountering a cure and in improving the outcome of patients infected with the SARS-CoV-2 virus. Despite these endeavors, COVID-19 is still a healthcare problem, with over 265 k reported cases worldwide. At the end of 2020, several researchers observed that some patients had a prolonged recovery period after acute COVID-19 infection. These subjects still had persistent symptoms or developed new complaints up to 4 months after the initial viral infection. This disease was named long COVID and, according to the World Health Organization, it affects 10-20% of all patients recovering from a SARS-CoV-2 infection. Long COVID has been classified as a complex syndrome, involving multiple systems and organs with a predisposition for the cardiovascular system. As long COVID can affect a person's functional status in several ways, from mild forms to debilitating ones, with severe symptoms, many efforts have been made to determine the underlying mechanisms, find a cure, and perfect the management of individuals suffering from long COVID. This Special Issue focuses on original articles and reviews on new approaches targeting the management, diagnosis, and treatment of cardiovascular symptoms and pathologies associated with long COVID.

Dr. Mariana Tudoran
Dr. Cristina Tudoran
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • long COVID
  • cardiovascular disease
  • long COVID therapy
  • management of long COVID
  • mechanisms of long COVID

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Published Papers (2 papers)

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Research

9 pages, 196 KiB  
Article
24 h Holter Monitoring and 14-Day Intermittent Patient-Activated Heart Rhythm Recording to Detect Arrhythmias in Symptomatic Patients After Severe COVID-19—A Prospective Observation
by Andrzej Kułach, Michał Kucio, Michał Majewski, Zbigniew Gąsior and Grzegorz Smolka
J. Clin. Med. 2025, 14(8), 2649; https://doi.org/10.3390/jcm14082649 - 12 Apr 2025
Viewed by 290
Abstract
Background/Objectives: COVID-19 is associated with various arrhythmias that continue into a post-COVID period and become a concern for patients and healthcare a long time after the infection. This study aimed to assess the incidence of arrhythmias and their relationship to presented symptoms in [...] Read more.
Background/Objectives: COVID-19 is associated with various arrhythmias that continue into a post-COVID period and become a concern for patients and healthcare a long time after the infection. This study aimed to assess the incidence of arrhythmias and their relationship to presented symptoms in patients with no history of rhythm disturbances who underwent severe COVID-19 within the past 6 months. Methods: A total of 54 severe COVID-19 survivors with no history of known arrhythmia were enrolled in the study 3–6 months after discharge. All subjects underwent echocardiography, 24 h Holter monitoring, and received a handheld ECG event recorder for 14 days of ambulatory single-lead ECG recording, which was evaluated for supraventricular and ventricular arrhythmias and patient-reported events. After 12 months of follow-up (FU), Holter monitoring and ECG recordings were repeated. Results: The incidence of palpitations was high at baseline and halved after 12 months (65% vs. 36%, p = 0.018), as was the symptom-induced utilization of the event monitor (36% vs. 12%, p0.012). Palpitations were more common in patients with CAD, diabetes, and hypertension, but were not related to any rhythm disturbances except sinus tachycardia (OR of 5.8 for each 10 bpm increase in HR; CI: 1.3–26.5, p = 0.02). Holter monitoring revealed a higher burden of PVCs 3–6 months after COVID vs. FU (PVCs > 200/d in 36% vs. 17%, p < 0.05), and PVCs were more commonly recorded events in symptomatic patients. Symptomatic subjects more frequently reported sinus tachycardia (48% vs. 13%, p < 0.05) and PVC (21% vs. 0%, p < 0.05). Neither arrhythmias nor palpitations were related to the severity of the infection. Conclusions: Palpitations are common after severe COVID-19, but the symptoms are related to sinus tachycardia rather than actual arrhythmia and are more pronounced in patients with cardiovascular conditions. Ventricular ectopy was the predominant finding early after severe COVID-19 and might have been responsible for symptoms in a fraction of symptomatic subjects. Both symptoms and sinus tachycardia resolved over time. Full article
(This article belongs to the Special Issue Long COVID and Cardiovascular Health: Clinical Perspectives on Risk and Management)
13 pages, 1461 KiB  
Article
Prevalence and Cardiopulmonary Characteristics of Post-COVID Syndrome at a Hungarian Tertiary Referral Hospital
by Krisztina Fekete, Barbara Sándor, Anita Kacsó, Anita Pálfi, Szilard Tóth, László Deres, Eszter Szabados, László Czopf, Miklós Rábai, Roland Gál, Tamas Alexy, Tamás Habon, Kálmán Tóth, Hussain Alizadeh, Szilvia Soós and Róbert Halmosi
J. Clin. Med. 2025, 14(8), 2604; https://doi.org/10.3390/jcm14082604 - 10 Apr 2025
Viewed by 314
Abstract
Background: After an acute COVID-19 infection, many patients suffered from various complaints called as post-COVID syndrome. Methods: Our post-COVID outpatient department was operational for 19 months, where patients (n = 252) underwent a detailed cardiopulmonary examination within a 3-month-long follow-up period. Results: Most [...] Read more.
Background: After an acute COVID-19 infection, many patients suffered from various complaints called as post-COVID syndrome. Methods: Our post-COVID outpatient department was operational for 19 months, where patients (n = 252) underwent a detailed cardiopulmonary examination within a 3-month-long follow-up period. Results: Most patients (69.9%) had mild acute symptoms with a higher hospitalization risk with preexisting hypertension (p < 0.05) and diabetes (p < 0.001). Most common post-COVID symptoms were fatigue (29.4%) and dyspnea (19.1%). Echocardiographic parameters showed no abnormalities and did not change during the follow-up period. Exercise capacity was also generally normal with no change over time; however, 9.9% of patients showed significant desaturation during a 6 min walk test. This finding showed correlation (p < 0.01) with decreased diffusion capacity (DLCO). Generally, DLCO improved slightly but significantly (p < 0.05) by the end of the follow-up period (from 72.4% to 74.1%). Our key finding was a 10× higher prevalence (24.6%) of lupus anticoagulant positivity among post-COVID patients compared to the normal population (estimated at 2–4%). Conclusions: In conclusion, post-COVID syndrome is a common consequence even after a mild infection. Severe infections tend to lead to worse cardiopulmonary outcomes. Higher prevalence of lupus anticoagulant positivity may underline the importance of autoimmunity in the pathomechanism of post-COVID syndrome. Full article
(This article belongs to the Special Issue Long COVID and Cardiovascular Health: Clinical Perspectives on Risk and Management)
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