Long-Term Effects of Covid-19 on Cardiovascular System and the Risk Markers: A Systematic Review Publisher



Hatmi ZN ; Mahboobian F
Source: SN Comprehensive Clinical Medicine Published:2025

Abstract

Long-term manifestation of the cardiovascular system following COVID-19 needs to be comprehensively described. To shed light on long-term consequences of COVID-19-related cardiac injuries to guide preventive measures in clinical practice and public health area. A systematic review on cardiovascular manifestations of long COVID-19 was designed. Eight million documented COVID-19 cases were recruited and followed up over time to detect cardiovascular manifestations. PubMed, OVID Med line, LIT COVID, and Cochrane library up to February 23, 2024, have been searched. The PICOT algorithm was used to retrieve full-text articles among 36,882 searched titles and abstracts. Meta-analysis was conducted for homogenous data. Random effect model fitted to the extracted data. Pooled hazard ratios and 95% confidence intervals (CI) were estimated. The Mantel-Hansel test was used to estimate parameters before the multivariate analysis model. Two hundred thirty-eight full-text articles were screened for appraising according to the GRADE approach. Among 40 full texts that were appraised, twenty-one out of which concluded to be eligible to allocate to the systematic review. 75% of included studies were graded as high quality and 25% as medium quality, p = 001. Long COVID-19 CVD manifestations after 12 weeks of follow-up demonstrated the strongest hazard ratios for atrial fibrillation, ischemic heart disease, heart rate variability, heart failure, pericarditis, myocardial infarction, thrombotic events, ventricular fibrillation, ischemic cardiomyopathy, fatigue, coronary artery disease, DM, and HTN. The systematic review results indicate that the incidence of cardiovascular manifestations and risk factors have significantly increased after 12 weeks of COVID-19. Hazard ratios revealed significant increments in the development of various cardiovascular manifestations after COVID-19. © 2025 Elsevier B.V., All rights reserved.