COVID Long-Haulers: Cardiovascular Effects 

Courtesy of Prajwal Saokar


The COVID-19 pandemic has infected over 180 million people across the globe, of which nearly 4 million have died to date (WHO, 2021). The disease has mutated multiple times as it spread throughout the world and infected people of all demographics and age groups. The short term consequences of this disease have been debilitating to the world’s economy, infrastructure, and health. Unfortunately, as all of COVID-19’s victims were infected from late 2019 onwards, there is a dearth of information about the disease’s effects on the long-term health of patients. 

Further understanding the long-term effects of this disease is essential in monitoring the health of patients of every group, from those who were completely asymptomatic to those who suffered from critical conditions and were hospitalized. This is crucial, as the potential long term effects of this disease range from mild neurological issues to severe organ failure (López-León, 2021). Moreover, with the recent development of the COVID vaccine, efforts to understand the vaccine’s mid and long term effects could help reduce vaccine hesitancy, a critical barrier to developing herd immunity to the virus and its mutations globally.

Meta-Analyses of Long Term Effects

The recent systematic review by Domingo et al. used over 36 studies and concluded that of individuals diagnosed with COVID in a lab, 56% had symptoms that continued in the long term (Domingo et al., 2021). These included continued respiratory issues, neurological issues like “brain fog” among other mostly mild conditions. Other systemic reviews furthered that many of the long-term issues found in patients may not be discovered for several years, as the damage that COVID-19 causes to tissues can take years to manifest in the form of chronic health conditions (López-León, 2021). Unfortunately, these analyses suffer from several constraints, as the clinical data recorded thus far has very low levels of certainty and it will require years of research before a consensus arrives on the long-term effects of the disease. Funding large studies with diverse groups of people is critical to furthering our understanding of the disease, as data gathered on issues like this must be conclusive in order for policymakers and healthcare professionals to develop an adequate response to the potential health crisis at hand. 

Cardiovascular Impacts of COVID-19

The effects of COVID-19 on the heart in the short and long term have already been severe. As among hospitalized patients, one-fourth of the patients continued to suffer from myocarditis even 3 months after being discharged from the hospital (Becker, 2020). Higher rates of heart failure have not been observed in this group yet, but they remain at an elevated risk of developing critical cardiovascular conditions. 

Figure 1. Diagram of how COVID-19 can cause myocarditis (Siripanthong et al., 2020) 

When accounting for the limitations of this data such as its small sample size, heart conditions as a result of COVID-19 are still considered by most medical professionals to be a rare effect, especially in comparison to the neurological and pulmonary symptoms that have been seen in those who were previously infected with COVID. 

However, COVID’s effects on the cardiovascular systems have two alarming characteristics. First, former COVID-19 patients who reported issues like chest pain after being discharged have shown signs of decreased global longitudinal strain, which is an indicator that the heart’s ability to pump blood to the rest of the body had been diminished. Many of these patients are also suffering from scarring or inflammation of the heart muscles (Barber, 2020). No causal analysis has been done on humans or human models, but recent research on cell cultures showed that COVID-19 disrupted the cells’ ability to form the organized structures that are characteristic of healthy, functioning organs (Bond, 2021). This is especially concerning, when looked at in conjunction with the second characteristic of the virus’ long-term effects on cardiovascular health, which is that asymptomatic victims of COVID-19 can develop mild to severe heart issues weeks or months after being infected. While these cases may be more likely to resolve themselves, groups of all ages have seen increasingly higher rates of myocarditis and other chronic conditions, with one study finding that 37% of healthcare workers who recovered from the coronavirus developed various forms of cardiovascular inflammation, of which half had asymptomatic cases of COVID (Barber, 2020).

Adverse Cardiovascular Effects of the Vaccine

With the administration of nearly 272 million doses of the COVID-19 vaccine in the United States, domestic vaccination efforts have been highly successful over the past year (Randall, 2021). However, the rise in adverse reactions to the vaccine in the form of heart inflammation (myocarditis), primarily in adolescent men, could increase vaccine hesitancy among certain population groups or pose long term health risks to those being administered the vaccine. Fortunately, 79% of patients who received vaccinations and began to develop myocarditis saw their symptoms quickly dissipate, and only 8 in 1 million persons aged 12 to 39 see any myocarditis or pericarditis after receiving the second dose of the Pfizer vaccine (Marill, 2021). As such, the Advisory Committee on Immunization Practices and Centers for Disease Control and Prevention (CDC) maintain their positions that the potential drawbacks of the vaccine are outweighed by the protection it provides from the disease and its variants. However, the CDC is continuing its research on whether there is a link between mRNA immunization technology and myocarditis. 


While much more analysis and research has to be done to create conclusive results, current evidence clearly illustrates the possibility that many patients who had previously contracted COVID-19, whether it was an asymptomatic case or a severe one in which the patient had to be hospitalized, may suffer from long term heart issues as a result of their infection. Specifically, better in vitro analysis of the effect of the COVID-19 virus on heart cells could tell us more about the structural changes it can cause to the heart of other organs, and large scale clinical studies could help us discover more heart disorders or gain a higher degree of certainty over the discoveries that have already been made. 

About the Author

Prajwal Saokar is a junior at Lambert High School in the United States. His interests outside of CVT include computer science, debate, and physics, and he aspires to use technology to drive improvements in medicine.


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