COVID-19 and the heart

Background There is evidence for a bi-directional relationship between COVID-19 and the cardiovascular (CV) system. Source of data Published literature. Areas of agreement Pre-existing heart failure (HF) increases the risk of mortality with COVID-19. CV complications are recognized, including increased rates of acute coronary syndromes, HF, arrhythmia and myocarditis. Drugs targeting the angiotensin system are safe and may provide prognostic benefit. Areas of controversy Vaccination as a cause of myocarditis remains a key area of contention. Growing points As the pandemic progresses, we are gaining more data about the long-term effects of COVID-19 on the CV system: long COVID, and medium-to-long-term increases in CV risk. Areas timely for developing research Large-scale longitudinal studies will shed light on long-term CV outcomes with COVID-19. Furthermore, the differential effects of COVID-19 variants on the CV system must be investigated.