AAPM&R releases new guidance for diagnosing and treating long COVID-19 cardiovascular complications

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The American Academy of Physical Medicine and Rehabilitation (AAPM&R) has released new guidance addressing caring for patients with long COVID-19.

The guidance, entitled “Multi-Disciplinary Collaborative Consensus Guidance Statement on the Assessment and Treatment of Cardiovascular Complications in Patients with Post-Acute Sequelae of SARS-CoV-2 Infection (PASC)” was released on June 7, and developed by the organization’s PASC Collaborative, a multidisciplinary group of physicians, clinicians, and patient advocates, according to a press release.

In addition to providing clinicians with diagnosis and treatment guidance, the statement warned that cardiovascular diseases stemming from long COVID may reduce life expectancy and economic productivity and urges governments and health systems worldwide to prepare.

“Unfortunately, many people could have chronic cardiovascular conditions due to COVID-19 infection–even patients without previous cardiovascular disease, comorbidities, and otherwise low risk of cardiovascular disease,” said Jonathan Whiteson, MD, FAAPMR, lead author of the guidance in statement. “Because of the chronic nature of cardiovascular conditions, there will likely be long-lasting consequences for patients and health systems worldwide.”

Post-Acute Sequelae of SARS-CoV-2 infection (PASC) or long COVID is a condition that occurs in individuals who have had COVID-19 and report at least one persistent symptom after acute illness, according to the physician's group. Long COVID encompasses a constellation of varied and ongoing symptoms – even in the same patient across time – and may include neurological challenges, cognitive symptoms such as brain fog, cardiovascular and respiratory issues, fatigue, pain, and mobility issues, among others. According to the guidance, more than 100 symptoms have been reported with PASC.

An estimated eight to twenty-five million Americans have or have had symptoms of long COVID. Cardiovascular complications are common and can be a serious long COVID-19 symptom, according to the AAPM&R.

Long COVID cardiovascular symptoms and complications range from mild to incapacitating. Individuals with pre-existing heart disease and risk factors for heart disease are at increased risk of severe COVID-19 illness and death, including from further cardiovascular system involvement. Incidence of pulmonary embolism, arterial and venous thromboses, myocardial infarction, and stroke are all elevated in post-acute COVID, the release said.

“There are already equity challenges in access, diagnosis, and treatment for certain patients with cardiovascular diseases,” said Alba Azola, MD, author of guidance in a statement. “Individuals from racial and ethnic minority groups already have lower referral rates to cardiac rehabilitation than people classified as white/caucasian. Women also may be underdiagnosed and undertreated for cardiac conditions.”

According to the guidance, the etiology of PASC is still to be elucidated and at this time there is no specific evidence-based treatment of PASC symptoms and conditions including cardiovascular disorders.

For more information on the organization’s guidance and recent call-to-actions, visit their website.