Covid vaccinations remain vital to protect global heart health

Regular Covid vaccinations should continue worldwide to reduce cardiac risks associated with the virus - according to new research from the University of East Anglia. 

A major report published today sets out ways of tackling the 'profound and lasting impact' of Covid and long Covid on cardiovascular health.

It makes recommendations for diagnosing, treating and preventing serious heart and blood vessel complications linked to the virus.

As well as continuing vaccination programmes, the report recommends structured cardiac rehabilitation - to prevent long-term problems after infection and boost long Covid recovery.

The clinical consensus statement is authored by a group of experts from across Europe, led by Prof. Vassilios Vassiliou from UEA and the Norfolk and Norwich University Hospital on behalf of the European Society of Cardiology (ESC).

Millions suffering

The Covid pandemic has had a profound and lasting impact on our health, with complications emerging during acute illness and recovery.

Millions of people around the world are suffering with serious cardiovascular problems caused by Covid infection and long Covid.

A lack of clear evidence-based guidance on how to reduce this suffering and prevent further harm means that patients are not receiving the care they need, and some are turning to unproven or unsafe treatments.

We wanted to change that."

Prof. Vassilios Vassiliou, UEA's Norwich Medical School

Almost one billion people are known to have been infected with Covid worldwide, although the true number is believed to be far higher.

Research shows that Covid patients, especially those who needed hospital treatment, have a higher risk of cardiovascular disease, including heart attack, stroke and death from cardiovascular disease.

Around 100 million people are currently living with long Covid, and about five per cent of these have cardiac long Covid, with symptoms including angina (chest pain), breathlessness, arrhythmia (abnormal heart rhythm), heart failure, fatigue and dizziness.

Long Covid can also lead to autonomic dysfunction where the nerves that normally control heart rate, breathing and body temperature do not work properly.

How the research happened

The team reviewed all existing research on the virus and cardiovascular disease, including the effects of an acute infection, long Covid and Covid vaccination.

They used this research to agree a set of recommendations for how to treat or prevent the damaging cardiovascular effects of Covid.

The report includes advice to continue vaccinating against Covid-19, as people who are fully vaccinated are far less likely to suffer cardiac complications or long Covid, even if they come down with the virus.

It also sets out how to diagnose and treat the symptoms brought on by Covid, such as shortness of breath, chest pain and fainting.

Cardiac rehabilitation vital

In particular, the paper recommends structured cardiac rehabilitation programmes, including specialised physiotherapy, to prevent longer term problems from developing following infection and to aid recovery from long Covid.

Prof Vassiliou said: "Covid doesn't just affect the lungs. It can also damage the heart and blood vessels, both during the acute infection and for months afterward. This means chest pain, breathlessness, palpitations, or fatigue may be signs of cardiac long Covid.

"If you already have heart disease, Covid raises your risk of serious complications both immediately and long after infection. In both cases, rehabilitation can protect your heart and support recovery.

"Our report provides unified, practical recommendations for prevention, rehabilitation, and long-term care, while also identifying critical research gaps to ensure strategies continue to evolve with emerging evidence."

Finally, the experts call for equal access to cardiac rehabilitation programmes, especially for people living in rural locations.

"At present, the capacity of rehabilitation services across much of Europe is insufficient to accommodate both conventional cardiac patients and those with cardiac long Covid," said Prof Vassiliou.

"There are also significant regional variations. Targeted financial investment and resource allocation are therefore required to expand service capacity and ensure equitable access.

"Unfortunately, even now, cardiac long Covid continues to affect the quality of life for many patients. We need to ensure patients have equitable access to rehabilitation services, support primary prevention through vaccination and lifestyle programmes, and fund research into long Covid and cardiovascular outcomes.

"Health systems must be prepared for the ongoing burden, not just the acute infection."

'Cardiovascular Disease Prevention and Management in COVID-19. A Clinical Consensus Statement of the European Association of Preventive Cardiology, the European Association of Cardiovascular Imaging, the Association of Cardiovascular Nursing & Allied Professions, the European Association of Percutaneous Cardiovascular Interventions, and the Heart Failure Association of the ESC' is published in the European Journal of Preventive Cardiology.