Palabras clave
Síndrome post agudo de COVID-19
Enfermedades cardiovasculares
Cardiopatías
Secuelas cardiovasculares
Cómo citar
Copyright © | Todos los derechos reservados.
La revista posee los derechos de autor exclusivos para la publicación de este artículo en los términos de la ley brasileña 9610/98.
Reproducción parcial
El uso de partes de los textos, figuras y cuestionario del artículo es libre, siendo obligatoria la citación de los autores y revista.
Reproducción total
Está expresamente prohibido y debe ser autorizado por la revista.
Resumen
Objetivo: Analizar las evidencias científicas sobre secuelas cardiovasculares pos-COVID-19 en adultos con y sin cardiopatía previa, destacando manifestaciones clínicas, mecanismos involucrados e implicaciones para el seguimiento en el contexto brasileño. Métodos: Revisión integrativa de la literatura, estructurada mediante la estrategia PICO, realizada en las bases PubMed/MEDLINE, Biblioteca Virtual en Salud y Literatura Latinoamericana y del Caribe en Ciencias de la Salud, incluyendo publicaciones de 2019 a 2025. Se seleccionaron estudios que abordaran desenlaces cardiovasculares después de la fase aguda de la COVID-19 en adultos. Resultados: La muestra final incluyó 30 estudios, con predominio de estudios observacionales, cohortes y registros clínicos. Las principales secuelas identificadas fueron lesión miocárdica, miocarditis, arritmias, disautonomía, taquicardia persistente, intolerancia al esfuerzo, insuficiencia cardíaca, disfunción endotelial, eventos tromboembólicos e hipertensión de inicio reciente. Los adultos con cardiopatía previa presentaron mayor vulnerabilidad a descompensaciones y peor capacidad funcional, mientras que individuos sin enfermedad cardiovascular conocida también desarrollaron manifestaciones persistentes en el período posagudo. Consideraciones finales: Las secuelas cardiovasculares pos-COVID-19 requieren atención longitudinal, individualizada y orientada por riesgo, integrando atención primaria, cardiología, rehabilitación cardiovascular y telemonitoreo, especialmente ante desigualdades asistenciales.
Referencias
BARROSO WKS, et al. Diretrizes Brasileiras de Hipertensão Arterial – 2020. Arquivos Brasileiros de Cardiologia, 2021; 116(3): 516-658.
BAUM P, et al. Cardiac function in relation to functional status and fatigue in patients with post-COVID syndrome. Scientific Reports, 2022; 12: 19575.
BLITSHTEYN S, WHITELAW S. Postural orthostatic tachycardia syndrome (POTS) and other autonomic disorders after COVID-19 infection: a case series of 20 patients. Immunologic Research, 2021; 69(2): 205-211.
BOPARAI MS, et al. Incidence and risk factors of new-onset hypertension up to 3 years post SARS-CoV-2 infection. Scientific Reports, 2025; 15: 28728.
BREITBART P, et al. Clinical and cardiac magnetic resonance findings in post-COVID patients referred for suspected myocarditis. Clinical Research in Cardiology, 2021; 110: 1832-1840.
CORDERO A, et al. Mortality associated with cardiovascular disease in patients with COVID-19. REC: CardioClinics, 2021; 56(1): 30-38.
COSTA IBSS, et al. O coração e a COVID-19: o que o cardiologista precisa saber. Arquivos Brasileiros de Cardiologia, 2020; 114(5): 805-816.
DANI M, et al. Autonomic dysfunction in ‘long COVID’: rationale, physiology and management strategies. Clinical Medicine, 2021; 21(1): e63-e67.
DEHGHAN M, et al. A deeper look at long-term effects of COVID-19 on myocardial function in survivors with no prior heart diseases: a GRADE approach systematic review and meta-analysis. Frontiers in Cardiovascular Medicine, 2024; 11: 1458389.
ERDEM K, et al. Evaluation of pulmonary artery pressures and right ventricular dimensions in post-COVID-19 patients without significant cardiac cardiovascular diseases. Cardiology Research and Practice, 2023; 2023: 5519228.
GARCIA-ZAMORA S, et al. Abnormal echocardiographic findings after COVID-19 infection: a multicenter registry. The International Journal of Cardiovascular Imaging, 2023; 39(1): 77-85.
GLUCKMAN TJ, et al. 2022 ACC expert consensus decision pathway on cardiovascular sequelae of COVID-19 in adults: myocarditis and other myocardial involvement, post-acute sequelae of SARS-CoV-2 infection, and return to play. Journal of the American College of Cardiology, 2022; 79(17): 1717-1756.
HUANG R, et al. Prevalence of cardiovascular symptoms in post-acute COVID-19 syndrome: a meta-analysis. International Journal of Cardiology, 2025; 433: 133006.
JARDIM ISC, et al. Impacto da COVID-19 nos programas de reabilitação cardiovascular no Brasil: um estudo transversal baseado em uma pesquisa online. Arquivos Brasileiros de Cardiologia, 2023; 120(3): e20220135.
KAPUSTA J, et al. Evaluation of myocardial dysfunction among non-hospitalized patients with previous COVID-19 disease and without previous cardiovascular disease. Scientific Reports, 2023; 13: 17235.
KOLE C, et al. Acute and post-acute cardiovascular complications of COVID-19: a comprehensive review. Progress in Cardiovascular Diseases, 2024; 83: 23-39.
LASSEN MCH, et al. Recovery of cardiac function following COVID-19 – ECHOVID-19: a prospective longitudinal cohort study. European Journal of Heart Failure, 2021; 23(11): 1903-1912.
LAWSON CA, et al. Long COVID and cardiovascular disease: a prospective cohort study. Open Heart, 2024; 11: e002662.
LIP S, et al. Long-term effects of SARS-CoV-2 infection on blood vessels and blood pressure – LOCHINVAR. Journal of Hypertension, 2025; 43(6): 1057-1065.
MITRANI RD, et al. COVID-19 cardiac injury: implications for long-term surveillance and outcomes in survivors. Heart Rhythm, 2020; 17(11): 1984-1990.
OLIVEIRA GMM, et al. Estatística cardiovascular – Brasil 2023. Arquivos Brasileiros de Cardiologia, 2024; 121(2): e20240079.
ØVREBOTTEN T, et al. Changes in cardiac structure and function from 3 to 12 months after hospitalization for COVID-19. Clinical Cardiology, 2022; 45(10): 1044-1052.
PAGE MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 2021; 372: n71.
PELÀ G, et al. Post-COVID-19 exaggerated exertional tachycardia: relationship with pulmonary and cardiac sequelae. Heart & Lung, 2025; 73: 228-235.
POYATOS P, et al. Endothelial dysfunction and cardiovascular risk in post-COVID-19 patients after 6- and 12-months SARS-CoV-2 infection. Infection, 2024; 52: 1269-1285.
RIBEIRO GJS, et al. Association between pre-existing cardiovascular risk factors and post-acute sequelae of COVID-19 in older adults. Anales del Sistema Sanitario de Navarra, 2025; 48(1): e1103.
RINALDI R, et al. Myocardial injury portends a higher risk of mortality and long-term cardiovascular sequelae after hospital discharge in COVID-19 survivors. Journal of Clinical Medicine, 2022; 11(19): 5964.
SEELEY MC, et al. High incidence of autonomic dysfunction and postural orthostatic tachycardia syndrome in patients with long COVID: implications for management and health care planning. The American Journal of Medicine, 2025; 138(2): 354-361.e1.
SHA’ARI NI, et al. Cardiovascular diseases as risk factors of post-COVID syndrome: a systematic review. BMC Public Health, 2024; 24: 1846.
SHOUMAN K, et al. Autonomic dysfunction following COVID-19 infection: an early experience. Clinical Autonomic Research, 2021; 31(3): 385-394.
SORIANO JB, et al. A clinical case definition of post-COVID-19 condition by a Delphi consensus. The Lancet Infectious Diseases, 2022; 22(4): e102-e107.
WARE AD, et al. Incidence and risk of post-COVID-19 thromboembolic disease and the impact of aspirin prescription; nationwide observational cohort at the US Department of Veteran Affairs. PLOS ONE, 2024; 19(9): e0302612.
WIERSINGA WJ, et al. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA, 2020; 324(8): 782-793.
WROBEL AG. Mechanism and evolution of human ACE2 binding by SARS-CoV-2 spike. Current Opinion in Structural Biology, 2023; 81: 102619.
XIE Y, et al. Long-term cardiovascular outcomes of COVID-19. Nature Medicine, 2022; 28: 583-590.
XU S-W, et al. Endothelial dysfunction in COVID-19: an overview of evidence, biomarkers, mechanisms and potential therapies. Acta Pharmacologica Sinica, 2023; 44(4): 695-709.
ZHANG T, et al. Cardiovascular outcomes in long COVID-19: a systematic review and meta-analysis. Frontiers in Cardiovascular Medicine, 2025; 12: 1450470.
ZHANG V, et al. Incidence of new-onset hypertension post-COVID-19: comparison with influenza. Hypertension, 2023; 80(10): 2135-2148.
ZUIN M, et al. Increased risk of new-onset hypertension after COVID-19: a systematic review and meta-analysis. High Blood Pressure & Cardiovascular Prevention, 2023; 30: 221-227.
ZUIN M, et al. Risk of incident heart failure after COVID-19 recovery: a systematic review and meta-analysis. Heart Failure Reviews, 2023; 28: 859-864.