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The wide array of clinical manifestations of the ongoing COVID-19 pandemic due to the SARS-CoV-2 infection continues to be a big puzzle to the healthcare professionals. The picture is becoming complex with appearance of new strains and widespread vaccination against the viral infection. The acute cardiovascular manifestations are diverse; but have been fairly well-documented. But the mechanism behind the persistent symptoms like dyspnea, fatigue, chest pain and other symptoms in some of the survivors, weeks and months after the onset of initial infection are poorly understood. The post-acute and long-term cardiovascular impact of COVID-19 affection on heart and other systems is not fully clear. As the survivors after an acute episode are fast growing in number, managing them is emerging as a new public health concern.

A recent study on cardiovascular outcomes of COVID-19 in post-acute phase by Xie et al in a cohort of 153,760 survivors of COVID showed that these individuals are at substantial risk of CV disorders like thromboembolic problems, arrhythmias, ischemic and non-ischemic myocardial injury, pericarditis, myocarditis and heart failure irrespective of the intensity of the initial infection. Currently, defining cardiovascular risk and predicting the long-term consequences in COVID survivors are issues of priority for the researchers and clinicians alike. The cardiac MRI is emerging as a useful tool to evaluate the myocardial damage in post-acute phase of COVID infection. This review is an attempt to analyze the existing knowledge and bring out the potential gaps in the understanding of these challenging issues after acute phase of COVID is over.

Keywords: SARS-CoV-2, long-COVID, myocardial injury, heart failure, Covid-heart