The impact of long COVID-19 on health outcomes among adults with pre-existing cardiovascular disease and hypertension: A systematic review

Background This review summarizes the impact of long COVID (LC) on the health of adults with pre-existing cardiovascular disease (CVD) and hypertension. Methods We searched Medline, Web of Science (Core Collection), and CINAHL without language restrictions for articles published from December 1, 2019 through October 10, 2023 to ensure all relevant studies were captured. We included studies that enrolled adults (18+) diagnosed with CVD prior to COVID-19 infection whose infection was subsequently determined to be LC per the World Health Organization definition. We excluded studies with adults diagnosed with CVD concurrent with or subsequent to COVID-19 or with those who solely self-reported LC. We used a custom-built data extraction form to collect a range of study characteristics. Study quality was assessed using modified versions of the National Heart, Lung, and Blood Institute quality assessment tools. Results 13,779 studies were identified; 53 were included in the final analysis. Of these, 27 were of good quality and 26 were of fair quality. Health outcomes consisted of the presence of prolonged symptoms of long COVID-19 (n=29), physiological health outcomes (n=20), lifestyle behaviours (n=19), psycho-social outcomes (n=13), CVD complications (n=5), and death and hospital readmission (n=5). Thirty-four studies incorporated two or more outcomes, with 19 integrating only one. Conclusions Considering the significant impact of long COVID among individuals with pre-existing CVD, specially tailored clinical management is needed for members of this population. Additional studies on the impact of LC among those with CVD and other underlying conditions would also be beneficial.