Cardiovascular disease prevention and management in COVID-19: a clinical consensus statement of the European Association of (...), 2025, Vassiliou et

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Full title: 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

Vassilios S Vassiliou, Vasiliki Tsampasian, Maria Luiza Luchian, Flavio D’Ascenzi, Fabrizio D’Ascenzo, Marc R Dweck, Javier Escaned, Sabiha Gati, Martin Halle, Konstantinos C Koskinas, Lis Neubeck, Michael Papadakis, Steffen E Petersen, Arsen Ristic, Marco Metra, Giuseppe Biondi-Zoccai

Abstract​

The coronavirus-associated disease 2019 (COVID-19) pandemic has posed significant challenges due to the complex interplay between SARS-CoV-2 infection and cardiovascular disease. COVID-19 can trigger and exacerbate cardiovascular complications, observed both during the acute phase of infection and in the post-acute phase, with some individuals developing long-term sequelae collectively termed Long COVID. Additionally, reinfection and adverse reactions to COVID-19 vaccines may contribute to cardiovascular events.

This clinical consensus statement, developed by associations of the European Society of Cardiology, aims to provide a comprehensive overview of cardiovascular prevention strategies across all stages of COVID-19. These include addressing cardiovascular risk associated with acute infection, prior infection, Long COVID, reinfection, and post-vaccination events. Key recommendations focus on preventing and managing cardiovascular manifestations in patients with acute or prior COVID-19, implementing targeted cardiovascular rehabilitation, and introducing interventions to mitigate the severity of Long COVID. The document also emphasizes lifestyle modifications and personalized therapeutic approaches to enhance patient outcomes.

Given the evolving nature of COVID-19 and its long-term cardiovascular implications, ongoing research is crucial to address existing knowledge gaps, optimize preventive strategies, and improve patient care. Future studies should prioritize the individualization of preventive measures for diverse populations, refine rehabilitation strategies, and advance long-term cardiovascular care, ensuring that evidence-based practices continue to evolve alongside emerging data.

Open access: https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwaf540/8255559
 
www.eurekalert.org

Major report tackles Covid’s cardiovascular crisis head-on

A major report recommends regular Covid vaccinations to reduce cardiac risks associated with the virus. Millions of people around the world are suffering with serious cardiovascular problems caused by Covid infection and long Covid. The report, to be published later this week, sets out ways of...
www.eurekalert.org

News Release 17-Sep-2025

Major report tackles Covid’s cardiovascular crisis head-on​

Peer-Reviewed Publication
University of East Anglia


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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

Prof Vassiliou, from UEA’s Norwich Medical School, said: “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.”

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

Journal​

European Journal of Preventive Cardiology

Method of Research​

Systematic review

Subject of Research​

People

Article Title​

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

Article Publication Date​

18-Sep-2025
 
www.eurekalert.org

Major new report sets out how to tackle the ‘profound and lasting impact’ of COVID-19 on cardiovascular health

Covid infection and long Covid have serious effects on the heart and blood vessels, and the pandemic has had a widespread and lasting impact on cardiovascular health. A set of expert recommendations explain how these conditions should be diagnosed, treated and prevented. Cardiac...
www.eurekalert.org

News Release 17-Sep-2025

Major new report sets out how to tackle the ‘profound and lasting impact’ of COVID-19 on cardiovascular health​

Peer-Reviewed Publication
European Society of Cardiology


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Key take-aways:

  • Covid infection and long Covid have serious effects on the heart and blood vessels, and the pandemic has had a widespread and lasting impact on cardiovascular health.
  • A set of expert recommendations explain how these conditions should be diagnosed, treated and prevented.
  • Cardiac rehabilitation is vital for Covid and long Covid patients, but many do not have access to rehabilitation programmes.
  • Vaccination reduces the cardiac risks of Covid, so vaccination programmes must continue.


Millions of people around the world are suffering with the serious cardiovascular effects of Covid infection and long Covid. A lack of clear 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.



A major report published in the European Journal of Preventive Cardiology [1] today (Thursday), sets out how to address this growing problem through diagnosis, treatment, rehabilitation and vaccination.



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



Professor Vassiliou said: “Covid-19 has a profound and lasting impact on cardiovascular health, with complications emerging during acute illness, recovery, and even after reinfections or vaccination. In the absence of clear evidence-based guidance, patients risk harmful treatments and clinicians face uncertainty.



“This statement 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.”



To prepare the report, the expert group reviewed all the existing research on Covid-19 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 on how to treat or prevent the damaging cardiovascular effects of Covid.



Almost one billion people are known to have been infected with Covid-19 worldwide, although the true number is believed to be far higher, and 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.



Researchers estimate that around of 100 million people are currently living with long Covid, and about 5% of these (five million) will 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.



The expert consensus statement includes advice to continue vaccinating against Covid-19, as people who are fully vaccinated are far less likely to suffer cardiac complication or long Covid, even if they develop a Covid infection. They also set out how to diagnose and treat the symptoms brought on by Covid, such as shortness of breath, chest pain and fainting. 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.



Professor Vassiliou said: “Covid doesn’t only 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.”



Finally, the experts call for equal access to cardiac rehabilitation programmes, especially for people living in rural locations. Professor Vassiliou explained: “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. 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.”



ENDS



Contact: 

ESC Press Office

Tel: +33 (0)6 61 40 1884
Email: press@escardio.org

Follow us on Twitter @ESCardioNews 



Funding: None



Disclosures: VSV received speaker fees from Novartis and a grant for investigator-initiated research from B Braun Ltd. LS received speaker fee Daiichi Sankyo. SPE received consultancy fees from Circle Cardiovascular Imaging, Inc., Calgary, Alberta, Canada. MM received consultancy fees from Abbott structural, Astra-Zeneca, Bayer, Cytokinetics, Edwards LifeSciences, Roche Diagnostics, NovoNordisk. GBZ received consultancy fees from Abiomed, Advanced Nanotherapies, Aleph, Amarin, Balmed, Cardionovum, Crannmedical, Endocore Lab, Eukon, Guidotti, Innovheart, Meditrial, Menarini, Microport, Opsens Medical, Terumo, and Translumina.
All the other authors report no conflicts of interest.



Reference:

Please acknowledge the European Journal of Preventive Cardiology as a source in any articles.

[1] ‘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’, by Vassilios S Vassiliou1 et al, European Journal of Preventive Cardiology, doi: 10.1093/eurjpc/zwaf540



Journalists can download an embargoed pdf of the full research paper and editorial from the European Journal of Preventive Cardiology before the publication date here.

N.B. Journalists: please don’t use this link in any stories that you publish. It is for the exclusive use of the media BEFORE publication. After publication the paper will be replaced, so please provide the following permanent link to the published research paper on the European Journal of Preventive Cardiology website in your stories:

https://academic.oup.com/eurjpc/article-lookup/doi/10.1093/eurjpc/zwaf540





When obtaining outside comment, journalists are requested to ensure that their contacts are aware of the embargo on this release.



About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.



The European Journal of Preventive Cardiology (EJPC) is an official, international, peer-reviewed, journal of the European Association of Preventive Cardiology (EAPC), an association of the European Society of Cardiology (ESC). It is published on behalf of the ESC by Oxford Journals, a division of Oxford University Press.

Journal​

European Journal of Preventive Cardiology

DOI​

10.1093/eurjpc/zwaf540

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This is delusional. Just straight up loony bin. They have no evidence for their claims about rehabilitation, and the idea that this many people will go through such programs is ludicrous. No one has the capacity for this, the budgets don't exist, and they don't even know what to do. It would be massively expensive, and it's an ongoing problem so it's impossible to even process more than a fraction.

All for something that doesn't even work, has no evidence of working. And they call this evidence-based medicine. They recognize the problem, but completely Glonzo it, invent some fake alternative interpretation of what it's about. It's beyond obvious how the problems modern medicine faces are too complex for them to manage. They've completely lost sight of things.

Plus:
The paper said:
Researchers estimate that around of 100 million people are currently living with long Covid, and about 5% of these (five million) will 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.
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I know this is focused on cardiology, sure, but this is exactly what has been done so far for everyone, IT DOESN'T WORK, and still everyone with Long Covid is totally being abandoned with nothing to show for it while they're fooling around. They can't even tell them apart. Really, they just have no idea what they're even talking about here:
It is also essential for those reporting chronic fatigue at rest or exercise intolerance during low physical activity levels.
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"Imagine a world"-based medicine:
In such cases, rehabilitation aims to restore cardiopulmonary function and improve exercise capacity through a structured programme incorporating exercise, education, lifestyle interventions (e.g. healthy nutrition and smoking cessation) and optimal pharmacological management.
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It aims to do that. It sets it as a goal. But it doesn't actually do that here, this is not the problem. Everything based on intent, not on outcomes.
The rehabilitation process should focus on gradual physical reconditioning, psychological support, and adherence to pharmacological therapies
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The problem is not deconditioning. We have been through 5 years of this and they're still buying and selling magic beans.

We have pretty much reached the point where AI medicine is no longer necessary to simply move forward and make progress, we are the point where it has become necessary simply because medicine itself is becoming dangerously out of touch with reality and massively regressing in too many places. We need machine intelligence to keep human folly from harming millions. The future is so damn ridiculous.
 
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