Justin E. Trivax, MD: Cardiovascular Consequences of Long COVID-19

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The longterm effects of COVID-19, or "long COVID", has affected a wide variety of patients who are are now suffering from new or persistent symptoms weeks or months after infection.

In an interview with HCPLive, Justin E. Trivax, MD, Beaumont Health, discussed his recent presentation “Long-term Cardiovascular Consequences of COVID 19” from the 30th Beaumont Annual Cardiovascular Conference at Beaver Creek held last month.

At the conference, Trivax's talk focused on the symptoms associated with long COVID, or more specifically he noted, the post-acute sequelae of SARS-CoV-2. It touched on the theoretical reasons behind symptoms developing within 3 months of COVID-19 infection and lasting for at least 2 months in patients. He noted that about 80% of individuals with confirmed infection will have at least 1 symptom beyond 2 weeks after healing.

“The most important thing in patients who are complaining of symptoms after a COVID infection is ruling out other possible causes, we don't want to just say you're short of breath because you had COVID,” Trivax said. “We don't want to say you are having a fast heart rate, because you have COVID need to rule out persistent lung infection, pulmonary embolism, anemia, deconditioning, a whole variety of other things that can be going on before we say nope, this is long COVID.”

Trivax additionally spoke to the conversations surrounding mRNA vaccines role in myocarditis, noting that while there may be an abnormal cardiac MRI, there may not be evidence of myocarditis. On the other hand, while vaccine-related myocarditis is rare, Trivax highlighted the favorable outcomes of patients with the condition.

“The most important thing to know, however, is that the outcomes of patients with vaccine associated myocarditis are extremely favorable,” he said. “And in the literature, very few of those patients have to go to the ICU, very few have to be put on inotropic support, and days in the hospital range from zero to 10.”

Trivax further discussed vaccine-associated myocarditis related to the patient populations who have been affected, including young men with prior infection. He explained that although COVID is a disease “in its infancy,” there is progress being made and more data is necessary to find the answers.

He noted the challenges of studying COVID, but future randomized trials studying long COVID will help provide good answers for patients who are struggling.

“Now, we're starting to see larger populations and the issue with long COVID is that it took a while for us to get a formal definition of the disease state,” Trivax said. “And without a formal definition, it's quite difficult to enroll patients in trials. We need randomized trials in patients who have long COVID, to see what those best outcomes are.”

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