Pre-existing cardiovascular disease was not associated with worse PASC symptoms or functional capacity but was linked to impaired post-COVID quality of life (p=0.007).
Does pre-existing cardiovascular disease augment the symptoms, quality of life, and functional capacity in patients with post-acute sequelae of SARS-CoV-2?
Pre-existing cardiovascular disease does not worsen the physical symptoms or functional capacity of long COVID, but is associated with worse quality of life and elevated cardiovascular biomarkers.
Abstract Background Acute SARS-CoV-2 infection has been associated with cardiovascular disease (CVD), but the role of CVD in Post-Acute Sequelae (PASC) remains unclear. Establishing this interaction between CVD and the manifestations of PASC bears important considerations for early identification and prevention of severe cardiovascular complications. Objective We sought to examine the role of CVD on the symptoms, quality of life (QoL), functional capacity, and cardiovascular phenotypes of PASC. Methods Symptomatic PASC was identified online in Australian communities. Those 3 months from SARS-CoV-2 diagnosis were investigated for symptoms, comorbidities, functional capacity (DASI), depression (PHQ-9), and QoL (AQoL). A subset completed haematology (cardiac troponin cTn and lipid profile; n=199), 6-minute walk test (6MWD; n=351), and vitals (n=343), to assess the utility of biomarkers and objective phenotypes in PASC, respectively. Results 668 PASC sufferers (55±11 years, 70% female, 92% white, 70% employed) completed all relevant surveys. The most prevalent symptoms were fatigue (n=492, 73.7%), dyspnoea (n=326, 48.8%), palpitations (n=194, 29.0%), and chest pain (n=167, 25.0%), with other symptoms infrequent (25%). Those with pre-existing CVD (n=283, 42.4%) had similar functional capacity, 6MWD, fatigue, dyspnoea, chest pain and palpitations. Systolic BP and cTn were elevated with prior CVD (p0.001). Post-Covid QoL was impaired in those with prior CVD (p=0.007). Conclusion Prior CVD is common and unrelated to PASC symptoms and functional capacity, but may exacerbate impaired QoL due to PASC.Table 1
Smith et al. (2025) studied this question. Pre-existing cardiovascular disease was not associated with worse PASC symptoms or functional capacity but was linked to impaired post-COVID quality of life (p=0.007).