Sep. 16, 2025

Tackling the Enduring Cardiovascular Impact of COVID-19: New Guidance for Primary Care

A new clinical consensus statement addresses the "profound and lasting impact" of COVID-19 on cardiovascular health. This major report provides essential, evidence-based recommendations for primary care practitioners to diagnose, treat, and prevent these widespread complications

Authored by a group of experts from the European Society of Cardiology (ESC) and led by Professor Vassilios Vassiliou of the University of East Anglia, the statement is a critical response to the growing number of people worldwide experiencing serious cardiac effects from both acute COVID-19 infection and long COVID.

"COVID-19 doesn't only affect the lungs. It can also damage the heart and blood vessels, both during the acute infection and for months afterward," said Professor Vassiliou. "In the absence of clear guidance, patients are not receiving the care they need, and clinicians face significant uncertainty. This statement provides unified, practical recommendations for prevention, rehabilitation, and long-term care, while also identifying critical research gaps."

Key Takeaways for Primary Care

The report highlights several key areas for general practitioners and other primary care providers:

• Long-Term Cardiovascular Risk: Research shows that COVID patients, particularly those who required hospitalization, have an increased risk of long-term cardiovascular issues, including heart attack, stroke, and cardiac death.
• The Burden of Cardiac Long COVID: An estimated 5 million people worldwide are living with "cardiac long COVID," experiencing symptoms such as chest pain (angina), breathlessness, abnormal heart rhythms (arrhythmia), heart failure, and fatigue.
• The Crucial Role of Vaccination: The report strongly recommends the continuation of COVID-19 vaccination programs. Fully vaccinated individuals are far less likely to suffer cardiac complications or long COVID, even if they become infected.
• Cardiac Rehabilitation is Vital: Structured cardiac rehabilitation programs, which include specialized physiotherapy, are a cornerstone of preventing long-term problems and aiding recovery. The experts call for targeted financial investment to expand these services and ensure equitable access, especially for patients in rural areas.

Professor Vassiliou stressed the importance of a proactive approach in primary care. "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."

The expert consensus statement is a call to action for health systems to prepare for the ongoing burden of COVID-19 beyond the acute phase. It emphasizes the need for equitable access to rehabilitation, continued support for prevention through vaccination, and robust funding for research into long COVID and cardiovascular outcomes.