# Long Covid - what's the prevalence and prognosis?

**URL:** <https://boards.straightdope.com/t/long-covid-whats-the-prevalence-and-prognosis/937157>\
**Category:** The Quarantine Zone\
**Tags:** covid-quarantine\
**Created:** [March 4, 2021, 8:31am UTC](https://boards.straightdope.com/t/long-covid-whats-the-prevalence-and-prognosis/937157 "2021-03-04T08:31:05Z")\
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**Author:** ![DavidNRockies](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/davidnrockies/32/6279_2.png) [@DavidNRockies](https://boards.straightdope.com/u/DavidNRockies)\
**Post date:** [December 22, 2021, 3:47pm UTC](https://boards.straightdope.com/t/long-covid-whats-the-prevalence-and-prognosis/937157/69 "2021-12-22T15:47:20Z")

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On another COVID thread, somewhere, I posted links to a couple of articles about long-COVID. The import was that significant inflammation (Cytokine Storm) was triggered by the virus, and that it doesn’t always resolve properly.

> **[Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently...](https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916)**
>
> This cohort study evaluates the presence of myocardial injury in unselected patients recently recovered from coronavirus disease 2019 (COVID-19).

> **[Cardiac inflammation in COVID-19: Lessons from heart failure](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505073/)**
>
> Cardiovascular disease (CVD) is the most common co-morbidity associated with COVID-19 and the fatality rate in COVID-19 patients with CVD is higher compared to other comorbidities, such as hypertension and diabetes. Preliminary data suggest that...

If the inflammation doesn’t resolve ‘normally,’ it can leave scar tissue (fibrosis) in place of healthy myocardium.

Think about blowing up a balloon. Now, think about sticking a balloon inside of a beer bottle, and _then_ trying to inflate it.

For a cohort of these long-COVID patients, their heart muscle has likely basically stiffened and become less able to properly relax.

These are _difficult_ findings to discern without a very high index of suspicion. Even cardiac MRI can miss it, because it can be a ‘diffuse’ process (ie, spread throughout the heart). The cMRI tends to best describe _differences._

Echocardiograms may elicit some abnormalities (again: requiring a high index of suspicion), but this kind of cardiac pathology can often only be diagnosed invasively, via Right Heart Catheterization and Endomyocardial Biopsy – not something routinely performed in ‘fairly healthy’ patients.

I haven’t looked to see if these studies have been repeated and the results reproduced, but my guess would be … this is still happening.

And the result can be tantamount to heart failure, though probably what’s called **[HFpEF](https://www.aafp.org/afp/2017/1101/p582.html#sec-1)** – Heart Failure with Preserved (ie, normal) Ejection Fraction.

And some cardiologists, seeing a patient with a normal ejection fraction, assume everything is normal.

Even when it decidedly is not.

DAMHIKT.

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