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REVIEW article

Front. Cardiovasc. Med.

Sec. General Cardiovascular Medicine

Cardiovascular damage and comorbidities related to long COVID: pathomechanisms, prevention, and therapy

Provisionally accepted
Miroslava KvandovaMiroslava Kvandova1Peter BalisPeter Balis1Barbora KalocayovaBarbora Kalocayova2,3Jana VlkovicovaJana Vlkovicova2Silvia DobrodenkovaSilvia Dobrodenkova4Angelika PuzserovaAngelika Puzserova1*
  • 1Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
  • 2Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, Bratislava, Slovakia
  • 3Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia
  • 4Travel Health Clinic, Bratislava, Slovakia

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Long COVID (LC) is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-associated chronic condition and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems, including cardiovascular. Extensive literature supports an association between SARS-CoV-2 infection and cardiovascular complications and increased cardiovascular risk after infection. The cardiovascular sequelae after SARS-CoV-2 infection have not yet been comprehensively characterized. A growing body of evidence suggests that endothelial dysfunction is a central mechanism in COVID-19 and has also been identified as a key pathogenic mechanism in LC. Although considerable progress has been made in characterizing the epidemiology, clinical course, and biology of LC, many questions remain unanswered. The incomplete understanding of the pathomechanisms of LC has hampered the development of targeted therapies to date. Further research and data are needed to develop effective therapeutic and preventive tools. Based on current literature this review aims to provide an up-to-date overview of the pathomechanisms affecting the cardiovascular system and the potential role of selected micronutrients, vitamins and minerals, and flavonoids as preventive and therapeutic strategies in LC.

Keywords: COVID-19, Endothelium, endothelial dysfunction, Flavonoids, Micronutrients, post-COVID, epicatechin, Vitamins

Received: 23 Jul 2025; Accepted: 19 Nov 2025.

Copyright: © 2025 Kvandova, Balis, Kalocayova, Vlkovicova, Dobrodenkova and Puzserova. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Angelika Puzserova, angelika.puzserova@savba.sk

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material