Aguiar CEO, Costa JMC, Oliveira MMGL, Lopes CF, Lima PHM, Dietrich VC, Grenfell RFQ, de Melo FF. Cardiovascular burden of long coronavirus disease: Clinical challenges and emerging biomarkers. World J Cardiol 2026; 18(1): 112466 [DOI: 10.4330/wjc.v18.i1.112466]
Corresponding Author of This Article
Fabrício Freire de Melo, PhD, Professor, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, 58 Rua Hormindo Barros, Quadra 17, Lote 58, Vitória da Conquista 45029-094, Bahia, Brazil. freiremeloufba@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 26, 2026 (publication date) through Jan 15, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Cardiology
ISSN
1949-8462
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Aguiar CEO, Costa JMC, Oliveira MMGL, Lopes CF, Lima PHM, Dietrich VC, Grenfell RFQ, de Melo FF. Cardiovascular burden of long coronavirus disease: Clinical challenges and emerging biomarkers. World J Cardiol 2026; 18(1): 112466 [DOI: 10.4330/wjc.v18.i1.112466]
World J Cardiol. Jan 26, 2026; 18(1): 112466 Published online Jan 26, 2026. doi: 10.4330/wjc.v18.i1.112466
Cardiovascular burden of long coronavirus disease: Clinical challenges and emerging biomarkers
Carlos Eduardo Oliveira Aguiar, Juan Marcos Caram Costa, Marina Maria Gomes Leite Oliveira, Caio Ferraz Lopes, Pedro Henrique Melo Lima, Victoria Cenci Dietrich, Rafaella Fortini Queiroz Grenfell, Fabrício Freire de Melo
Carlos Eduardo Oliveira Aguiar, Juan Marcos Caram Costa, Marina Maria Gomes Leite Oliveira, Caio Ferraz Lopes, Pedro Henrique Melo Lima, Victoria Cenci Dietrich, Fabrício Freire de Melo, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
Rafaella Fortini Queiroz Grenfell, Department of Diagnosis and Therapy of Infectious Diseases and Cancer, Oswaldo Cruz Foundation, Belo Horizonte 30190-009, Minas Gerais, Brazil
Rafaella Fortini Queiroz Grenfell, Department of Infectious Diseases, University of Georgia, College of Veterinary Medicine, Athens, GA 30602, United States
Author contributions: Aguiar CEO, Costa JMC, Oliveira MMGL, Lopes CF, Lima PHM, and Dietrich VC researched the content and wrote the original draft; Aguiar CEO and Costa JMC developed the table and the figure; Aguiar CEO, as the first author, also systematized the text, developed the abstract, introduction, conclusion, and handled the guidelines for the preparation and submission of the review; de Melo FF and Grenfell RFQ reviewed the articles during the writing process, providing suggestions, and directing the research; de Melo FF, as the corresponding author, thoroughly reviewed the entire article; all authors contributed significantly to the production of the article and approved the final version to publish.
Supported by CNPq Research Productivity Fellowship, No. 309110/2025-4; and CNPq Research Grant, No. 445479/2023-0.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabrício Freire de Melo, PhD, Professor, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, 58 Rua Hormindo Barros, Quadra 17, Lote 58, Vitória da Conquista 45029-094, Bahia, Brazil. freiremeloufba@gmail.com
Received: July 28, 2025 Revised: October 5, 2025 Accepted: November 20, 2025 Published online: January 26, 2026 Processing time: 171 Days and 2.1 Hours
Abstract
Long coronavirus disease (LC) is a condition characterized by a persistent state, with recurrent/remitting or progressive episodes, that may affect one or multiple organ systems following severe acute respiratory syndrome coronavirus 2 infection. The cardiovascular system is particularly impacted by this condition. This review aims to discuss the cardiovascular implications in LC and its potential mechanisms. We offer an updated summary of established and emerging biomarkers with clinical potential for diagnosis, risk stratification, and therapy monitoring. Conventional markers with established clinical roles, such as cardiac troponins, natriuretic peptides (B-type natriuretic peptide/N-terminal pro-B-type natriuretic peptide), D-dimer, and inflammatory markers (e.g., C-reactive protein, interleukin-6), coexist with less established but promising biomarkers, such as growth differentiation factor-15, galectin-3, von Willebrand factor, endothelin-1, and circulating microRNAs. The incomplete understanding of the mechanisms and their diverse clinical manifestations, underscores the urgent need for efficient diagnostic tests and predictive models. In this context, besides the lack of standardization in biomarker testing and the absence of validated longitudinal predictive models, the use of biomarker-based strategies represents a potential tool to improve early detection of high-risk patients, enable personalized follow-up, and support more effective prevention of cardiovascular complications in LC patients in clinical practice.
Core Tip: Long coronavirus disease (LC) is often accompanied by continuing cardiovascular complications, yet objective tools for diagnosis, risk stratification, and therapeutic monitoring remain limited. This review explores unresolved mechanisms and critically examines the role of conventional and emerging biomarkers in the cardiovascular sequelae of LC. We provide a critical appraisal of evidence strength and highlight gaps in clinical translation, including assay standardization, accessibility, and validation. Finally, we propose multimarker strategies and omics-based approaches as promising tools to support personalized interventions and improve long-term cardiovascular outcomes in patients with LC within clinical practice.
