Long-term Effects of COVID-19 on the Cardiopulmonary System in Adults and Children: Current Status and Questions to be Resolved by the NIH RECOVER Initiative.

Long COVID may occur in at least 10% of subjects recovering from severe acute respiratory syndrome coronavirus-2 (SARS-Co-V-2) infection and is often associated with debilitating symptoms. Among the organ systems that might be involved in its pathogenesis, the respiratory and cardiovascular systems may be central to common complaints seen in survivors of COVID including fatigue, dyspnea, chest pain, cough, and exercise intolerance. Understand the exact symptomatology, causes, and effects of Long COVID on the heart and lungs may help to discover new therapies. To that end, the National Institutes of Health (NIH) is sponsoring a national study population of diverse volunteers to support large-scale studies on the long-term effects of COVID-19. The NIH (REsearching COVID to Enhance Recovery) RECOVER Initiative is currently recruiting participants in the United States to answer critical questions about Long COVID. The study consists of adult and pediatric cohorts as well as an electronic health records (EHR) cohort. Based upon symptoms, individuals undergo prespecified medical testing to understand whether abnormalities can be detected and followed longitudinally. Here we outline current understanding of the clinical symptoms and pathophysiology of Long COVID with respect to the cardiopulmonary system in adults and children and then determine how the clinical, EHR, and autopsy cohorts of RECOVER will attempt the answer the most pressing questions surrounding the long-term effects of COVID-19. Summary- Data generated from RECOVER will provide guidance about missing gaps in our knowledge about Long COVID and how they might be filled by data gathered through RECOVER.

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