Graphical Abstract.

Central illustration depicting (A) Pathophysiological mechanisms underlying acute and chronic severe acute respiratory syndrome coronavirus 2-induced myocardial injury (including effects of vaccine) and its relation with timing of infection and onset of long COVID symptoms, (B) post-COVID-19 cardiovascular sequelae, (C) anticipated long-term cardiovascular complications and outcomes, and (D) the unpredictable trajectory of long COVID and its impact on mental health, ability to work, exercise tolerance, and potential to exacerbate the obesity epidemic. ACE2, angiotensin-converting enzyme 2; CCL, chemokine ligand; COVID, coronavirus disease; IL, interleukin; IFN, interferon; Ig, immunoglobulin; PCR, polymerase chain reaction; POTS, postural orthostatic tachycardia syndrome; RNA, ribonucleic acid; TNF, tumour necrosis factor.