- SARS-CoV-2 viral persistence was found in the left ventricle of decedents with Long COVID cardiac symptoms.
- Cardiac Long COVID (CLC) was significantly more common in cases with viral persistence (82%) compared to those without (37%).
- Viral persistence was associated with structural heart changes, including higher heart-weight-to-wall-thickness ratios and LV dilatation.
- Gene expression analysis revealed significant alterations in 44 genes related to inflammation, particularly interferon regulatory factor 4 (IRF4).
- The findings suggest viral persistence may drive structural and immune changes underlying cardiac Long COVID symptoms.