Identifying novel therapeutic targets and implementing treatment in patients with cardiovascular phenotypes of post covid

We have recently discovered three cardiovascular phenotypes in post covid: Postural orthostatic tachycardia syndrome (POTS), unspecific sinus tachycardia and cardiac microvascular dysfunction. The pathophysiology and optimal treatment strategies for these remain unknown.

The overall aim is to characterize several biological aspects of the cardiovascular phenotypes to identify pathophysiological mechanisms (identifying novel therapeutic targets) and to conduct a series proof-of-concept randomized, placebo-controlled, double-blind, clinical trials (RCTs) using available interventions targeting putative mechanisms.Patients will be included from the post covid clinic at Karolinska University Hospital and the study will run 2022-2025.

In collaboration with several experts at Karolinska University Hospital and nationally, stress-perfusion cardiac magnetic resonance imaging (microvascular dysfunction), endothelial function studies and advanced assessment of dysautonomias (e.g. POTS) will be performed. Protein- and lipid biomarkers (proteomics and lipidomics; mass spectrometry) will be analyzed.

In parallel, proof-of-concept RCT using drugs with documented effect in similar diseases will be conducted. These RCTs will then serve as a foundation for future clinical studies targeting discovered mechanisms.

The result from this study may lead to rapid implementation of evidence-based treatment and discoveries of novel therapeutic targets in a large and underserved patient population.