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Cardiac involvement in COVID-19 patients: Risk factors, predictors, and complications: A review
Ghazal Aghagoli1, Benjamin Gallo Marin1, Luke B Soliman1
1Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Insights
COVID-19 (coronavirus disease) can significantly impact the heart, especially in patients with existing cardiovascular disease, leading to poorer outcomes. Further research is crucial for understanding cardiac effects and improving patient treatment.
Area of Science:
- Cardiology
- Infectious Diseases
- Pulmonology
Background:
- Respiratory complications are common in COVID-19.
- Cardiac involvement is increasingly recognized as a factor in severe COVID-19 outcomes.
- Pre-existing cardiovascular disease exacerbates COVID-19 severity and mortality.
Purpose of the Study:
- To review and synthesize current literature on the cardiac implications of COVID-19.
- To consolidate fragmented knowledge regarding cardiovascular disease in COVID-19 patients.
Main Methods:
- Systematic review of English-language literature.
- Focused search on papers detailing cardiac effects of COVID-19.
Main Results:
- COVID-19 patients with cardiovascular disease have higher ICU admission and mortality rates.
- Reported cardiac manifestations include acute pericarditis and left ventricular dysfunction.
- Evidence of acute myocardial injury and elevated troponin I levels observed in some patients.
- Limited data exists on myocardial protection during cardiac surgery for COVID-19 patients.
Conclusions:
- Current understanding of COVID-19 cardiac pathophysiology is fragmented.
- Further studies are essential for developing clear clinical guidelines.
- Improved understanding will lead to better treatment and patient outcomes.
Background:
Respiratory complications have been well remarked in the novel coronavirus disease (SARS-CoV-2/COVID-19), yet an emerging body of research indicates that cardiac involvement may be implicated in poor outcomes for these patients.
Aims:
This review seeks to gather and distill the existing body of literature that describes the cardiac implications of COVID-19.
Materials And Methods:
The English literature was reviewed for papers dealing with the cardiac effects of COVID-19.
Results:
Notably, COVID-19 patients with pre-existing cardiovascular disease are counted in greater frequency in intensive care unit settings, and ultimately suffer greater rates of mortality. Other studies have noted cardiac presentations for COVID-19, rather than respiratory, such as acute pericarditis and left ventricular dysfunction. In some patients there has been evidence of acute myocardial injury, with correspondingly increased serum troponin I levels. With regard to surgical interventions, there is a dearth of data describing myocardial protection during cardiac surgery for COVID-19 patients. Although some insights have been garnered in the study of cardiovascular diseases for these patients, these insights remain fragmented and have yet to cement clear guidelines for actionable clinical practice.
Conclusion:
While some information is available, further studies are imperative for a more cohesive understanding of the cardiac pathophysiology in COVID-19 patients to promote more informed treatment and, ultimately, better clinical outcomes.
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