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Effect of coronavirus infection on the human heart: A scoping review
Jamie Sy Ho1, Paul A Tambyah2,3, Andrew Fw Ho4,5,6
1School of Clinical Medicine, University of Cambridge, UK.
Insights
Coronaviruses can significantly impact cardiovascular health, leading to conditions like myocardial injury and arrhythmias, especially in patients with existing heart disease. Understanding these interactions is crucial for managing COVID-19 and other coronavirus infections.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- The global COVID-19 pandemic underscored the critical link between coronavirus infections and cardiovascular health.
- Individuals with pre-existing cardiovascular comorbidities face more severe disease outcomes.
- Cardiac manifestations include myocardial injury, arrhythmias, and heart failure.
Purpose of the Study:
- To systematically review and summarize current knowledge on the cardiovascular effects of human coronavirus infections.
- To elucidate the mechanisms by which coronaviruses impact cardiovascular function.
- To understand the interaction between coronaviruses and pre-existing cardiovascular diseases.
Main Methods:
- A systematic review of 135 studies was conducted.
- Searched major databases including MEDLINE, EMBASE, CENTRAL, Scopus, and Web of Science.
- Included studies on SARS, MERS, COVID-19, and other coronaviruses, primarily case reports, case series, and cohort studies.
Main Results:
- Cardiac manifestations such as tachycardia, bradycardia, arrhythmias, and myocardial injury were reported.
- Cardiac injury and arrhythmias are more prevalent in COVID-19 patients.
- Elevated cardiac markers correlate with ICU admission and mortality; comorbidities increase severe outcomes.
Conclusions:
- Coronaviruses exert significant effects on cardiovascular function.
- Interactions between coronavirus infections and pre-existing cardiovascular diseases are complex and impactful.
- Further research is needed to fully understand and manage these cardiovascular implications.
Background:
The global coronavirus disease 2019 pandemic has highlighted the importance of understanding the cardiovascular implications of coronavirus infections, with more severe disease in those with cardiovascular co-morbidities, and resulting cardiac manifestations such as myocardial injury, arrhythmias, and heart failure.
Design:
A systematic review of the current knowledge on the effects of coronavirus infection on the cardiovascular system in humans was performed and results were summarized.
Methods:
Databases such as MEDLINE, EMBASE, CENTRAL, Scopus, Web of Science, ClinicalTrials.gov, Chinese Knowledge Resource Integrated Database and Chinese Clinical Trial Registry were searched on 20 March 2020.
Results:
In total, 135 studies were included, involving severe acute respiratory syndrome, Middle East respiratory syndrome, coronavirus disease 2019 and other coronaviruses. Most were case reports, case series and cohort studies of poor to fair quality. In post-mortem examinations of subjects who died from infection, around half had virus identified in heart tissues in severe acute respiratory syndrome, but none in Middle East respiratory syndrome and coronavirus disease 2019. Cardiac manifestations reported include tachycardia, bradycardia, arrhythmias, and myocardial injury, secondary to both systemic infection and treatment. Cardiac injury and arrhythmias are more prevalent in coronavirus disease 2019, and elevated cardiac markers are associated with intensive care unit admission and death. In severe acute respiratory syndrome, Middle East respiratory syndrome, and coronavirus disease 2019, comorbidities such as hypertension, diabetes mellitus, and heart disease are associated with intensive care unit admission, mechanical ventilation, and mortality. There were cases of misdiagnosis due to overlapping presentations of cardiovascular diseases and coronavirus infections, leading to hospital spread and delayed management of life-threatening conditions.
Conclusion:
This review highlighted the ways in which coronaviruses affect cardiovascular function and interacts with pre-existing cardiovascular diseases.
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