Cardiovascular involvement in COVID-19: not to be missed

Area of Science:

• Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• Emergence of SARS-CoV2 causing viral pneumonia and high mortality in patients with cardiovascular disease.
• SARS-CoV2 entry via ACE2 receptors impacts cardiovascular modulation and endothelial function.
• COVID-19 associated with coagulopathy, inflammation, and ventilation-perfusion mismatch.

Purpose of the Study:

• To discuss the influence of SARS-CoV2 infection on the cardiovascular system and hemodynamics.
• To highlight the importance of clinical management strategies during mechanical ventilation.
• To emphasize the need for monitoring microhemodynamic repercussions.

Main Methods:

• Review of clinical observations and known pathophysiological mechanisms of SARS-CoV2.
• Analysis of cardiovascular manifestations and coagulation disorders in COVID-19 patients.
• Discussion of mechanical ventilation strategies and hemodynamic monitoring.

Main Results:

• Significant prevalence of cardiovascular disease in fatal COVID-19 cases (20-35%).
• COVID-19 induces coagulopathy (high D-dimer, prolonged prothrombin time) and inflammatory conditions.
• Potential for non-ischemic myocardial injury and myocarditis due to severe infection and inflammation.

Conclusions:

• Invasive mechanical ventilation requires caution due to potential microhemodynamic effects.
• Monitoring central venous oxygen saturation during mechanical ventilation is recommended.
• Early clinical strategies and advanced therapies like ECMO may be necessary for severe cases.