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Published on: April 7, 2015
Cardiac complications in community-acquired pneumonia and COVID-19
1Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Insights
Community-acquired pneumonia (CAP) significantly increases the risk of cardiovascular events, including heart attack and heart failure. These cardiac complications contribute to both short-term and long-term mortality in patients with pneumonia.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Community-acquired pneumonia (CAP) is a major global health concern associated with significant morbidity and mortality.
- A substantial proportion of hospitalized CAP patients experience cardiovascular events, including arrhythmias, heart failure, and myocardial infarction.
- These cardiac events are linked to both in-hospital and long-term mortality following CAP diagnosis.
Purpose of the Study:
- To review the cardiovascular complications associated with community-acquired pneumonia (CAP).
- To explore the pathogenic mechanisms underlying cardiac events in CAP, focusing on *Streptococcus pneumoniae* and COVID-19.
- To differentiate the impact of various pathogens on cardiovascular outcomes in CAP.
Main Methods:
- Literature review of studies on cardiovascular events in CAP.
- Focus on research investigating pathogenic mechanisms of cardiac events in pneumococcal and COVID-19 CAP.
- Exclusion of COVID-19 in initial review, followed by separate discussion.
Main Results:
- CAP is strongly associated with an increased risk of cardiovascular events.
- Mechanisms linking *Streptococcus pneumoniae* and SARS-CoV-2 to cardiovascular events have been identified.
- Cardiac events in CAP contribute significantly to patient mortality beyond hospitalization.
Conclusions:
- Cardiovascular complications are a critical aspect of CAP management and prognosis.
- Understanding the mechanisms of cardiac injury in CAP is essential for developing targeted therapies.
- Addressing cardiovascular risks is crucial for improving long-term outcomes in CAP survivors.
Abstract:
Community-acquired pneumonia (CAP) remains a global health problem with significant morbidity and mortality. Much recent published literature about the infection has indicated that a substantial number of patients with CAP, particularly those ill enough to be admitted to hospital, will suffer a cardiovascular event. While these may include events such as deep venous thrombosis and stroke, most of the events involve the heart and include the occurrence of an arrhythmia (most commonly atrial fibrillation), new onset or worsening of heart failure and acute myocardial infarction. While such cardiac events may occur, for example, in all-cause CAP and CAP due to influenza virus infection, and more recently described with the SARS-CoV-2 pandemic, a significant amount of research work has been investigating the pathogenic mechanisms of these cardiac events in patients with CAP due to Streptococcus pneumoniae (pneumococcus) and, more recently, COVID-19 infections. Such research has identified a number of mechanisms by which these microorganisms may cause cardiovascular events. Importantly, these cardiac events appear not only to be associated with in-hospital mortality, but they also appear to contribute to longer-term mortality of patients with CAP, even after their discharge from hospital. This review will focus initially on studies of cardiovascular events in all-cause CAP and pneumococcal CAP, excluding COVID-19 infection, and then address similar issues in the latter infection.
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