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Published on: November 5, 2021
Cardiovascular disease in SARS-CoV-2 infection
Kei Sato1,2, Jane E Sinclair3, Habib Sadeghirad4
1Critical Care Research Group The Prince Charles Hospital Brisbane QLD Australia.
Insights
COVID-19 (SARS-CoV-2) can cause new cardiovascular disease and worsen existing conditions. This review examines acute and long-term heart problems, aiding in identifying at-risk patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Pre-existing cardiovascular disease (CVD) is a major risk factor for severe COVID-19 outcomes.
- SARS-CoV-2 infection can precipitate new-onset acute and chronic cardiovascular conditions.
- Understanding these effects is crucial for patient management and prognosis.
Purpose of the Study:
- To review the current evidence on acute and long-term cardiovascular consequences of SARS-CoV-2 infection.
- To explore the mechanisms by which SARS-CoV-2 impacts cardiovascular health.
- To identify risk factors for long-term cardiovascular disease post-infection.
Main Methods:
- Literature review of studies on COVID-19 and cardiovascular disease.
- Analysis of reported acute cardiac complications (arrhythmia, myocarditis, heart failure).
- Assessment of potential long-term cardiovascular sequelae (hypertension, atherosclerosis).
Main Results:
- Acute cardiac complications are linked to increased in-hospital mortality.
- Mechanisms include direct viral damage and systemic inflammation.
- Long-term effects like hypertension and heart failure are emerging but require further characterization.
- Risk factors for long-term CVD are not well-defined.
Conclusions:
- SARS-CoV-2 poses significant risks for both acute and chronic cardiovascular disease.
- Further research is needed to elucidate long-term impacts and identify high-risk individuals.
- Targeted follow-up strategies are essential for patients experiencing cardiovascular complications after COVID-19.
Abstract:
Pre-existing cardiovascular disease (CVD) increases the morbidity and mortality of COVID-19 and is strongly associated with poor disease outcomes. However, SARS-CoV-2 infection can also trigger de novo acute and chronic cardiovascular disease. Acute cardiac complications include arrhythmia, myocarditis and heart failure, which are significantly associated with higher in-hospital mortality. The possible mechanisms by which SARS-CoV-2 causes this acute cardiac disease include direct damage caused by viral invasion of cardiomyocytes as well as indirect damage through systemic inflammation. The long-term cardiac complications associated with COVID-19 are incompletely characterised and thought to include hypertension, arrhythmia, coronary atherosclerosis and heart failure. Although some cardiac-related symptoms can last over 6 months, the effect of these complications on long-term patient health remains unclear. The risk factors associated with long-term cardiovascular disease remain poorly defined. Determining which patients are most at-risk of long-term cardiovascular disease is vital so that targeted follow-up and patient care can be provided. The aim of this review was to summarise the current evidence of the acute and long-term cardiovascular consequences of SARS-CoV-2 infection and the mechanisms by which SARS-CoV-2 may cause cardiovascular disease.
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