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Acute myocardial injury in patients with COVID-19: Possible mechanisms and clinical implications

Iulia Rusu1, Malina Turlacu1, Miruna Mihaela Micheu2

  • 1Department of Cardiology, Clinical Emergency Hospital of Bucharest, Bucharest 014461, Romania.

World Journal of Clinical Cases
|February 7, 2022
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes myocardial injury (MI) in COVID-19 patients, increasing mortality risk. Understanding the mechanisms of SARS-CoV-2-induced MI is crucial for developing targeted therapies.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pathophysiology

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacts multiple organs, including the cardiovascular system.
  • Myocardial injury (MI) is a significant complication of coronavirus infectious disease 2019 (COVID-19), linked to poor outcomes and increased mortality.
  • Manifestations of COVID-19-related MI include myocarditis, stress cardiomyopathy, acute coronary syndrome, and pulmonary embolism.

Purpose of the Study:

  • To review the current understanding of potential mechanisms underlying COVID-19-induced MI.
  • To discuss advancements in therapeutic strategies for managing MI in COVID-19 patients.

Main Methods:

  • Literature review of studies investigating SARS-CoV-2 and cardiovascular complications.
  • Analysis of proposed pathophysiological pathways for myocardial injury.
  • Synthesis of current therapeutic approaches and future directions.

Main Results:

  • Multiple mechanisms contribute to COVID-19-related MI, including direct viral invasion and indirect inflammatory/thrombotic pathways.
  • The interaction with angiotensin I converting enzyme 2 (ACE2) and endothelial dysfunction are implicated.
  • Understanding these mechanisms is key to developing effective treatments.

Conclusions:

  • COVID-19 poses a significant threat to cardiovascular health, with MI being a critical concern.
  • Further research into the complex mechanisms of SARS-CoV-2-induced MI is warranted.
  • Targeted therapeutic strategies are needed to mitigate cardiovascular complications and improve patient outcomes.

Keywords:
Acute coronary syndromeCoronavirus infectious diseaseMyocardial injuryMyocarditisPulmonary embolismSARS-CoV-2Stress cardiomyopathy

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