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The Pathogenesis and Long-Term Consequences of COVID-19 Cardiac Injury

Bhurint Siripanthong1, Babken Asatryan2, Thomas C Hanff3

  • 1School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.

JACC. Basic to Translational Science
|February 15, 2022
PubMed

Insights

Coronavirus disease (COVID-19) can cause heart damage through direct viral effects or indirect immune responses. Preliminary findings suggest potential long-term cardiac issues and rare post-vaccination myocarditis, particularly in young males.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Immunology

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with myocardial injury.
  • Mechanisms include direct viral invasion and indirect cellular damage via hypercoagulability and immune responses.
  • Preliminary data indicate potential long-term structural and functional cardiac changes in affected patients.

Purpose of the Study:

  • To summarize the mechanisms of COVID-19-related myocardial injury.
  • To highlight preliminary findings on long-term cardiac consequences.
  • To note the occurrence of myocarditis following COVID-19 vaccination.

Main Methods:

  • Review of existing literature and preliminary clinical data.
  • Analysis of reported cases of COVID-19 cardiac involvement.
  • Examination of data on post-vaccination myocarditis.

Main Results:

  • COVID-19 can lead to myocardial fibrosis, edema, and intraventricular thrombi.
  • Functional changes include left ventricular enlargement, reduced ejection fraction, and arrhythmias.
  • Post-vaccination myocarditis is rare but observed more frequently in young males.

Conclusions:

  • COVID-19 poses risks for myocardial injury with potential for lasting cardiac effects.
  • Further large-scale prospective studies are needed to validate these early findings.
  • Understanding these cardiac implications is crucial for patient management and public health.

Keywords:
CMR, cardiovascular magnetic resonanceCOVID-19COVID-19, coronavirus disease-2019CT, Computerized TomographyLGE, late gadolinium enhancementMI, myocardial infarctionSARS-CoV-2, severe acute respiratory syndrome coronavirus-2athletecardiovascular magnetic resonance imaginginflammationmyocardial injurymyocarditissudden cardiac deathtroponin

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