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Cardiac Manifestations in Patients with COVID-19: A Scoping Review

Sasha Peiris1,2, Pedro Ordunez3, Donald DiPette4

  • 1Incident Management Systems for COVID-19, Pan American Health Organization, Washington, DC, USA.

Global Heart
|February 17, 2022
PubMed

Insights

COVID-19 frequently impacts the heart, causing cardiac injury, arrhythmias, and acute coronary syndromes, particularly in severe cases. Further research is needed to clarify the role of viral infection versus inflammation and guide treatment.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19) primarily affects the lungs but frequently involves the heart.
  • Cardiac manifestations are prevalent in COVID-19 patients, impacting prognosis and outcomes.
  • Understanding these cardiac complications is crucial for managing COVID-19 patients.

Purpose of the Study:

  • To review the literature on cardiac manifestations in adult COVID-19 patients.
  • To summarize the frequency and types of cardiac complications associated with COVID-19.
  • To analyze clinical parameters, biomarkers, and pharmacotherapy outcomes related to cardiac involvement in COVID-19.

Main Methods:

  • A scoping review of systematic reviews was conducted.
  • Databases searched included Embase, PubMed, Epistomonikos, Medrxiv, and BioRxiv up to November 2020.
  • Sixty-three systematic reviews were included and their findings extracted.

Main Results:

  • Acute cardiac injury occurred in 15%–33% of patients.
  • Arrhythmias were more frequent in severe COVID-19 (33.0%–48.0%) compared to non-severe cases (3.1%–6.9%).
  • Acute coronary syndromes and myocarditis were also significant complications; Renin-angiotensin-aldosterone system inhibitors (RAASI) showed no association with COVID-19 outcomes.

Conclusions:

  • Cardiac injury, arrhythmias, myocarditis, and acute coronary syndrome are significant complications of COVID-19, linked to disease severity and mortality.
  • Further research is needed to differentiate between direct viral myocarditis and inflammation-induced cardiac injury.
  • Heterogeneous results from systematic reviews highlight the need for randomized trials to establish optimal pharmacotherapy.
Abstract

Keywords:
COVID-19ComplicationsHeartHeart DiseasesReview

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