[2 years COVID-19 pandemic-What have we learned?]

Area of Science:

• Cardiology
• Infectious Diseases
• Virology

Background:

• The COVID-19 pandemic, caused by SARS-CoV-2, has evolved over two years with multiple waves and global superspreader events.
• SARS-CoV-2 is a rapidly mutating virus exhibiting diverse clinical presentations beyond respiratory infections.
• Cardiac and renal involvement, leading to conditions like myocarditis and pericarditis, presents both short-term and long-term health consequences.

Purpose of the Study:

• To summarize the evolving understanding of SARS-CoV-2 clinical phenotypes, particularly cardiac manifestations.
• To discuss the management of myocarditis and pericarditis in the context of acute COVID-19 infections and vaccinations.
• To provide guidance on preventive measures and personal protective equipment (PPE) for patients and healthcare professionals.

Main Methods:

• Review of clinical observations and experiences from Germany and worldwide regarding COVID-19 waves and superspreader events.
• Analysis of data concerning cardiac involvement, including elevated troponin levels and cardiac MRI findings.
• Evaluation of the efficacy of mRNA vaccination and non-pharmaceutical interventions.

Main Results:

• While direct myocarditis with myocytolysis is rare in autopsy or biopsy specimens, elevated troponin and suggestive cardiac MRI findings are more common.
• Myocarditis and pericarditis can occur as rare complications of both acute SARS-CoV-2 infection and vaccination.
• Complete double basic vaccination plus booster vaccination with mRNA vaccines is identified as the most effective preventive strategy.

Conclusions:

• Effective management strategies for cardiac complications of SARS-CoV-2 infection and vaccination have been developed.
• Adherence to preventive measures, including vaccination and the distancing-hygiene-mask-airing (DHMA) rule, is crucial for mitigating COVID-19 spread and its consequences.
• Accurate information on PPE and behavior is essential for both patients and medical personnel to navigate the pandemic effectively.