Cardiac Implications of COVID-19 in Deceased and Recovered Patients: A Systematic Review
Rajaram Khanal1, Shreeyash Raj Bhattarai2, Kriti Basnet2
1Department of Cardiology, Manmohan Cardiothoracic Vascular and Transplant Center, Kathmandu, Nepal.
Insights
Coronavirus disease 2019 (COVID-19) commonly causes cardiac complications, including heart failure and arrhythmias, leading to significant mortality. Early cardiac biomarker monitoring is crucial for prognosis in COVID-19 patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) primarily affects the respiratory system, but cardiac implications are significant.
- Cardiac complications in COVID-19 patients are less understood compared to pulmonary issues.
Purpose of the Study:
- To investigate and summarize the cardiac implications of COVID-19.
- To highlight the association between COVID-19 and cardiovascular complications.
Main Methods:
- A systematic literature search was conducted on PubMed, PubMed Central, and Google Scholar.
- NHLBI Study Quality Assessment Tools were used to evaluate the risk of bias in observational and cross-sectional studies.
Main Results:
- All 14 selected studies demonstrated high quality (score ≥9).
- Cardiac complications are frequent in COVID-19 patients and are linked to increased mortality.
- Pre-existing cardiovascular diseases and diabetes mellitus worsen prognosis in COVID-19 patients.
- Elevated cardiac biomarkers (highly sensitive troponin I, creatinine, creatinine kinase-MB) on admission are indicative of poor prognosis.
Conclusions:
- Common cardiac complications include heart failure, myocardial injury, and arrhythmias.
- Continuous cardiac monitoring and prompt management of elevated cardiac markers are essential for COVID-19 patients.
- Understanding cardiac involvement is critical for comprehensive COVID-19 patient care.
Background:
Patients infected with coronavirus disease 2019 (COVID-19) present with various clinical presentations with majority of them developing pulmonary complications. This study focuses on cardiac implications of COVID-19 which are less discussed and thus will help to address cardiac implications of COVID-19.
Methods:
PubMed, PubMed Central, and Google Scholar were screened for articles which mentioned cardiac implications of COVID-19. NHLBI Study Quality Assessment Tools for the observational cohort and cross-sectional studies was used for assessing the risk of bias of our studies.
Results:
All 14 studies selected were good and had score of ≥9 by NHLBI Study Quality Assessment Tools. Cardiac complications of COVID-19 are common. They are associated with significant mortality. Also, people infected with COVID-19 with premorbid conditions such as cardiovascular diseases and diabetes mellitus have poor prognosis as compared to those without premorbid conditions. Cardiac biomarkers such as highly sensitive troponin I, creatinine, and creatinine kinase-MB on admission are good prognostic markers.
Conclusions:
Cardiac complications such as heart failure, myocardial injury, and arrhythmias are common among patients infected with COVID-19. Elevated cardiac markers and patients with cardiac complications require utmost care and continuous cardiac monitoring.
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