Cardiac Complications of COVID-19 in Low-Risk Patients
Akash Srinivasan1, Felyx Wong1, Liam S Couch2
1Department of Medicine, Faculty of Medicine, Imperial College London, London SW7 2AD, UK.
Insights
COVID-19 can cause serious heart problems, even in young, healthy people. This review covers acute and chronic cardiac issues, their causes, and ways to predict outcomes in low-risk individuals.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathophysiology
Background:
- The COVID-19 pandemic has caused millions of deaths globally.
- COVID-19 presents with diverse cardiovascular complications during acute and post-acute phases.
- Pre-existing cardiovascular disease increases susceptibility, but low-risk individuals are also affected.
Purpose of the Study:
- To review acute and chronic cardiac consequences of COVID-19 in low-risk patients.
- To explore the underlying pathophysiology of these cardiac complications.
- To discuss novel predictive factors for adverse outcomes.
Main Methods:
- Literature review of studies on COVID-19 and cardiovascular complications.
- Analysis of pathophysiological mechanisms including direct viral impact and cytokine storm.
- Identification and discussion of risk factors and predictive markers.
Main Results:
- COVID-19 is linked to myocarditis and pediatric inflammatory multisystem syndrome (PIMS) in the acute phase.
- Persistent cardiac symptoms are reported in post-COVID syndrome.
- Both direct viral effects via ACE2 and indirect inflammation contribute to cardiac damage.
Conclusions:
- COVID-19 poses significant cardiac risks beyond respiratory symptoms, affecting all age groups.
- Understanding pathophysiology is crucial for managing acute and chronic cardiac manifestations.
- Identifying predictive factors can improve outcomes for affected individuals.
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic has resulted in over 6 million deaths and significant morbidity across the globe. Alongside common respiratory symptoms, COVID-19 is associated with a variety of cardiovascular complications in the acute and post-acute phases of infection. The suggested pathophysiological mechanisms that underlie these complications include direct viral infection of the myocardium via the angiotensin-converting enzyme 2 (ACE2) protein and a cytokine release syndrome that results in indirect inflammatory damage to the heart. Patients with pre-existing cardiovascular disease and co-morbidities are generally more susceptible to the cardiac manifestations of COVID-19. However, studies have identified a variety of complications in low-risk individuals, including young adults and children. Myocarditis and paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS) are among the adverse events reported in the acute phase of infection. Furthermore, patients have reported cardiac symptoms persisting beyond the acute phase in post-COVID syndrome. This review summarises the acute and chronic cardiac consequences of COVID-19 in low-risk patients, explores the pathophysiology behind them, and discusses new predictive factors for poor outcomes.
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