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COVID-19 and cardiovascular complications: updates of emergency medicine
Jianli Zhao1,2, Yaoli Xie1, Zhijun Meng1
1Emergency Medicine Department, Thomas Jefferson University, Philadelphia, PA, USA.
Insights
Coronavirus disease 2019 (COVID-19) significantly impacts cardiovascular health, increasing risks for patients with existing heart conditions. Early detection and adapted treatments are crucial for managing COVID-19's cardiac complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has led to a global pandemic with substantial morbidity and mortality.
- Severe COVID-19 cases often involve hypoxemia, hyper-inflammation, and cytokine storms, particularly affecting the lungs.
- Existing cardiovascular disease (CVD) is linked to severe COVID-19 symptoms and increased mortality, with elevated cardiac injury biomarkers.
Purpose of the Study:
- To review the latest clinical and research advancements regarding cardiovascular complications associated with COVID-19.
- To explore the potential mechanisms of SARS-CoV-2-induced cardiac injury.
- To offer perspectives on managing cardiac complications of COVID-19 within Emergency Medicine settings.
Main Methods:
- This is a review article, synthesizing current clinical and research findings.
- It focuses on reported associations between COVID-19 and cardiovascular disease.
- It discusses suspected etiologies of SARS-CoV-2-induced cardiac injury and treatment strategies.
Main Results:
- COVID-19 can induce or exacerbate cardiovascular conditions such as myocarditis, arrhythmia, acute coronary syndrome, cardiogenic shock, and venous thromboembolism.
- Suspected causes of cardiac injury include myocarditis, cytokine-mediated damage, microvascular injury, and stress-related cardiomyopathy.
- Vaccinations are effective in reducing overall mortality, but adapted treatment and monitoring of cardiac biomarkers are vital for at-risk populations.
Conclusions:
- COVID-19 presents significant risks for cardiovascular complications, even in patients without prior heart conditions.
- Understanding the mechanisms of cardiac injury is crucial for developing targeted treatments.
- Integrated management strategies, including monitoring cardiac biomarkers and adapted emergency care, are essential for improving outcomes in COVID-19 patients with cardiovascular involvement.
Abstract:
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and SARS-CoV-2 variants, has become a global pandemic resulting in significant morbidity and mortality. Severe cases of COVID-19 are characterized by hypoxemia, hyper-inflammation, cytokine storm in lung. Clinical studies have reported an association between COVID-19 and cardiovascular disease (CVD). Patients with CVD tend to develop severe symptoms and mortality if contracted COVID-19 with further elevations of cardiac injury biomarkers. Furthermore, COVID-19 itself can induce and promoted CVD development, including myocarditis, arrhythmia, acute coronary syndrome, cardiogenic shock, and venous thromboembolism. Although the direct etiology of SARS-CoV-2 induced cardiac injury remains unknown and under-investigated, it is suspected that it is related to myocarditis, cytokine-mediated injury, microvascular injury, and stress-related cardiomyopathy. Despite vaccinations having provided the most effective approach to reducing mortality overall, an adapted treatment paradigm and regular monitoring of cardiac injury biomarkers is critical for improving outcomes in vulnerable populations at risk for severe COVID-19. In this review, we focus on the latest progress in clinic and research on the cardiovascular complications of COVID-19 and provide a perspective of treating cardiac complications deriving from COVID-19 in Emergency Medicine.
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