Cardiac involvement in COVID-19 patients: Risk factors, predictors, and complications: A review

J Card Surg. 2020 Jun;35(6):1302-1305. doi: 10.1111/jocs.14538. Epub 2020 Apr 19.

Abstract

Background: Respiratory complications have been well remarked in the novel coronavirus disease (SARS-CoV-2/COVID-19), yet an emerging body of research indicates that cardiac involvement may be implicated in poor outcomes for these patients.

Aims: This review seeks to gather and distill the existing body of literature that describes the cardiac implications of COVID-19.

Materials and methods: The English literature was reviewed for papers dealing with the cardiac effects of COVID-19.

Results: Notably, COVID-19 patients with pre-existing cardiovascular disease are counted in greater frequency in intensive care unit settings, and ultimately suffer greater rates of mortality. Other studies have noted cardiac presentations for COVID-19, rather than respiratory, such as acute pericarditis and left ventricular dysfunction. In some patients there has been evidence of acute myocardial injury, with correspondingly increased serum troponin I levels. With regard to surgical interventions, there is a dearth of data describing myocardial protection during cardiac surgery for COVID-19 patients. Although some insights have been garnered in the study of cardiovascular diseases for these patients, these insights remain fragmented and have yet to cement clear guidelines for actionable clinical practice.

Conclusion: While some information is available, further studies are imperative for a more cohesive understanding of the cardiac pathophysiology in COVID-19 patients to promote more informed treatment and, ultimately, better clinical outcomes.

Keywords: COVID-19; cardiac surgery; heart; respiratory failure; virus.

Publication types

  • Review

MeSH terms

  • Betacoronavirus
  • COVID-19
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cause of Death*
  • Comorbidity
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Disease Outbreaks / statistics & numerical data*
  • Female
  • Global Health
  • Humans
  • Male
  • Pandemics
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Prevalence
  • Risk Assessment
  • SARS-CoV-2
  • Severity of Illness Index
  • Survival Analysis