Abstract
COVID-19 has shown significant morbidity with the involvement of multiple systems, including the cardiovascular system. Cardiovascular manifestations in the acute phase can include myocardial injury itself, myocardial infarction, venous thromboembolic events, myocarditis, Takotsubo syndrome, and different arrhythmic events. Myocardial injury defined by the rise of cardiac biomarkers in blood has been found in multiple studies with a prevalence of about 20%. Its presence is related to worse clinical outcomes and in-hospital mortality. The mechanisms of myocardial injury have been the subject of intense research but still need to be clarified. The characterization of the cardiac affectation with echocardiography and cardiac magnetic resonance has found mixed results in different studies, with a striking incidence of imaging criteria for myocarditis. Regarding post-acute and chronic follow-up results, the persistence of symptoms and imaging changes in recovered COVID-19 patients has raised concerns about the duration and the possible significance of these findings. Even though the knowledge about this disease has increased incredibly in the last year, many aspects are still unclear and warrant further research.
Highlights
Coronavirus disease 2019 (COVID-19) has become a community health issue, causing social and economic problems in almost all countries worldwide
This inflammatory environment led by a cytokine storm with interleukin 1 (IL-1), interleukin 6 (IL-6), and tumoral necrosis factor (TNF) could conduce to the rupture of previous stable atherosclerotic plaques or accelerate the atherogenic process
All the coagulation disturbances were described under the denomination of COVID-19 associated coagulopathy (CAC)
Summary
Coronavirus disease 2019 (COVID-19) has become a community health issue, causing social and economic problems in almost all countries worldwide. COVID-19 is caused by the severe acute respiratory syndrome coronavirus-2 (SARSCoV-2). The pathophysiologic mechanism of this virus was mainly related to an acute respiratory distress syndrome (ARDS) and systemic severe inflammatory reaction [3]. Information about the post-acute and chronic phases is still insufficient. It is unknown if cardiac involvement chronicthe phases still insufficient. It is unknown if cardiac during during acuteisphase of COVID-19 may have a clinical impact on theinvolvement long-term prognothe acute phaseworsening of COVID-19 may have a clinical impact on the long-term prognosis, includsis, including previous cardiac disease or developing new cardiac conditions ing worsening previous cardiac disease or developing new cardiac conditions (Figure 1)
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