Abstract
Coronavirus disease (COVID-19) caused by infection of SARS-CoV-2 as of April 2020 has been confirmed in more than 2.3 million people, with more than 150 thousands deaths across the globe. It has been known that COVID-19 patients with underlying cardiovascular diseases and its risks including: hypertension, diabetes, coronary artery disease, and cerebrovascular diseases may develop more severe respiratory track symptoms requiring intensive care. Some patients may presenting with myocarditis or acute cardiomyopathy, which has high mortality and morbidity. There was also evidence of myocardial Injury with an increase of troponin in one-third of those infected by covid-19. It is conceivable that among those who recover from COVID-19 infection, there is a risk of developing further cardiomypathy once the pandemic receding in the future. It is important to pay attention to this survivor group since the pandemic may be lasting for longer period. Optimal medical treatment and comprehensive prevention should be taken to manage those high risk patients of developing cardiomyopathy during hospital care as well post discharge. These includes provide best available COVID-19 drugs, cardiovascular medications, and social preventive measures.
Highlights
Coronavirus disease of 2019 (COVID-19) is caused by new strain of coronavirus named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[1]
The risk of Torsades de Pointes (TdP) increases in critical patients, Cardiomyopathy is a catasthropic condition of the heart leading for congestive heart failure (CHF), which increase risk of future mortality and morbidity.[4]
We can learn from animal experimental in the past looking for cardiac sequela of coronavirus family infection focusing on development of cardiomyopathy.[5]
Summary
Coronavirus disease of 2019 (COVID-19) is caused by new strain of coronavirus named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).[1]. To assess cardiac involvement in COVID-19 patients laboratory testing for troponin and NT pro-BNP is required.[12] The other essential tests especially for those requiring hospital care might be including: C-reactive protein (CRP), ferritin, Ddimer, IL-6, and LDH, which were known elevated as response to SARS-CoV-2 The presence of these inflammatory biomarkers are associated with poor prognosis.13 - Echocardiography. 7,12,13 For severe COVID-19 with possible cardiac involvement optimal supportive care is very important These include: - Volume status and fluid resuscitation should be performed cautiously to avoid increase load in possible cardiomyopathy patients - Maintaning targeted MAP by using proper inotropics if necessary - Mechanical support /ECMO might be required in those with failing heart such as those with acute cardiomyopathy.[13]. Further study should be needed to resolve this issues
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