Abstract
Based on the clinical experience, it has been observed that when it comes to the impact of SARS-CoV-2 virus on the cardiovascular system, it is significant. In patients with COVID-19 infection, the development of myocarditis occurs a few days after the onset of fever. The mechanism of myocardial injury alone, as well as most pathologies caused by the SARS-CoV-2 virus, is the subject of research by many experts, but two basic ways can certainly be assumed: a direct toxic effect of SARS-CoV-2 on myocardial cells and another possible way of myocardial injury is to activate the innate immune response by releasing proinflammatory cytokines, as well as to activate the adaptive mechanisms of the autoimmune type by molecular mimicry. The approach to treatment is the same as for other viral myocarditis; it is non-specific, applied supportive treatment, such as anti-inflammatory drugs, low-dose corticosteroid therapy, and immunoglobulins. The aim of this review is to present the previous experiences of physicians around the world on the clinical presentation of myocarditis caused by COVID-19 infection, diagnostic and therapeutic approach in a specific situation of high-risk infection.
Highlights
In December 2019, when the first cases of pneumonia of an unknown case appeared in China, Hubei Province, in Wuhan City, nobody could even imagine what consequences this pneumonia would have on the infected individual, and especially on the whole world, given its rapid spread potential
The first study to describe “myocardial injury” caused by the SARS CoV-2 virus was that of Wuhan, which described that 5 of the first 41 patients with confirmed COVID-19 infection had significantly elevated levels of a highly sensitive troponin I> 28 pg/ml
One study found that 7% of deaths in patients with COVID-19 infection were associated with the development of myocarditis [12]
Summary
In December 2019, when the first cases of pneumonia of an unknown case appeared in China, Hubei Province, in Wuhan City, nobody could even imagine what consequences this pneumonia would have on the infected individual, and especially on the whole world, given its rapid spread potential. When there are 38 million patients globally and with the experiences of doctors around the world during the past months, we can write about the current knowledge in the approach to diagnosis and treatment of cardiovascular consequences. Acute respiratory disease COVID-19 (according to the coronavirus disease) is caused by a new coronavirus, which, according to the international taxonomy, is called SARS-CoV-2 virus. At the beginning of the pandemic, the SARS-CoV-2 virus was known to primarily cause a respiratory infection, whose disturbances span a wide range: from asymptomatic infection through acute respiratory infection to severe pneumonia with multiorgan failure. Based on the clinical experience, it was realized that when it comes to the impact of SARS-CoV-2 virus on the cardiovascular system, it is significant.
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