Perfect Storm: COVID-19 Associated Cardiac Injury and Implications for Neurological Disorders.

Catherine Ruth Jutzeler,Matthias Walter,Andrei Vasilievich Krassioukov,Thomas Edward Nightingale

doi:10.1089/neur.2020.0002

Abstract

Coronavirus disease 2019 (COVID-19) can lead to considerable lung damage and even death. Less is known about the effects of COVID-19 on the cardiovascular system. In their recent JAMA Cardiology article, Shi and colleagues reported an association between cardiac injury and higher risk of in-hospital mortality in patients with COVID-19. Approximately 20% (82 patients) of the study cohort presented with a cardiac injury. The investigators identified cardiac injury as an independent risk factor of mortality during hospitalization (52% with cardiac injury vs. 5% without cardiac injury, p < 0.001). Consequently, their findings are highly relevant for patients with pre-existing cardiovascular and cerebrovascular diseases. Among those are patients with neurological disorders. There is a considerable prevalence of myocardial injury in patients with acute neurological illness, which appears to adversely affect prognosis. Individuals with an underlying neurological disorder are particularly vulnerable to increased cardio-cerebrovascular disease risk due to physical limitations and the pathophysiology of their condition. Thus, we would like to specifically highlight the attention of health care professionals treating patients with pervasive neurological disorders to their potentially elevated risk of poorer COVID-19 related outcomes.

Highlights

Viral infections, such as coronavirus disease 2019 (COVID-19), can trigger respiratory infections that may lead to considerable lung damage and even death
Less is known about the effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, on the cardiovascular system
It is of utmost importance that the practice of social distancing is emphasized in these population groups and vulnerable individuals adhere to self-isolation practices to minimize transmission of the disease. These practices are relevant for individuals with neurological disorders given the increased prevalence and constellation of risk factors identified by Shi and colleagues as important for the prognosis of COVID-19 patients

Summary

Introduction

Viral infections, such as coronavirus disease 2019 (COVID-19), can trigger respiratory infections that may lead to considerable lung damage and even death. In their recent JAMA Cardiology article, Shi and colleagues shed light on the association between cardiac injury and a higher risk of in-hospital mortality in patients with laboratory-confirmed COVID-19.1 The investigators defined cardiac injury as high-sensitivity troponin I

Results

Conclusion