Covid-19 and Heart Involvement: A Systematic Review of Literature

Abstract

Background: Recent reports in the literature have indicated that infection by coronavirus disease 2019 (COVID-19) causes cardiac complications, such as heart failure, arrhythmia, myocardial infarction, and even fulminant myocarditis. These complications have been identified as the cause of death in some patients infected with SARS-CoV-2. Objectives:To analyze echocardiographic and electrocardiographic changes, treatments used, and clinical outcomes in patients with myocarditis and COVID-19. Methods:The items described for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. This review included articles in English, Portuguese, and Spanish that reported cardiac involvement, injury, or myocardial inflammation in patients who acquired COVID-19 (SARS-CoV-2).Results: Five databases were consulted to find 1,726 articles. After applying the eligibility criteria, a total of 22 studies were considered qualified. ST-segment (section of the electrocardiogram corresponding the end of the S wave to the beginning of the T wave) elevation and tachyarrhythmia were the most common changes found in the electrocardiographic analysis of patients affected with COVID-19. Concerning echocardiography, there was a high frequency of decreased ejection fraction and occurrence of pericardial effusion. Conclusion:This systematic review provides a potential tool for the analysis of cardiac changes and implications caused in patients affected by SARS-CoV-2 infection, with emphasis on the presence of tachyarrhythmia on electrocardiogram (ECG) and decreased ejection fraction on echocardiogram.

Iniciativas Brasileiras Lideram com Forte Cooperação Científica para Enfrentar Questões da COVID-19: O Caso da Coalizão COVID-19 Brasil

“…One of the major complications associated with COVID-19 is thromboembolic events, which can have serious consequences for patients. 6 In this context, the CARE study aims to investigate the potential benefits of antithrombotic prophylaxis with rivaroxaban in COVID-19 outpatients. 7 The rationale for this study is based on previous evidence that suggests that COVID-19 infection can cause direct damage to endothelial cells and lead to a procoagulant state.…”

Cardiac Involvement in COVID-19: A Matter Close to the Heart, Beyond the Acute Illness

“…3 Moraes et al, in this systematic review of literature, consolidate the findings described as myocarditis, ventricular dysfunction, cardiogenic shock, takotsubo cardiomyopathy, and sudden cardiac death due to association with ventricular arrhythmias. 4 However, other outcomes linked to more significant morbidity are still not completely understood. In other words, what can and what should we expect from recovered cases?…”

“…Thus, patients with positive troponins, myocardial dysfunction, and severe arrhythmia/ electrocardiographic alterations not explained by other methods may be candidates for CMR. 4,7 Another crucial point is the concept of long COVID characterized by the persistence of COVID-19 symptoms beyond 3 months, not explained by any other illness. Cardiopulmonary symptoms such as chest pain, shortness of breath, fatigue, autonomic manifestation as postural orthostatic tachycardia syndrome, and palpitations are frequently observed.…”