Cardiac manifestations in COVID‐19 patients—A systematic review

Abstract

Objectives The coronavirus disease‐2019 (COVID‐19) pandemic has resulted in the worst global pandemic of our generation, affecting 215 countries with nearly 5.5 million cases. The association between COVID‐19 and the cardiovascular system has been well described. We sought to systematically review the current published literature on the different cardiac manifestations and the use of cardiac‐specific biomarkers in terms of their prognostic value in determining clinical outcomes and correlation to disease severity. Methods A systematic literature review across PubMed, Cochrane database, Embase, Google Scholar, and Ovid was performed according to PRISMA guidelines to identify relevant articles that discussed risk factors for cardiovascular manifestations, cardiac manifestations in COVID‐19 patients, and cardiac‐specific biomarkers with their clinical implications on COVID‐19. Results Sixty‐one relevant articles were identified which described risk factors for cardiovascular manifestations, cardiac manifestations (including heart failure, cardiogenic shock, arrhythmia, and myocarditis among others) and cardiac‐specific biomarkers (including CK‐MB, CK, myoglobin, troponin, and NT‐proBNP). Cardiovascular risk factors can play a crucial role in identifying patients vulnerable to developing cardiovascular manifestations of COVID‐19 and thus help to save lives. A wide array of cardiac manifestations is associated with the interaction between COVID‐19 and the cardiovascular system. Cardiac‐specific biomarkers provide a useful prognostic tool in helping identify patients with the severe disease early and allowing for escalation of treatment in a timely fashion. Conclusion COVID‐19 is an evolving pandemic with predominate respiratory manifestations, however, due to the interaction with the cardiovascular system; cardiac manifestations/complications feature heavily in this disease, with cardiac biomarkers providing important prognostic information.

Acute Pericarditis and Pericardial Effusion in a Hypertensive COVID-19 Patient

“…Risk estimation of cardiovascular manifestations can be performed by evaluating cardiac risk factors and comorbidities of an infected patient [ 6 ]. Preexisting cardiovascular comorbidities are considered to be the major risk factor for the occurrence of cardiovascular events in COVID-19 patients with a higher proportion of hypertensive patients suffering from acute cardiac injury and heart failure [ 7 ].…”

Pleural diseases and COVID-19: ubi fumus, ibi ignis

“…About half of COVID-19 patients have comorbidities [ 12 , 13 ], including pre-existing cardiovascular diseases (12.6%) or heart failure (6.5%) [ 14 ]. Moreover, more than 25% of infected patients exhibit myocardial injury of potential inflammatory pathogenesis (a cause of impaired cardiac function) as demonstrated by elevation of troponin T levels [ 14 ] and, at least 20% develop heart failure during disease course [ 15 ]. On the other hand, the incidence of pulmonary embolism was 8.3% among 1240 infected patients who were subjected to a CT pulmonary angiography [ 16 ].…”

Transcatheter aortic valve implantation versus surgical aortic valve replacement during the COVID‐19 pandemic—Current practice and concerns

“…4 Published data have shown that patients with cardiovascular comorbidities are at an increased risk of adverse outcomes related to COVID-19 infection. 5,6 Furthermore COVID-19 increases the risk of developing thrombotic disease including ACS, venous thromboembolism, and stroke, 7 important consideration in cardiac surgery.…”