Cardiac Manifestations of Coronavirus Disease 2019 (COVID-19): A Comprehensive Review

Tahir, Faryal; Arif, Taha Bin; Ahmed, Jawad; Malik, Farheen; Muhammad, Khalid

doi:10.7759/cureus.8021

Cited by 28 publications

(29 citation statements)

References 45 publications

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“…COVID-19 results in acute respiratory distress syndrome (ARDS) 34 and is frequently associated with RV dysfunction, increased pulmonary resistance 35 , increased values of systolic pulmonary arterial pressure, increased RV afterload 36,37 , severe hypoxia, oxidative stress, and increased myocardial oxygen demand induced by ARDS 38 .…”

Section: Discussionmentioning

confidence: 99%

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Wang

Jiang

et al. 2020

Preprint

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Background: Coronavirus disease 2019 (COVID-19) induces myocardial injury, either direct myocarditis or indirect injury due to systemic inflammatory response. Myocardial involvement has been proved to be one of the primary manifestations of COVID-19 infection, according to laboratory test, autopsy, and cardiac magnetic resonance imaging (CMRI). However, the middle-term outcome of cardiac involvement after the patients were discharged from the hospital is yet unknown. The present study aimed to evaluate mid-term cardiac sequelae in recovered COVID-19 patients by CMRIMethods: A total of 47 recovered COVID-19 patients were prospectively recruited and underwent CMRI examination in this study. The CMRI protocol consisted of black blood fat-suppressed T2 weighted imaging (BB-T2WI), T2 star mapping, left ventricle cine imaging, pre- and post-contrast T1 mapping, and late gadolinium enhancement (LGE). Myocardium edema and LGE were assessed in recovered COVID-19 patients. The left ventricle (LV) and right ventricle (RV) function and LV mass were assessed and compared with normal controls.Results: Finally, 44 recovered COVID-19 patients and 31 normal controls were included in this study. No edema was observed in any patient. LGE was found in 13 patients. All LGE lesions were located in the middle myocardium and/or sub-epicardium with a scattered distribution. Further analysis showed that LGE-positive patients had significantly decreased left ventricle peak global circumferential strain (LVpGCS), right ventricle peak global circumferential strain (RVpGCS), right ventricle peak global longitudinal strain (RVpGLS) as compared to non-LGE patients (p＜0.05), while no difference was detected between the non-LGE patients and normal controls.Conclusion: Myocardium injury existed in about 30% of COVID-19 patients. These patients had peak right ventricle strain that decreased at the 3-month follow-up. Cardiac MRI can monitor the COVID-19-induced myocarditis progression, and CMR strain analysis is a sensitive tool to evaluate the recovery of left ventricle circumferential contraction dysfunction and right ventricular dysfunction.

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Section: Discussionmentioning

confidence: 99%

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Wang

Jiang

et al. 2020

Preprint

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“…Troponin elevation three times the upper reference limit is known to be associated with worse in-hospital outcomes in COVID-19 patients 19,20 . It remains unclear whether the rise in cardiac biomarkers is related to viral myocarditis 5,6 or plaque rupture secondary to virus-induced inflammatory response [29][30][31] or a type 1 AMI. In this cohort of suspected type 1 myocardial infarction, there was a low prevalence of non-obstructive coronary disease and the angiographic characteristics and procedural management of the COVID-19 ACS were similar to the non COVID-19 ACS group.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Outcomes of COVID-19 Positive Acute Coronary Syndrome Patients; a multisource Electronic Healthcare Records Study from England

Rashid

Curzen

et al. 2020

Preprint

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Background: Patients with underlying cardiovascular disease and Coronavirus disease 2019 (COVID-19) infection are at increased risk of morbidity and mortality. However, there is limited information on management and outcomes of patients presenting with acute coronary syndrome (ACS) and concomitant COVID19 infection. Objectives: This multisource national analysis of live data from England was designed to characterise the presenting profile and outcomes of patients hospitalized with ACS and COVID-19 infection. Methods: Multisource data from all acute NHS hospital in England was linked to study the characteristics and outcomes of patients hospitalized with COVID-19 ACS compared to non COVID-19 ACS patients. Hierarchical multilevel models were constructed to study the association between COVID19 ACS and in-hospital and 30-day mortality. Results: Between 1st March 2020 and 31st May 2020, 517 (4.0%) were admitted with COVID- 19 ACS from a total of 12,958 ACS patients. COVID-19 ACS patients were generally older, BAME ethnicity, more comorbid and had unfavourable presenting characteristics compared to non-COVID-19 ACS patients. They were less likely to receive invasive coronary strategy in the form of coronary angiography (67.7% vs 81.0%), PCI (30.2% vs 53.9%), dual antiplatelet medication 76.3% vs 88.0%), and other important secondary medication. Patients with COVID-19 ACS had higher in-hospital (aOR 3.27 95%CI 2.41-4.42) and 30-day mortality (aOR 6.53 95%CI 5.1-8.36) compared to non COVID-19 ACS group. Conclusion: COVID-19 infection is prevalent but less frequent in the patients hospitalized with ACS in England. Presence of COVID-19 infection in patients with ACS is associated with significant mortality hazard.

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“…The disease can progress to cause pneumonia, leukopenia, and lymphopenia [8]. Severe complications may occur, such as acute respiratory distress syndrome (ARDS), RNAaemia, acute cardiac injury (ACI), secondary infection, heart failure (HF), and multiple organ failure requiring intensive care unit (ICU) admissions [3,8].…”

Section: Introductionmentioning

confidence: 99%

“…SARS-CoV-2 is classified as a type of RNA virus, a member of the coronavirus family, and belongs to the "beta" genus. Other members of the same genus include SARS-CoV-1 and Middle East respiratory syndrome coronavirus (MERS-CoV) [ 1 - 3 ]. The possible origin of SARS-CoV-2 from bats could be elucidated by its similarity (88% identical) to two other SARS-like CoVs derived from bats (bat-SL-CoVZC45 and bat-SL-CoVZXC21) [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological and Clinical Features of SARS-CoV-2: A Retrospective Study from East Karachi, Pakistan

Tahir¹,

Tahir²,

Arif³

et al. 2020

Cureus

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Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread to almost every country on the globe, and each country is reporting the symptomatic presentation of their patients to give better insight into the various clinical presentations of SARS-CoV-2. However, the epidemiological literature from Pakistan is scanty. Methods We retrospectively analyzed data from 412 patients who were residents of East Karachi and tested positive for SARS-CoV-2 between February 26 to April 24, 2020. Patients' demographics, symptoms, travel and contact history, and outcomes were recorded. All statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 22 (IBM SPSS Statistics for Windows, IBM Corp, Armonk, NY). Results Most of the patients were male (64.6%), the majority (43.3%) belonging to the 21-to 40year age group. Most of the patients (65.5%) were residents of Gulshan Iqbal. A total of 15.8% of the patients were admitted to the hospital, and 3.9% of patients expired. The three most common presenting symptoms were fever (74.8%), cough (60.4%), and flu (35.5%). The majority of patients (89.3%) gave a history of contact with SARS-CoV-2 patients. Conclusion The number of SARS-CoV-2 cases is rapidly increasing in Karachi, Pakistan. There is a need to educate the population about the most common sign and symptoms of the virus so that individuals can identify these symptoms and get themselves tested. The concerned authorities should devise an adequate and effective plan to flatten the infectivity curve.

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Cardiac Manifestations of Coronavirus Disease 2019 (COVID-19): A Comprehensive Review

Cited by 28 publications

References 45 publications

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Clinical Characteristics and Outcomes of COVID-19 Positive Acute Coronary Syndrome Patients; a multisource Electronic Healthcare Records Study from England

Epidemiological and Clinical Features of SARS-CoV-2: A Retrospective Study from East Karachi, Pakistan

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