COVID-19 cardiovascular epidemiology, cellular pathogenesis, clinical manifestations and management

Sattar, Yasar; Ullah, Waqas; Rauf, Hiba; Virk, Hafeez Ul Hassan; Yadav, Sunita; Chowdhury, Medhat; Connerney, Michael; Mamtani, Sahil; Pahuja, Mohit; Patel, Raj; Mir, Tanveer; Almas, Talal; Pacha, Homam Moussa; Alraies, M. Chadi

doi:10.1016/j.ijcha.2020.100589

Cited by 55 publications

(104 citation statements)

References 83 publications

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“…Specifically, infection with SARS and MERS, close relatives of the current COVID-19 virus, has demonstrated a propensity to cause arrhythmias including sinus bradycardia [8,21]. In COVID-19, arrhythmias could be secondary to medication side effects [35], hypoxia and pulmonary disease, activated protein kinase C, direct oxidized Ca2+/calmodulin-dependent protein kinase II activity [36], and myocarditis [2,37]. Sinus bradycardia is one of the most common arrhythmias seen in COVID-19 patients, and it can be persistent for up to 2 weeks [22,23].…”

Section: Discussionmentioning

confidence: 99%

Arrhythmia in COVID-19

Babapoor-Farrokhran

Rasekhi

Gill

et al. 2020

SN Compr. Clin. Med.

102

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The current outbreak of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) also known as coronavirus disease 2019 (COVID-19) has quickly progressed to a global pandemic. There are well-documented cardiac complications of COVID-19 in patients with and without prior cardiovascular disease. The cardiac complications include myocarditis, heart failure, and acute coronary syndrome resulting from coronary artery thrombosis or SARS-CoV-2-related plaque ruptures. There is growing evidence showing that arrhythmias are also one of the major complications. Myocardial inflammation caused by viral infection leads to electrophysiological and structural remodeling as a possible mechanism for arrhythmia. This could also be the mechanism through which SARS-CoV-2 leads to different arrhythmias. In this review article, we discuss arrhythmia manifestations in COVID-19.

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Section: Discussionmentioning

confidence: 99%

Arrhythmia in COVID-19

Babapoor-Farrokhran

Rasekhi

Gill

et al. 2020

SN Compr. Clin. Med.

102

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“… 9 Myocardial infarction in these patients is caused by inflammatory response syndrome, which principally might result in plaque rupture and thrombus formation. 16 Infection-induced hypoxemia and vasoconstriction are other mechanisms that indirectly affect the heart, leading to ischemia in the heart muscles. COVID-19 can induce hypoxia by promoting ARDS or severe pneumonia.…”

Section: Cardiovascular System Manifestationsmentioning

confidence: 99%

“… 62 Viral infections such as COVID-19 may provoke the occurrence of cerebrovascular diseases such as acute ischemic stroke. 5 , 16 It may be caused by the downregulation of natural anticoagulant mechanisms by inflammatory mediators and disturbance of the coagulation system. In this regard, similar to MERS, disruption of the coagulation system is reported in COVID-19 patients.…”

Section: Nervous System Manifestationsmentioning

confidence: 99%

Extrapulmonary Clinical Manifestations in COVID-19 Patients

Sarkesh

Sorkhabi

Baghi

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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COVID-19 manifestations in symptomatic patients can be in the form of pneumonia, acute respiratory syndrome, and multiple organ dysfunction as well. Renal complications, gastrointestinal dysfunctions, endocrine system disorders, myocardial dysfunction and arrhythmia, neurological dysfunctions, dermatological symptoms, hematological manifestations, and thromboinflammation are among the reported extrapulmonary complications. Moreover, the presence of coagulopathy, excessive and dysregulated immune responses, and autoimmunity by COVID-19 patients is considerable. The pathogenesis of infection entails the entry of the virus via receptors on cells, principally angiotensin-converting enzyme 2 receptors. Direct virus damage coupled with indirect effects of viral infection including thromboinflammation, dysfunction of the immune system, and dysregulation of the renin-angiotensin system leads to multiple organ failure. This review outlines the extrapulmonary organ-specific complications and their pathophysiology and epidemiology.

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“…Evidence suggests that SARS-CoV-2 may also lead to myocardial dysfunction by inducing an excessive inflammatory response, which results in a dysregulated immune response, cytokine release syndrome (CRS), and eventual cytokine storm ( 30 , 31 ). The increased cytokine production induces the release of reactive oxygen species (ROS), superoxide anion, and endogenous nitric oxide – all of which contribute to the myocardial damage commonly seen with severe cases of COVID-19 ( 32 ). As the myocardium becomes more damaged, it eventually releases damage-associated molecular proteins (DAMPs), which exacerbate the pro-inflammatory response to injure myocytes further.…”

Section: Pathophysiology Of Covid-19-related Cardiovascular Infectionmentioning

confidence: 99%

Impact of COVID-19 infection on the cardiovascular system: An evidence-based analysis of risk factors and outcomes

Kaye

Spence

Mayerle

et al. 2021

Best Practice & Research Clinical Anaesthesiology

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Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), also known as COVID-19 emerged in late 2019 in Wuhan, China and the World Health Organization declared the virus a pandemic on March 11, 2020. Disease progression from COVID-19 infection has increasingly shown significant symptom manifestations within organ systems beyond the respiratory system. In this regard, literature has shown increasing numbers of cardiovascular involvement during disease course and an associated increase in mortality among infected patients. Complications involving the cardiovascular system include myocardial infarction, arrhythmias, shock, and heart failure. In this evidence-based review, we discuss risk factors of cardiovascular involvement in COVID-19 infection, pathophysiology of COVID-19-related cardiovascular infection and injury, COVID-19 effects on the cardiovascular system and corresponding treatments, and hematologic effects of COVID-19 and COVID-19 in heart transplant patients. Clinicians managing COVID-19 patients should appreciate the potential cardiovascular effects related to the disease process.

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COVID-19 cardiovascular epidemiology, cellular pathogenesis, clinical manifestations and management

Cited by 55 publications

References 83 publications

Arrhythmia in COVID-19

Arrhythmia in COVID-19

Extrapulmonary Clinical Manifestations in COVID-19 Patients

Impact of COVID-19 infection on the cardiovascular system: An evidence-based analysis of risk factors and outcomes

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