Coronavirus disease-19 and cardiovascular disease: A risk factor or a risk marker?

Rev Med Virol. 2021 May;31(3):e2172. doi: 10.1002/rmv.2172. Epub 2020 Sep 22.

Abstract

Severe acute respiratory syndrome coronavirus-2 causes the clinical syndrome of coronavirus disease of 2019 (COVID-19) which has become a global pandemic resulting in significant morbidity and mortality. While the virus primarily affects the respiratory system, it also causes a wide variety of complex cardiac manifestations such as acute myopericarditis, acute coronary syndrome, congested heart failure, cardiogenic shock and cardiac arrhythmias. There are numerous proposed mechanisms of cardiac injury, including direct cellular injury, pro-inflammatory cytokine storm, myocardial oxygen-demand mismatch, and systemic inflammation causing multi-organ failure. Additionally, medications commonly used to treat COVID-19 patients have various cardiovascular side effects. We aim to provide a succinct review about the pathophysiology and cardiac manifestations of COVID-19, as well as treatment considerations and the various adaptations made to the current healthcare structure as a result of the pandemic.

Keywords: COVID-19; cardiovascular diseases; complications.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / epidemiology
  • Acute Coronary Syndrome / pathology
  • Acute Coronary Syndrome / therapy*
  • Acute Coronary Syndrome / virology
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects
  • Arrhythmias, Cardiac / epidemiology
  • Arrhythmias, Cardiac / pathology
  • Arrhythmias, Cardiac / therapy*
  • Arrhythmias, Cardiac / virology
  • Biomarkers / analysis
  • COVID-19 / epidemiology
  • COVID-19 / pathology
  • COVID-19 / therapy*
  • COVID-19 / virology
  • Cardiac Catheterization / methods
  • Comorbidity
  • Disease Management
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects
  • Heart Failure / epidemiology
  • Heart Failure / pathology
  • Heart Failure / therapy*
  • Heart Failure / virology
  • Hospitalization
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / adverse effects
  • Pandemics*
  • Pericarditis / epidemiology
  • Pericarditis / pathology
  • Pericarditis / therapy*
  • Pericarditis / virology
  • Risk Factors
  • SARS-CoV-2 / pathogenicity
  • Severity of Illness Index
  • Shock, Cardiogenic / epidemiology
  • Shock, Cardiogenic / pathology
  • Shock, Cardiogenic / therapy*
  • Shock, Cardiogenic / virology
  • Texas / epidemiology

Substances

  • Antiviral Agents
  • Biomarkers
  • Glucocorticoids
  • Immunologic Factors