Cardiovascular manifestations and treatment considerations in COVID-19

• Published in: Heart (British Cardiac Society) Vol. 106; no. 15; pp. 1132 - 1141
• Main Authors: Kang, Yu, Chen, Tiffany, Mui, David, Ferrari, Victor, Jagasia, Dinesh, Scherrer-Crosbie, Marielle, Chen, Yucheng, Han, Yuchi
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd and British Cardiovascular Society 01.08.2020; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Angiotensin Receptor Antagonists - therapeutic use; Angiotensin-Converting Enzyme 2; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Anticoagulants - therapeutic use; Azithromycin - therapeutic use; Betacoronavirus; Biomarkers - blood; cardiac risk factors and prevention; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - therapy; Chloroquine - therapeutic use; Comorbidity; Coronavirus Infections - epidemiology; Coronavirus Infections - mortality; Coronaviruses; COVID-19; Cytokine Release Syndrome - epidemiology; Disseminated Intravascular Coagulation - epidemiology; Extracorporeal Membrane Oxygenation; Humans; Hydroxychloroquine - therapeutic use; Immunosuppressive Agents - therapeutic use; Influenza, Human - mortality; Lung - metabolism; Lung - pathology; Middle East respiratory syndrome; Mortality; myocarditis; Myocardium - metabolism; Myocardium - pathology; Pandemics; Peptidyl-Dipeptidase A - metabolism; Pneumonia, Viral - epidemiology; Respiratory diseases; Review; SARS-CoV-2; Severe Acute Respiratory Syndrome - mortality; systemic inflammatory diseases; Troponin - blood; Venous Thromboembolism - epidemiology; Venous Thromboembolism - prevention & control; Viral infections; Middle East; United States > US; China; cardiac risk factors and prevention; myocarditis; systemic inflammatory diseases
• ISSN: 1355-6037; 1468-201X; 1468-201X
• DOI: 10.1136/heartjnl-2020-317056

Since its recognition in December 2019, covid-19 has rapidly spread globally causing a pandemic. Pre-existing comorbidities such as hypertension, diabetes, and cardiovascular disease are associated with a greater severity and higher fatality rate of covid-19. Furthermore, COVID-19 contributes to cardiovascular complications, including acute myocardial injury as a result of acute coronary syndrome, myocarditis, stress-cardiomyopathy, arrhythmias, cardiogenic shock, and cardiac arrest. The cardiovascular interactions of COVID-19 have similarities to that of severe acute respiratory syndrome, Middle East respiratory syndrome and influenza. Specific cardiovascular considerations are also necessary in supportive treatment with anticoagulation, the continued use of renin-angiotensin-aldosterone system inhibitors, arrhythmia monitoring, immunosuppression or modulation, and mechanical circulatory support.