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Cardiovascular manifestations of COVID-19: An evidence-based narrative review
Yash Paul Sharma1, Sourabh Agstam2, Ashutosh Yadav3, Anunay Gupta2, Ankur Gupta1
1 Department of Cardiology, Advanced Cardiac Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
2 Department of Cardiology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
3 Department of Cardiology, Fortis Hospital, Mohali, Sahibzada Ajit Singh Nagar, Punjab, India
Correspondence Address:
Ankur Gupta,
Department of Cardiology, Advanced Cardiac Centre, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/ijmr.IJMR_2450_20 PMID: 33281125
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The recent outbreak of coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization on March 11, 2020. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, primarily involves the respiratory system with viral pneumonia as a predominant manifestation. In addition, SARS-CoV-2 has various cardiovascular manifestations which increase morbidity and mortality in COVID-19. Patients with underlying cardiovascular diseases and conventional cardiovascular risk factors are predisposed for COVID-19 with worse prognosis. The possible mechanisms of cardiovascular injury are endothelial dysfunction, diffuse microangiopathy with thrombosis and increased angiotensin II levels. Hyperinflammation in the myocardium can result in acute coronary syndrome, myocarditis, heart failure, cardiac arrhythmias and sudden death. The high level of cardiac troponins and natriuretic peptides in the early course of COVID-19 reflects an acute myocardial injury. The complex association between COVID-19 and cardiovascular manifestations requires an in-depth understanding for appropriate management of these patients. Till the time a specific antiviral drug is available for COVID-19, treatment remains symptomatic. This review provides information on the cardiovascular risk factors and cardiovascular manifestations of COVID-19. |
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