Abstract
Coronavirus Disease 2019 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has become a worldwide pandemic. Since 2019, the virus has mutated into multiple variants that have made it harder to eradicate and have increased the rate of infection. This virus can affect the structure and the function of the heart and can lead to cardiovascular symptoms that can have long-lasting effects despite recovery from COVID-19. These symptoms include chest pain, palpitations, fatigue, shortness of breath, rapid heartbeat, arrhythmias, cough and hypotension. These symptoms may persist due to myocardial injury, cardiac inflammation or systemic damage that may have been caused during infection. If these symptoms persist, the patient should visit their cardiologist for diagnosis and treatment plan for any type of cardiovascular disease that may have developed Post-COVID 19.
Keywords: SARS-CoV-2, COVID-19, cardiovascular effects, cardiovascular, long term, cardiology
[1]
World Health Organization. WHO Coronavirus (COVID-19) dashboard with vaccination data. World health organization. 2021. Available from:https://covid19.who.int (Accessed on 11 Oct 2021).
[2]
Centers for Disease Control and Prevention. Coronavirus disease 2019 (covid-19). Centers for disease control and prevention. 2021. Available from: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html (Accessed on Sept 28, 2021).
[3]
Zaim S, Chong J, Sankaranarayanan V, Harky A. Covid-19 and multiorgan response. Curr Probl Cardiol 2020; 45(8): 100618. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7187881/ (Accessed on Sep 28 2021).
[4]
Cordero A, Santos García-Gallego C, Bertomeu-González V, et al. Mortality associated with cardiovascular disease in patients with COVID-19. Revista Espanola De Cardiologia 2021; 56(1): 30-8. Available from: https://www.reccardioclinics.org/en-mortality-associated-with-cardiovascular-disease-articulo-S260515322030114X (Accessed on Sep 28 2021).
[5]
Chakinala R, Shah C, Rakholiya J, et al. COVID-19 outcomes amongst patients with pre-existing cardiovascular disease and hypertension. Nat Center Biotechnol Inf 2021; 13(2): e13420. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980770/ (Accessed on Sep 29 2021).
[6]
Banerjee A, Chen S, Pasea L, et al. Excess deaths in people with cardiovascular diseases during the COVID-19 pandemic. Eur J Prev Cardiol 2021; 28(14): 1599-609. Available from: https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwaa155/6145858 (Accessed on 29 Sept 2021).
[7]
Malik Y. Properties of coronavirus and SARS-COV-2. Nat Center Biotechnol Inf 2020; 42(1):3-11. Available from: https://pubmed.ncbi.nlm.nih.gov/32342926/ (Accessed on 29 Sept 2021).
[8]
Gorbalenya AE, Baker SC, Baric RS, et al. Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species severe acute respiratory syndrome-related coronavirus: Classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol 2020; 5(4): 536-44.
[http://dx.doi.org/10.1038/s41564-020-0695-z] [PMID: 32123347]
[http://dx.doi.org/10.1038/s41564-020-0695-z] [PMID: 32123347]
[9]
Centers for Disease Control and Prevention. SARS-COV-2 variant classifications and definitions. 2021. Available from: https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.html (Accessed on 29 Sept 2021).
[10]
Le Page M, McNamara A. Alpha covid-19 variant (b.1.1.7). New Scientist. 2021. Available from: https://www.newscientist.com/definition/uk-covid-19-variant-b-1-1-7/ (Accessed on 29 Sept 2021).
[11]
Le Page M, Conlon A. Beta COVID-19 variant (b.1.351). New Scientist. 2021. Available from: https://www.newscientist.com/definition/south-african-covid-19-variant/ (Accessed on 29 Sept 2021).
[12]
Chicago NBC. Mu, Delta, lambda: Here's a breakdown of COVID variants and what we know so far. NBC Chicago 2021. Available from: https://www.nbcchicago.com/news/coronavirus/mu-delta-lambda-heres-a-breakdown-of-covid-variants-and-what-we-know-so-far/2604173/ (Accessed on 29 Sept 2021).
[13]
Lovelace B. Who says delta is the fastest and fittest covid variant and will 'pick off' most vulnerable. CNBC 2021. Available from: https://www.cnbc.com/2021/06/21/covid-delta-who-says-variant-is-the-fastest-and-fittest-and-will-pick-off-most-vulnerable-.html (Accessed on 29 Sept 2021).
[14]
Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/variants/delta-variant.html (Accessed on 29 Sept 2021).
[15]
Katella K. Comparing the COVID-19 vaccines: How are they different? Yale Medicine 2021. Available from: https://www.yalemedicine.org/news/covid-19-vaccine-comparison (Accessed on 29 Sept 2021).
[16]
Garg N, McClafferty B, Ramgobin D, Golamari R, Jain R, Jain R. Cardiology and covid-19: Do we have sufficient information? Fut Med 2020; 17(4): 8.
[http://dx.doi.org/10.2217/fca-2020-0126]
[http://dx.doi.org/10.2217/fca-2020-0126]
[17]
Oudit G, Kassiri Z, Jiang C. SARS-coronavirus modulation of myocardial ACE2 expression and inflammation in patients with SARS. Eur J Clin Invest 2009; 39(7): 618-25.
[PMID: 19453650]
[PMID: 19453650]
[18]
Mayo Foundation for Medical Education and Research. Myocarditis. Mayo Clinic 2021. Available from: https://www.mayoclinic.org/diseases-conditions/myocarditis/symp toms-causes/syc-20352539 (Accessed on 29 Sept 2021).
[19]
Cockburn P. Australia's top heart doctor has been studying delta - and has a warning for young people. ABC 2021. Available from: https://www.abc.net.au/news/2021-08-07/delta-variant-of-covid-19-causing-heart-problems-young-people/100352868 (Accessed on 29 Sept 2021).
[20]
Lohse MJ, Engelhardt S, Eschenhagen T. What is the role of β-adrenergic signaling in heart failure? Circ Res 2003; 93(10): 896-906.
[http://dx.doi.org/10.1161/01.RES.0000102042.83024.CA] [PMID: 14615493]
[http://dx.doi.org/10.1161/01.RES.0000102042.83024.CA] [PMID: 14615493]
[21]
Sharma S, Taegtmeyer H, Phil D, Adrogue J, Essop M. Dynamic changes of gene expression in hypoxia- induced right ventricular hypertrophy. Am J Physiol Heart Circ Physiol 2004; 286(3): H1185-92.
[http://dx.doi.org/10.1097/00042871-200401001-00733]
[http://dx.doi.org/10.1097/00042871-200401001-00733]
[22]
Bikdeli B, Madhavan M, Jimenez D, Chuich T, Dreyfus I, Driggin E. COVID-19 and thrombotic or thromboembolic disease: Implications for prevention, antithrombotic therapy, and follow-up. J Am Coll Cardiol 2020; 75(23): 2950-73.
[PMID: 32311448]
[PMID: 32311448]
[23]
World Health Organization. Coronavirus World Health Organization 2020 Available from:. https://www.who.int/health-topics/coronavirus#tab=tab_1
[24]
Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. COVID-19 and cardiovascular disease: From basic mechanisms to clinical perspectives. Nat Rev Cardiol 2020; 17(9): 543-58.
[http://dx.doi.org/10.1038/s41569-020-0413-9] [PMID: 32690910]
[http://dx.doi.org/10.1038/s41569-020-0413-9] [PMID: 32690910]
[25]
Chahine J, Alvey H. Left ventricular failure. National Center for Biotechnology Information 2021. In StatPearls.
[PMID: NBK537098]
[PMID: NBK537098]
[26]
Awad HH, McNeal AR, Goyal H. Reverse Takotsubo cardiomyopathy: A comprehensive review. Ann Transl Med 2018; 6(23): 460.
[http://dx.doi.org/10.21037/atm.2018.11.08] [PMID: 30603648]
[http://dx.doi.org/10.21037/atm.2018.11.08] [PMID: 30603648]
[27]
Shi S, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients With COVID-19 in Wuhan, China. JAMA Cardiol 2020; 5(7): 802-10.
[http://dx.doi.org/10.1001/jamacardio.2020.0950] [PMID: 32211816]
[http://dx.doi.org/10.1001/jamacardio.2020.0950] [PMID: 32211816]
[28]
Chan M, Andreotti F, Becker R. Hypercoagulable states in cardiovascular disease. AHA Journal 2008; 118(22): 2286-97.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.108.778837]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.108.778837]
[29]
Joob B, Wiwanitkit V. Blood viscosity of COVID-19 patient: A preliminary report. Am J Blood Res 2021; 11(1): 93.
[PMCID: PMC8010604]
[PMCID: PMC8010604]
[30]
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Nat Center Biotechnol Inf 2020; 395(10229): 1054-62.
[PMID: 32171076]
[PMID: 32171076]
[31]
Kemp S, Meng B, Ferriera I, et al. Recurrent emergence and transmission of a SARS-CoV-2 Spike deletion H69/V70. BioRxiv 2020.
[http://dx.doi.org/10.1101/2020.12.14.422555]
[http://dx.doi.org/10.1101/2020.12.14.422555]
[32]
Meng B. Recurrent emergence of SARS-CoV-2 spike deletion H69/V70 and its role in the Alpha variant B117. Cell Reports 2021; 35(13): 109292.
[http://dx.doi.org/10.1016/j.celrep.2021.109292]
[http://dx.doi.org/10.1016/j.celrep.2021.109292]
[33]
Public Health Ontario. SARS-CoV-2 (COVID-19 Virus) Variant of Concern (VoC) Surveillance. Public Health Ontario 2021. Available from: https://www.publichealthontario.ca/en/laboratory-services/test-information-index/covid-19-voc (Accessed on 03 Oct 2021).
[34]
Bollinger R, Ray S. COVID Variants: What you should know. Johns Hopkins Medicine. 2021. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/a-new-strain-of-coronavirus-what-you-should-know (Accessed on 03 Oct 2021).
[35]
Mayo Foundation for Medical Education and Research. Do covid-19 vaccines protect against the variants? Mayo Clinic. Available from: https://www.mayoclinic.org/coronavirus-covid-19/covid-variant-vaccineye (Accessed on 03 Oct 2021).
[36]
MacMillan C. Will you need a COVID-19 booster? what we know so far. Yale Medicine 2021. Available from: https://www.yalemedicine.org/news/covid-19-booster (Accessed on 03 Oct 2021).
[37]
Centers for Disease Control and Prevention. Myocarditis and pericarditis after mrna COVID-19 vaccination. Centers for Disease Control and Prevention. Available from: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html (Accessed on 05 Oct 2021).
[38]
Kochi A, Tagliari A, Forleo G, Fassini G, Tondo C. Cardiac and arrhythmic complications in patients with COVID-19. J Cardiovasc Electrophysiol 2020; 31(5): 1003-5.
[http://dx.doi.org/10.1111/jce.14479] [PMID: 32270559]
[http://dx.doi.org/10.1111/jce.14479] [PMID: 32270559]
[39]
Robert D, Chow C, Kritharides L. Cardiovascular and logistic issues associated with COVID-19 pandemic. Heart Lung Circ 2020; 29(5): 655-6.
[PMID: 32305329]
[PMID: 32305329]
[40]
McCrimmon K. The truth about COVID-19 and asymptomatic spread: It’s common, so wear a mask and avoid large gatherings. UcHealth 2021. Available from: https://www.uchealth.org/today/the-truth-about-asymptomatic-spread-of-covid-19/ (Accessed on 05 Oct 2021).
[41]
American College of Cardiology. Are COVID-19 Patients With STEMI at Increased Risk of Mortality, Stroke? 2021. Available from: https://www.acc.org/Latest-in-Cardiology/Articles/2021/04/19/19/09/Are-COVID-19-Patients-With-STEMI-at-Increased-Risk-of-Mortality-Stroke (Accessed on 05 Oct 2021).
[42]
Lou N. STEMI patients with confirmed COVID had higher mortality risk 2021. Available from: https://www.medpagetoday.com/cardiology/pci/92155 (Accessed on 05 Oct 2021).
[43]
Bangalore S, Sharma A, Slotwiner A. ST-Segment elevation in patients with COVID-19 - a case series. N Engl J Med 2020; 382: 2478-80. Available from: https://www.nejm.org/doi/full/10.1056/NEJMc2009020 (Accessed on 06 Oct 2021).
[44]
Fornell D. The long-term cardiovascular impact of COVID-19 2021. Available from: https://www.dicardiology.com/article/long-term-cardiovascular-impact-covid-19 (Accessed on 06 Oct 2021).
[45]
Desk L. Steep rise in cases of arterial thrombosis in post-COVID patients, say doctors 2021. Available from: https://indianexpress.com/article/lifestyle/health/arterial-thrombosis-blood-clots-gangrene-amputation-post-covid-patients-doctors-symptoms-treatment-7460872/ (Accessed on 06 Oct 2021).
[46]
Johns Hopkins Medicine. Covid long haulers: Long-term effects of COVID-19. Johns Hopkins Medicine 2021. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-long-haulers-long-term-effects-of-covid19 (Accessed on 06 Oct 2021).
[47]
Campbell G. Managing lingering cardiovascular effects of COVID-19 through a dedicated program 2021. Available from: https://consultqd.clevelandclinic.org/managing-lingering-cardiovascular-effects-of-covid-19-through-a-dedicated-program/ (Accessed on 06 Oct 2021).
[48]
Mayo Clinic. Blood tests for heart disease. Mayo Clinic 2019. Available from: https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20049357 (Accessed on 20 Oct 2021).
[49]
Hang W, Chen C, Seubert J. Fulminant myocarditis: A comprehensive review from etiology to treatments and outcomes 2020. Available from: https://www.nature.com/articles/s41392-020-00360-y (Accessed on 20 Oct 2021).
[50]
Mayo Clinic. Pericarditis - Diagnosis and treatment - Mayo Clinic. 2020. Available from: https://www.mayoclinic.org/diseases-conditions/pericarditis/diagnosis-treatment/drc-20352514 (Accessed on 20 Oct 2021).
[51]
Gilotra N. Myocarditis. John Hopkin Medicine 2021. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/myocarditis (Accessed on 20 Oct 2021).
[52]
NHS website. Arterial thrombosis. NHS website 2020. Available from: https://www.nhs.uk/conditions/arterial-thrombosis/ (Accessed on 21 Oct 2021).
[53]
Yang B, Fulcher J, Ahn J, et al. Clinical characteristics and outcomes of coronavirus disease 2019 patients who received compassionate-use leronlimab. Clin Inf Dis 2021; 73(11): e4082-9.
[PMID: 33079180]
[PMID: 33079180]
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