COVID-19 and Cardiovascular Manifestations

COVID-19 disease caused by Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) has rapidly established itself as a devastating pandemic of a larger magnitude. The most common symptoms of COVID-19 include fever, dry cough, myalgia, and fatigue. Severe symptoms and critical disease occur in 5 to 15% of patients, progressing to acute respiratory distress syndrome and multi-organ dysfunction syndrome. Risk factors for severe disease and death include old age, hypertension, diabetes, underlying cardiovascular and respiratory diseases, cancer, and obesity. The SARS-CoV-2 virus has broad tissue tropism, and a quarter of patients can have cardiac involvement. Cardiovascular (CV) manifestations include subclinical and overt myocarditis, acute coronary syndromes, arrhythmias, exacerbation of heart failure, thromboembolism, cardiogenic shock, and death. Patients with preexisting cardiovascular disease (CVD) or CV involvement during the course of illness may have poor clinical outcomes. Patients who have recovered from acute illness can have persistent long-term effects with clinical significance. The focus of this chapter is about the bidirectional interaction between COVID-19 disease and CVD, its various cardiovascular manifestations, their outcomes, and management.

Keywords: ACE2, Cardiovascular manifestations, COVID-19, COVID-19 myocarditis, Cytokine release syndrome, Systemic inflammation, COVID-19 arrhythmias, COVID-19 heart failure, COVID-19 ACS, Thromboembolism, Long COVID.