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Ortega-Paz L, Talasaz AH, Sadeghipour P, Potpara TS, Aronow HD, Jara-Palomares L, Sholzberg M, Angiolillo DJ, Lip GYH, Bikdeli B. COVID-19-Associated Pulmonary Embolism: Review of the Pathophysiology, Epidemiology, Prevention, Diagnosis, and Treatment. Semin Thromb Hemost 2023; 49:816-832. [PMID: 36223804 DOI: 10.1055/s-0042-1757634] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
COVID-19 is associated with endothelial activation in the setting of a potent inflammatory reaction and a hypercoagulable state. The end result of this thromboinflammatory state is an excess in thrombotic events, in particular venous thromboembolism. Pulmonary embolism (PE) has been of special interest in patients with COVID-19 given its association with respiratory deterioration, increased risk of intensive care unit admission, and prolonged hospital stay. The pathophysiology and clinical characteristics of COVID-19-associated PE may differ from the conventional non-COVID-19-associated PE. In addition to embolic events from deep vein thrombi, in situ pulmonary thrombosis, particularly in smaller vascular beds, may be relevant in patients with COVID-19. Appropriate prevention of thrombotic events in COVID-19 has therefore become of critical interest. Several changes in viral biology, vaccination, and treatment management during the pandemic may have resulted in changes in incidence trends. This review provides an overview of the pathophysiology, epidemiology, clinical characteristics, and risk factors of COVID-19-associated PE. Furthermore, we briefly summarize the results from randomized controlled trials of preventive antithrombotic therapies in COVID-19, focusing on their findings related to PE. We discuss the acute treatment of COVID-19-associated PE, which is substantially similar to the management of conventional non-COVID-19 PE. Ultimately, we comment on the current knowledge gaps in the evidence and the future directions in the treatment and follow-up of COVID-19-associated PE, including long-term management, and its possible association with long-COVID.
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Affiliation(s)
- Luis Ortega-Paz
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida
| | - Azita H Talasaz
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
- Clinical Trial Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Intensive Arrhythmia Care, Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia
| | - Herbert D Aronow
- Department of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Cardiology, Henry Ford Health, Detroit, Michigan
| | - Luis Jara-Palomares
- Respiratory Unit, Hospital Universitario Virgen del Rocio, Sevilla, Spain
- Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Carlos III Health Institute, Madrid, Spain
| | - Michelle Sholzberg
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Dominick J Angiolillo
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Behnood Bikdeli
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Yale/YNHH Center for Outcomes Research and Evaluation (CORE), New Haven, Connecticut
- Cardiovascular Research Foundation (CRF), New York, New York
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Shaikh A, Khan SD, Baloch F, Virani SS, Samad Z. The COVID-19 Pandemic and Coronary Heart Disease: the Next Surge. Curr Atheroscler Rep 2023; 25:559-569. [PMID: 37531071 DOI: 10.1007/s11883-023-01131-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE OF REVIEW In this narrative review, we highlight different ways in which the COVID-19 pandemic has impacted coronary heart disease (CHD) burden and how a surge in morbidity and mortality may be expected in the near future. We also discuss potential solutions, and the direction subsequent research and corrective actions should take. RECENT FINDINGS COVID-19 has been implicated in the development and worsening of CHD via acute and chronic mechanisms in the form of plaque rupture, destabilization, and sustenance of a chronic inflammatory state leading to long COVID syndrome and increased rates of myocardial infarction. However, indirectly the pandemic is likely to further escalate the CHD burden through poor health behaviors such as tobacco consumption, reduced physical activity, economic devastation and its associated sequelae, and regular cardiac care interruptions and delays. COVID-19 has increased the total CHD burden and will require extensive resource allocation and multifaceted strategies to curb future rise.
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Réa ABBAC, Luk A. Incident Myocarditis in Patients Recovered From COVID-19: Is There a Cause for Concern? Can J Cardiol 2023; 39:845-848. [PMID: 36731606 PMCID: PMC9886388 DOI: 10.1016/j.cjca.2023.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 12/29/2022] [Accepted: 01/01/2023] [Indexed: 02/01/2023] Open
Affiliation(s)
- Ana Beatriz B A C Réa
- Division of Cardiology, Department of Medicine, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Adriana Luk
- Division of Cardiology, Department of Medicine, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada.
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Ortega-Paz L, Arévalos V, Fernández-Rodríguez D, Jiménez-Díaz V, Bañeras J, Campo G, Rodríguez-Santamarta M, Díaz JF, Scardino C, Gómez-Álvarez Z, Pernigotti A, Alfonso F, Amat-Santos IJ, Silvestro A, Rampa L, de la Torre Hernández JM, Bastidas G, Gómez-Lara J, Bikdeli B, García-García HM, Angiolillo DJ, Rodés-Cabau J, Sabaté M, Brugaletta S. One-year cardiovascular outcomes after coronavirus disease 2019: The cardiovascular COVID-19 registry. PLoS One 2022; 17:e0279333. [PMID: 36583998 PMCID: PMC9803130 DOI: 10.1371/journal.pone.0279333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 12/05/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The long-term cardiovascular (CV) outcomes of COVID-19 have not been fully explored. METHODS This was an international, multicenter, retrospective cohort study conducted between February and December 2020. Consecutive patients ≥18 years who underwent a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV2 were included. Patients were classified into two cohorts depending on the nasopharyngeal swab result and clinical status: confirmed COVID-19 (positive RT-PCR) and control (without suggestive symptoms and negative RT-PCR). Data were obtained from electronic records, and clinical follow-up was performed at 1-year. The primary outcome was CV death at 1-year. Secondary outcomes included arterial thrombotic events (ATE), venous thromboembolism (VTE), and serious cardiac arrhythmias. An independent clinical event committee adjudicated events. A Cox proportional hazards model adjusted for all baseline characteristics was used for comparing outcomes between groups. A prespecified landmark analysis was performed to assess events during the post-acute phase (31-365 days). RESULTS A total of 4,427 patients were included: 3,578 (80.8%) in the COVID-19 and 849 (19.2%) control cohorts. At one year, there were no significant differences in the primary endpoint of CV death between the COVID-19 and control cohorts (1.4% vs. 0.8%; HRadj 1.28 [0.56-2.91]; p = 0.555), but there was a higher risk of all-cause death (17.8% vs. 4.0%; HRadj 2.82 [1.99-4.0]; p = 0.001). COVID-19 cohort had higher rates of ATE (2.5% vs. 0.8%, HRadj 2.26 [1.02-4.99]; p = 0.044), VTE (3.7% vs. 0.4%, HRadj 9.33 [2.93-29.70]; p = 0.001), and serious cardiac arrhythmias (2.5% vs. 0.6%, HRadj 3.37 [1.35-8.46]; p = 0.010). During the post-acute phase, there were no significant differences in CV death (0.6% vs. 0.7%; HRadj 0.67 [0.25-1.80]; p = 0.425), but there was a higher risk of deep vein thrombosis (0.6% vs. 0.0%; p = 0.028). Re-hospitalization rate was lower in the COVID-19 cohort compared to the control cohort (13.9% vs. 20.6%; p = 0.001). CONCLUSIONS At 1-year, patients with COVID-19 experienced an increased risk of all-cause death and adverse CV events, including ATE, VTE, and serious cardiac arrhythmias, but not CV death. STUDY REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT04359927.
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Affiliation(s)
- Luis Ortega-Paz
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Universitari Clinic, Barcelona, Spain
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States of America
| | - Victor Arévalos
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Universitari Clinic, Barcelona, Spain
| | | | | | - Jordi Bañeras
- Department of Cardiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Gianluca Campo
- Department of Cardiology, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | | | | | - Claudia Scardino
- Department of Cardiology, Hospital Universitario Joan XXIII, Tarragona, Spain
| | | | - Alberto Pernigotti
- Department of Cardiology, Hospital de Tortosa Verge de la Cinta, Tarragona, Spain
| | - Fernando Alfonso
- Department of Cardiology, Hospital Universitario La Princesa, Madrid, Spain
| | - Ignacio J. Amat-Santos
- Department of Cardiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Antonio Silvestro
- Department of Cardiology, Azienda Ospedaliera Bolognini Seriate, Bérgamo, Italy
| | - Lorenzo Rampa
- Department of Cardiology, Clinical Institute Saint Ambrogio, Milano, Italy
| | | | - Gabriela Bastidas
- Department of Cardiology, Hospital Universitario Sagrat Cor, Barcelona, Spain
| | - Josep Gómez-Lara
- Department of Cardiology, Hospital de Bellvitge, Barcelona, Spain
| | - Behnood Bikdeli
- Cardiovascular Medicine Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Center for Outcomes Research and Evaluation (CORE), Yale School of Medicine, New Haven, Connecticut, United States of America
- Cardiovascular Research Foundation (CRF), New York, New York, United States of America
| | - Hector M. García-García
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Dominick J. Angiolillo
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida, United States of America
| | - Josep Rodés-Cabau
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Universitari Clinic, Barcelona, Spain
| | - Manel Sabaté
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Universitari Clinic, Barcelona, Spain
| | - Salvatore Brugaletta
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Universitari Clinic, Barcelona, Spain
- * E-mail:
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Mohammad KO, Lin A, Rodriguez JBC. Cardiac Manifestations of Post-Acute COVID-19 Infection. Curr Cardiol Rep 2022; 24:1775-1783. [PMID: 36322364 PMCID: PMC9628458 DOI: 10.1007/s11886-022-01793-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW There is emerging evidence that the post-acute and chronic phases of COVID-19 infection are associated with various significant cardiovascular sequelae. RECENT FINDINGS Long COVID has been shown to be associated with multiple cardiovascular sequelae including direct myocardial injury, arrhythmias, and cardiomyopathies. Hypotheses on the mechanism of myocardial injury include direct viral infiltration and autoimmune dysregulation. Long COVID is associated with persistent cardiac ischemia in patients with no previous history of coronary disease, atrial and ventricular arrhythmias, and the development of new-onset heart failure in previously healthy patients. Onset of long COVID may be related to severity of the initial SARS-CoV2 infection. Cardiac MRI is a valuable tool in assessing myocarditis and the development of cardiomyopathies in the setting of long COVID. Both patients with and without pre-existing cardiovascular disease are at risk of developing myocardial injury in the setting of long COVID. Future studies will elucidate both cardiovascular mortality and cardiac rehabilitation in the post-acute and chronic phases of COVID-19.
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Affiliation(s)
- Khan O. Mohammad
- Department of Internal Medicine, Dell Medical School at The University of Texas, 1500 Red River St., Austin, TX 78701 USA
| | - Andrew Lin
- Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, San Diego, CA USA
| | - Jose B. Cruz Rodriguez
- Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego, San Diego, CA USA
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Pratistha FSM, Maliawan RPI, Wirawan H, Gunadhi IP. Systematic Review of Cardiovascular Manifestations in COVID-19 and Management Consideration. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is a health problem that is still engulfing the world that contributes to the high mortality rate globally. Death arises from the severity of the disease due to complications in important organs such as the heart. The purpose of this study was to systematically review the manifestations of cardiovascular disease in COVID-19 patients and their management in terms of published articles.
Method: This research is a systematic review research. The research was conducted using the PRISMA method. Article searches are carried out by online publications throughPubMed, Science Direct and Google Scholarthat meet the inclusion and exclusion criteria. The population is articles about the manifestations of cardiovascular disease in COVID-19 patients and their management between 2011 and 2021. Inclusion criteria are studies that examine the manifestations of cardiovascular disease in COVID-19 patients and their management using primary data in the form of cohort research designs, in English and full text available. The exclusion criteria were a case study, review study and used secondary data. The data were analyzed by univariate analysis by calculating the frequency and percentage.
Result: The results show that several manifestations of cardiovascular disease in COVID-19 patients include cardiac injury, heart failure, myocardial infarction, myocarditis, cardiomegaly and others.Complications of these diseases occur with or without comorbidities and the risk increases with comorbid cardiovascular disease. The management of COVID-19 patients is basically done with antiviral agents, reducing symptoms and protecting important organs such as the heart.
Conclusion: In the treatment of COVID-19 patients with cardiovascular complications, the use of antiviral agents such as lopinavir or ritonavir should be used with caution because: may interact with cardiovascular drugs. Mechanical circulation support is suggested and the use of extracorporeal membrane oxygenation (ECMO) can also be performed totreat cardiovascular complications in COVID-19 patients.
Keywords: COVID-19, cardiovascular, manifestation, management, systematic review.
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Visco V, Vitale C, Rispoli A, Izzo C, Virtuoso N, Ferruzzi GJ, Santopietro M, Melfi A, Rusciano MR, Maglio A, Di Pietro P, Carrizzo A, Galasso G, Vatrella A, Vecchione C, Ciccarelli M. Post-COVID-19 Syndrome: Involvement and Interactions between Respiratory, Cardiovascular and Nervous Systems. J Clin Med 2022; 11:jcm11030524. [PMID: 35159974 PMCID: PMC8836767 DOI: 10.3390/jcm11030524] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
Though the acute effects of SARS-CoV-2 infection have been extensively reported, the long-term effects are less well described. Specifically, while clinicians endure to battle COVID-19, we also need to develop broad strategies to manage post-COVID-19 symptoms and encourage those affected to seek suitable care. This review addresses the possible involvement of the lung, heart and brain in post-viral syndromes and describes suggested management of post-COVID-19 syndrome. Post-COVID-19 respiratory manifestations comprise coughing and shortness of breath. Furthermore, arrhythmias, palpitations, hypotension, increased heart rate, venous thromboembolic diseases, myocarditis and acute heart failure are usual cardiovascular events. Among neurological manifestations, headache, peripheral neuropathy symptoms, memory issues, lack of concentration and sleep disorders are most commonly observed with varying frequencies. Finally, mental health issues affecting mental abilities and mood fluctuations, namely anxiety and depression, are frequently seen. Finally, long COVID is a complex syndrome with protracted heterogeneous symptoms, and patients who experience post-COVID-19 sequelae require personalized treatment as well as ongoing support.
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Affiliation(s)
- Valeria Visco
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Carolina Vitale
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Antonella Rispoli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Carmine Izzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Nicola Virtuoso
- Cardiology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84081 Salerno, Italy; (N.V.); (A.M.)
| | - Germano Junior Ferruzzi
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Mario Santopietro
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Americo Melfi
- Cardiology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84081 Salerno, Italy; (N.V.); (A.M.)
| | - Maria Rosaria Rusciano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Angelantonio Maglio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Paola Di Pietro
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
- Vascular Physiopathology Unit, IRCCS Neuromed Mediterranean Neurological Institute, 86077 Pozzilli, Italy
| | - Gennaro Galasso
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Alessandro Vatrella
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
- Vascular Physiopathology Unit, IRCCS Neuromed Mediterranean Neurological Institute, 86077 Pozzilli, Italy
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy; (V.V.); (C.V.); (A.R.); (C.I.); (G.J.F.); (M.S.); (M.R.R.); (A.M.); (P.D.P.); (A.C.); (G.G.); (A.V.); (C.V.)
- Correspondence: ; Tel.: +39-08996-5021
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Arévalos V, Ortega-Paz L, Rodríguez-Arias JJ, Calvo López M, Castrillo-Golvano L, Salazar-Rodríguez A, Sabaté-Tormos M, Spione F, Sabaté M, Brugaletta S. Acute and Chronic Effects of COVID-19 on the Cardiovascular System. J Cardiovasc Dev Dis 2021; 8:128. [PMID: 34677197 PMCID: PMC8541609 DOI: 10.3390/jcdd8100128] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 01/08/2023] Open
Abstract
COVID-19 has shown significant morbidity with the involvement of multiple systems, including the cardiovascular system. Cardiovascular manifestations in the acute phase can include myocardial injury itself, myocardial infarction, venous thromboembolic events, myocarditis, Takotsubo syndrome, and different arrhythmic events. Myocardial injury defined by the rise of cardiac biomarkers in blood has been found in multiple studies with a prevalence of about 20%. Its presence is related to worse clinical outcomes and in-hospital mortality. The mechanisms of myocardial injury have been the subject of intense research but still need to be clarified. The characterization of the cardiac affectation with echocardiography and cardiac magnetic resonance has found mixed results in different studies, with a striking incidence of imaging criteria for myocarditis. Regarding post-acute and chronic follow-up results, the persistence of symptoms and imaging changes in recovered COVID-19 patients has raised concerns about the duration and the possible significance of these findings. Even though the knowledge about this disease has increased incredibly in the last year, many aspects are still unclear and warrant further research.
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Affiliation(s)
- Victor Arévalos
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, 08036 Barcelona, Spain; (V.A.); (L.O.-P.); (J.J.R.-A.); (M.C.L.); (L.C.-G.); (A.S.-R.); (F.S.); (M.S.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Luis Ortega-Paz
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, 08036 Barcelona, Spain; (V.A.); (L.O.-P.); (J.J.R.-A.); (M.C.L.); (L.C.-G.); (A.S.-R.); (F.S.); (M.S.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Juan José Rodríguez-Arias
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, 08036 Barcelona, Spain; (V.A.); (L.O.-P.); (J.J.R.-A.); (M.C.L.); (L.C.-G.); (A.S.-R.); (F.S.); (M.S.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Margarita Calvo López
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, 08036 Barcelona, Spain; (V.A.); (L.O.-P.); (J.J.R.-A.); (M.C.L.); (L.C.-G.); (A.S.-R.); (F.S.); (M.S.)
| | - Leticia Castrillo-Golvano
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, 08036 Barcelona, Spain; (V.A.); (L.O.-P.); (J.J.R.-A.); (M.C.L.); (L.C.-G.); (A.S.-R.); (F.S.); (M.S.)
| | - Anthony Salazar-Rodríguez
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, 08036 Barcelona, Spain; (V.A.); (L.O.-P.); (J.J.R.-A.); (M.C.L.); (L.C.-G.); (A.S.-R.); (F.S.); (M.S.)
| | - Marta Sabaté-Tormos
- Department of Medicine, Medical School, Universitat de Barcelona, 08036 Barcelona, Spain;
| | - Francesco Spione
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, 08036 Barcelona, Spain; (V.A.); (L.O.-P.); (J.J.R.-A.); (M.C.L.); (L.C.-G.); (A.S.-R.); (F.S.); (M.S.)
| | - Manel Sabaté
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, 08036 Barcelona, Spain; (V.A.); (L.O.-P.); (J.J.R.-A.); (M.C.L.); (L.C.-G.); (A.S.-R.); (F.S.); (M.S.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Salvatore Brugaletta
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, 08036 Barcelona, Spain; (V.A.); (L.O.-P.); (J.J.R.-A.); (M.C.L.); (L.C.-G.); (A.S.-R.); (F.S.); (M.S.)
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
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