Raffaello WM, Huang I, Budi Siswanto B, Pranata R. In-depth review of cardiopulmonary support in COVID-19 patients with heart failure. World J Cardiol 2021; 13(8): 298-308 [PMID: 34589166 DOI: 10.4330/wjc.v13.i8.298]
Corresponding Author of This Article
Raymond Pranata, MD, Doctor, Faculty of Medicine, Universitas Pelita Harapan, Jl. Jend. Sudirman No.20, Bencongan, Kec. Klp. Dua, Tangerang 15810, Indonesia. raymond_pranata@hotmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Aug 26, 2021; 13(8): 298-308 Published online Aug 26, 2021. doi: 10.4330/wjc.v13.i8.298
In-depth review of cardiopulmonary support in COVID-19 patients with heart failure
Wilson Matthew Raffaello, Ian Huang, Bambang Budi Siswanto, Raymond Pranata
Wilson Matthew Raffaello, Raymond Pranata, Faculty of Medicine, Universitas Pelita Harapan, Tangerang 15810, Indonesia
Ian Huang, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia
Bambang Budi Siswanto, Department of Cardiology and Vascular Medicine, National Cardiovascular Center Harapan Kita, Universitas Indonesia, Jakarta 11420, Indonesia
Author contributions: Raffaello WM contributed in literature reviewing, manuscript writing and editing; Huang I, Siswanto BB, and Pranata R contributed in reviewing and performing extensive editing of the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raymond Pranata, MD, Doctor, Faculty of Medicine, Universitas Pelita Harapan, Jl. Jend. Sudirman No.20, Bencongan, Kec. Klp. Dua, Tangerang 15810, Indonesia. raymond_pranata@hotmail.com
Received: March 2, 2021 Peer-review started: March 3, 2021 First decision: March 31, 2021 Revised: April 13, 2021 Accepted: August 5, 2021 Article in press: August 5, 2021 Published online: August 26, 2021
Abstract
Coronavirus disease 2019 infection has spread worldwide and causing massive burden to our healthcare system. Recent studies show multiorgan involvement during infection, with direct insult to the heart. Worsening of the heart function serves as a predictor of an adverse outcome. This finding raises a particular concern in high risk population, such as those with history of preexisting heart failure with or without implantable device. Lower baseline and different clinical characteristic might raise some challenge in managing either exacerbation or new onset heart failure that might occur as a consequence of the infection. A close look of the inflammatory markers gives an invaluable clue in managing this condition. Rapid deterioration might occur anytime in this setting and the need of cardiopulmonary support seems inevitable. However, the use of cardiopulmonary support in this patient is not without risk. Severe inflammatory response triggered by the infection in combination with the preexisting condition of the worsening heart and implantable device might cause a hypercoagulability state that should not be overlooked. Moreover, careful selection and consideration have to be met before selecting cardiopulmonary support as a last resort due to limited resource and personnel. By knowing the nature of the disease, the interaction between the inflammatory response and different baseline profile in heart failure patient might help clinician to salvage and preserve the remaining function of the heart.
Core Tip: Coronavirus disease 2019 (COVID-19) infection might cause severe respiratory distress and demonstrates an extrapulmonary involvement. Recent evidence shows direct involvement of COVID-19 and deterioration of the heart function. Severe infection is commonly found in high risk population, indicates a complex interaction between host inflammatory response and the infection itself, signifies the use of cardiopulmonary support and associated with high mortality. There are relatively scarce information regarding the use of ventricular assist device and extracorporeal membrane oxygenation and here we will be discussing the possible mechanism of how cardiopulmonary support may improve COVID-19 infection outcome.
