Xanthopoulos A, Bourazana A, Giamouzis G, Skoularigki E, Dimos A, Zagouras A, Papamichalis M, Leventis I, Magouliotis DE, Triposkiadis F, Skoularigis J. COVID-19 and the heart. World J Clin Cases 2022; 10(28): 9970-9984 [PMID: 36246800 DOI: 10.12998/wjcc.v10.i28.9970]
Corresponding Author of This Article
Andrew Xanthopoulos, FACC, MD, PhD, Doctor, Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. andrewvxanth@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Review
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 Clin Cases. Oct 6, 2022; 10(28): 9970-9984 Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.9970
COVID-19 and the heart
Andrew Xanthopoulos, Angeliki Bourazana, Grigorios Giamouzis, Evangelia Skoularigki, Apostolos Dimos, Alexandros Zagouras, Michail Papamichalis, Ioannis Leventis, Dimitrios E Magouliotis, Filippos Triposkiadis, John Skoularigis
Andrew Xanthopoulos, Angeliki Bourazana, Grigorios Giamouzis, Evangelia Skoularigki, Apostolos Dimos, Alexandros Zagouras, Michail Papamichalis, Ioannis Leventis, Filippos Triposkiadis, John Skoularigis, Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
Dimitrios E Magouliotis, Department of Cardiothoracic Surgery, University of Thessaly, Larissa Biopolis, Larissa 41110, Greece
Author contributions: All authors made substantial contributions to conception and design of the study, acquisition of data or analysis and interpretation of data, drafted the article or made critical revisions related to important intellectual content of the manuscript, and gave final approval of the version of the article to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andrew Xanthopoulos, FACC, MD, PhD, Doctor, Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. andrewvxanth@gmail.com
Received: March 23, 2022 Peer-review started: March 23, 2022 First decision: June 16, 2022 Revised: July 27, 2022 Accepted: August 24, 2022 Article in press: August 24, 2022 Published online: October 6, 2022 Processing time: 188 Days and 2.3 Hours
Abstract
An outbreak of coronavirus disease 2019 (COVID-19) occurred in December 2019 due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is a strain of SARS-CoV. Patients infected with the virus present a wide spectrum of manifestations ranging from mild flu-like symptoms, cough, fever and fatigue to severe lung injury, appearing as bilateral interstitial pneumonia or acute respiratory failure. Although SARS-CoV-2 infection predominantly offends the respiratory system, it has been associated with several cardiovascular complications as well. For example, patients with COVID-19 may either develop type 2 myocardial infarction due to myocardial oxygen demand and supply imbalance or acute coronary syndrome resulting from excessive inflammatory response to the primary infection. The incidence of COVID-19 related myocarditis is estimated to be accountable for an average of 7% of all COVID-19 related fatal cases, whereas heart failure (HF) may develop due to infiltration of the heart by inflammatory cells, destructive action of pro-inflammatory cytokines, micro-thrombosis and new onset or aggravated endothelial and respiratory failure. Lastly, SARS-CoV-2 can engender arrhythmias through direct myocardial damage causing acute myocarditis or through HF decompensation or secondary, through respiratory failure or severe respiratory distress syndrome. In this comprehensive review we summarize the COVID-19 related cardiovascular complications (acute coronary syndromes, myocarditis, HF, arrhythmias) and discuss the main underlying pathophysiological mechanisms.
Core Tip: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) disease. Although SARS-CoV-2 infection predominantly offends the respiratory system, it leads to various cardiovascular complications as well. SARS-CoV-2 infected patients with a history of cardiovascular disease exhibit poor outcomes. The main COVID-19 related cardiovascular complications include acute coronary syndromes, myocarditis, heart failure and arrhythmias.
