“COVID-19” and its Cardiovascular Complications – Review

  • Muhammad Saad bin Tahir Institute of Microbiology and Molecular genetics, University of the Punjab, Lahore 54000, Pakistan.
  • Muhammad Salman ullah King Edward Medical university (KEMU), Lahore 54000, Pakistan.
  • Mahnoor basit Institute of Microbiology and Molecular genetics, University of the Punjab, Lahore 54000, Pakistan.
  • Rohama zahid School of Biological Sciences, University of the Punjab, Lahore 54000, Pakistan
Keywords: COVID-19, Cardiovascular diseases, Myocardial Infraction, Cardiovascular drugs, Troponin, ACE2, Spike protein

Abstract

By the end of December in 2019, the world got trapped under the dark shadow of the deadly novel virus that was given the name as “Severe Acute Respiratory Syndrome‐coronaVirus 2 (SARS‐CoV‐2)”. Due to its rapid spread in all the continents, “Coronavirus disease 2019 (COVID-19)” was announced as the pandemic due to its high potential of infecting the human beings. This viral infection not only become the reason of mortality, but it also lethally effected the the infrastructure of public health care system and the global economic situation. “COVID-19” generally maifestated as the “viral pneumonia”, sporadically leading to “acute respiratory distress syndrome (ARDS)” and death. Frequent clinical studies have depicted an interrelation between this deadly virus and cardiovascular diseases. Precedent cardiovascular disease in a person seems to be linked with adverse consequences and high chances of mortality in patients with (COVID-19 infection), whereas this virus itself has a potential of inducing the arrhythmia, acute coronary syndrome, myocardial injury and venous thromboembolism. One of the most significant point of concern is the drug & disease interactions that affect the patients with viral infection and comorbid cardiovascular diseases. By integrating the data and information regarding the biological features of this contagious novel virus, this review has summarized the pivotal cardiac manifestations, their management, and future implications. By correlating the facts and figures related to the biological conditions of this lethal virus with the reported clinical findings, we can ameliorate our conceptions regarding the significant mechanisms underlying (COVID-19), ultimately leading towards the control of this viral infection by the progressive development in preventions and treatments.

References

. Zhou P, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579:270–273.

. Wu F, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579:265–269.

. Lu R, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395:565–574.

. Hoffmann M, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181:271–280.

. Tay MZ, Poh CM, Renia L, MacAry PA, Ng LFP. The trinity of COVID-19: immunity, inflammation and intervention. Nat. Rev. Immunol. 2020;20:363–374.

. Bikdeli B, et al. COVID-19 and thrombotic or thromboembolic disease: implications for prevention, antithrombotic therapy, and follow-up: JACC state-of-the-art review. J. Am. Coll. Cardiol. 2020;75:2950–2973.

. Connors JM, Levy JH. Thromboinflammation and the hypercoagulability of COVID-19. J. Thromb. Haemost. 2020;18:1559–1561. Wrapp D, et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science. 2020;367:1260–1263.

. Walls AC, et al. Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein. Cell. 2020;181:281–292.

. Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS coronavirus. J. Virol. 2020;94:e00127–20.

. Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nat. Med. 2020;26:450–452.

. Driggin E, Madhavan M V., Bikdeli B, Chuich T, Laracy J, Bondi-Zoccai G, et al. Cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic. J Am Coll Cardiol. 2020.

. Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington state. JAMA. 2020.

. Hu H, Ma F, Wei X, Fang Y. Coronavirus fulminant myocarditis saved with glucocorticoid and human immunoglobulin Hongde. Eur Heart J. 2020;1307800.

. Chen C, Zhou Y, Wang DW. SARS-CoV-2: a potential novel etiology of fulminant myocarditis. Herz. 2020;10–2.

. Zeng JH, Liu Y-X, Yuan J, Wang F-X, Wu W-B, Li J-X, et al. First case of COVID-19 infection with fulminant myocarditis complication: case report and insights. 2020.

. Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of Cardiac Injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;1–8.

. Zheng Y-Y, Ma Y-T, Zhang J-Y, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020.

. Liu Y, Li J, Liu D, Song H, Chen C, Lv M, et al. Clinical features and outcomes of 2019 novel coronavirus-infected patients with 1 cardiac injury.

. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020.

. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;2019:3–6.

. Waxman DA, Kanzaria HK, Schriger DL. Acute myocardial infarction after laboratory-confirmed influenza infection. N Engl J Med. 2018;378(26):2538–2541. doi: 10.1056/NEJMc1805679.

. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, Wang H, Wan J, Wang X, Lu Z. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2019. https://doi.org/10.1001/jamacardio.2020.1017.

. Chen L, Li X, Chen M, Feng Y, Xiong C. The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2. Cardiovasc Res. 2020;116(6):1097–100.

. Oudit GY, Kassiri Z, Jiang C, Liu PP, Poutanen SM, Penninger JM, et al. SARScoronavirus modulation of myocardial ACE2 expression and inflammation in patients with SARS. Eur J Clin Invest. 2009;39(7):618–25.

. Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol. 2020 doi: 10.1001/jamacardio.2020.1286.

. Clerkin KJ, et al. COVID-19 and cardiovascular disease. Circulation. 2020;141:1648–1655.

. Han Y, et al. CSC expert consensus on principles of clinical management of patients with severe emergent cardiovascular diseases during the COVID-19 epidemic. Circulation. 2020;141:e810–e816.

. Huang C, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. doi: 10.1016/S0140-6736(20)30183-5.

. Wang D, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020 doi: 10.1001/jama.2020.1585.

. Guan WJ, et al. Clinical characteristics of coronavirus disease 2019 in China. N. Engl. J. Med. 2020;382:1708–1720.

. Shi S, et al. Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019. Eur. Heart J. 2020;41:2070–2079.

. Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395:1607–1608.

. Sellers SA, Hagan RS, Hayden FG, Fischer WA 2nd. The hidden burden of influenza: a review of the extra‐pulmonary complications of influenza infection. Influenza Other Respir Viruses. 2017;11:372‐393.

. Alexander LK, Small JD, Edwards S, Baric RS. An experimental model for dilated cardiomyopathy after rabbit coronavirus infection. J Infect Dis. 1992;166:978‐985.

. Xiong TY, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long‐term implications. Eur Heart J. 2020. 10.1093/eurheartj/ehaa231.

. Yu CM, Wong RS, Wu EB, et al. Cardiovascular complications of severe acute respiratory syndrome. Postgrad Med J. 2006;82:140‐144.

. Lau ST, Yu WC, Mok NS, Tsui PT, Tong WL, Cheng SW. Tachycardia amongst subjects recovering from severe acute respiratory syndrome (SARS). Int J Cardiol. 2005;100:167‐169.

. Pan SF, Zhang HY, Li CS, Wang C. Cardiac arrest in severe acute respiratory syndrome: analysis of 15 cases. Zhonghua Jie He He Hu Xi Za Zhi. 2003;26:602‐605.

. Kwong JC, Schwartz KL, Campitelli MA, Chung H, Crowcroft NS, Karnauchow T, et al. Acute myocardial infarction after laboratory-confirmed influenza infection. N Engl J Med. 2018;378(4):345–53.

. Bandyopadhyay D, Ashish K, Ghosh S, Hajra A, Modi VA. Cardiovascular implications of Zika virus infection. Eur J Intern Med. 2018;52:e35–e3636.

. Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, Bi Z, Zhao Y. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109(5):531–8.

. Rivara MB, Bajwa EK, Januzzi JL, Gong MN, Thompson BT, Christiani DC. Prognostic significance of elevated cardiac troponin-T levels in acute respiratory distress syndrome patients. PLoS ONE. 2012;7(7):e40515.

. Bajwa EK, Boyce PD, Januzzi JL, Gong MN, Thompson BT, Christiani DC. Biomarker evidence of myocardial cell injury is associated with mortality in acute respiratory distress syndrome. Crit Care Med. 2007;35(11):2484–90.

. Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020;55(5):2000524.

. Han H, Xie L, Liu R, Yang J, Liu F, Wu K, et al. Analysis of heart injury laboratory parameters in 273 COVID-19 patients in one hospital in Wuhan, China. J Med Virol. 2020. https://doi.org/10.1002/jmv.25809.

. Deng Q, Hu B, Zhang Y, Wang H, Zhou X, Hu W, et al. Suspected myocardial injury in patients with COVID-19: evidence from front-line clinical observation in Wuhan, China. Int J Cardiol. 2020;311:116–21.

. Zhou B, She J, Wang Y, Ma X. The clinical characteristics of myocardial injury in severe and very severe patients with 2019 novel coronavirus disease. J Infect. 2020. https://doi.org/10.1016/j.jinf.2020.03.021.

. Li JW, Han TW, Woodward M, Anderson CS, Zhou H, Chen YD, Neal B. The impact of novel coronavirus on heart injury: a systematic review and meta-analysis. Prog Cardiovasc Dis. 2020. https://doi.org/10.1016/j.pcad.2020.04.008.

. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus‐infected pneumonia in wuhan, China. JAMA. 2020. 10.1001/jama.2020.1585.

. Shi S, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID‐19 in Wuhan, China. JAMA. 2020. 10.1001/jamacardio.2020.0950.

. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497‐506.

. Guo T, Fan Y, Chen M, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID‐19). JAMA Cardiol. 2020. 10.1001/jamacardio.2020.1017.

. Wang D., Hu B., Hu C. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. J Am Med Assoc. 2020.

. Li B., Yang J., Zhao F. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020.

. Wu Z., McGoogan J.M. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese center for disease Control and prevention. J Am Med Assoc. 2020.

. Arentz M., Yim E., Klaff L. Characteristics and outcomes of 21 critically Ill patients with COVID-19 in Washington state. J Am Med Assoc. 2020.

. Ratliff NB, Estes ML, McMahon JT, Myles JL. Chloroquine‐induced cardiomyopathy. Arch Pathol Lab Med. 1988;112:578.

. Roden DM, Harrington RA, Poppas A, Russo AM. Considerations for drug interactions on QTc in exploratory COVID-19 treatment. Circulation. 2020;141:e906–e907.

. Mercuro NJ, et al. Risk of QT interval prolongation associated with use of hydroxychloroquine with or without concomitant azithromycin among hospitalized patients testing positive for coronavirus disease 2019 (COVID-19) JAMA Cardiol. 2020 doi: 10.1001/jamacardio.2020.1834.

. Hancox JC, Hasnain M, Vieweg WV, Crouse EL, Baranchuk A. Azithromycin, cardiovascular risks, QTc interval prolongation, Torsade de Pointes, and regulatory issues: a narrative review based on the study of case reports. Ther. Adv. Infect. Dis. 2013;1:155–165.

. Rosenberg ES, et al. Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York state. JAMA. 2020 doi: 10.1001/jama.2020.8630.

. Hong N, Du XK. Avascular necrosis of bone in severe acute respiratory syndrome. Clin Radiol. 2004;59(7):602–8.

. Zhang P, Li J, Liu H, Han N, Ju J, Kou Y, et al. Long-term bone and lung consequences associated with hospital-acquired severe acute respiratory syndrome: a 15-year follow-up from a prospective cohort study. Bone Res. 2020;8:8.

. Sung PH, Yang YH, Chiang HJ, Chiang JY, Chen CJ, Yip HK, et al. Cardiovascular and cerebrovascular events are associated with nontraumatic osteonecrosis of the femoral head. Clin Orthop Relat Res. 2018;476(4):865–74.

. Kang JH, Lin HC. Increased risk for coronary heart disease after avascular necrosis of femoral head: a 3-year follow-up study. Am Heart J. 2010;159(5):803–808e1.

. Lam MH, Wing YK, Yu MW, Leung CM, Ma RC, Kong AP, et al. Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up. Arch Intern Med. 2009;169(22):2142–7.

. Das A, Roy B, Schwarzer G, Silverman MG, Ziegler O, Bandyopadhyay D, et al. Comparison of treatment options for depression in heart failure: a network meta-analysis. J Psychiatr Res. 2019;108:7–23.

. Patel N, Chakraborty S, Bandyopadhyay D, Amgai B, Hajra A, Atti V, et al. Association between depression and readmission of heart failure: a national representative database study. Prog Cardiovasc Dis. 2020. https://doi.org/10.1016/j.pcad.2020.03.014.

. De Hert M, Detraux J, Vancampfort D. The intriguing relationship between coronary heart disease and mental disorders. Dialogues Clin Neurosci. 2018;20(1):31–40.

. Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J Am Coll Cardiol. 2020. https://doi.org/10.1016/j.jacc.2020.04.011.

. De Filippo O, D’Ascenzo F, Angelini F, Bocchino PP, Conrotto F, Saglietto A, et al. Reduced rate of hospital admissions for ACS during Covid-19 outbreak in Northern Italy. N Engl J Med. 2020. https://doi.org/10.1056/NEJMc2009166.

. Baldi E, Sechi GM, Mare C, Canevari F, Brancaglione A, Primi R, et al. Out-of-hospital cardiac arrest during the Covid-19 outbreak in Italy. N Engl J Med. 2020. https://doi.org/10.1056/NEJMc2010418.

Published
2021-09-01
Section
Articles