Monday, March 30, 2020

COVID-19: Cardiovascular complications

Hi everyone... 

Virus infections are the most common cause of myocarditis. The previous severe acute respiratory syndrome (SARS) beta-coronavirus SARS-CoV-1 was associated with tachyarrhythmias, signs, and symptoms of heart failure.

Let's learn about SARS-CoV-2:
  • COVID-19 patients who died had higher levels of troponin, myoglobin, C-reactive protein, serum ferritin, and IL-6.
  • This is because of the high inflammatory burden in COVID-19.
Let’s find out and understand about CVS complications by COVID-19:
  • Mainly, vascular inflammation, myocarditis, and cardiac arrhythmias
  • The possible late phenomenon of the viral respiratory infection
  • Commonly observed in severe cases
  • Strongly associated with mortality
Cardiovascular complications of COVID-19 



Cardiac MRI Findings in COVID-19:
  • ⬆️ Wall thickness with diffuse biventricular hypokinesis (especially in the apical segments) 
  • Severe LV dysfunction (LVEF < 35%)
  • Circumferential pericardial effusion ( notable around the right chambers) 
Short tau inversion recovery and T2-mapping sequences: 
  • Marked biventricular myocardial interstitial edema
  • Diffuse late gadolinium enhancement involving the entire biventricular wall 
CVS complications as an important prognostic factor:
Patients who have high troponin levels showed a higher incidence of complications such as
  • ARDS 
  • Malignant arrhythmias 
  • Acute renal injury 
  • Acute coagulopathy 
Lastly, what are the major risk factors for COVID-19 mortality?
  • advanced age (>60 years)
  • male sex
Strong and independent risk factors: 
  • the presence of comorbidities ( HTN, coronary artery disease) 
  • cardiac injury, myocarditis, and ARDS 
Thank you,
Written by Drashtant 

References:
Inciardi RM, Lupi L, Zaccone G, et al. Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. Published online March 27, 2020. doi:10.1001/jamacardio.2020.1096

Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA Cardiol. Published online March 27, 2020. doi:10.1001/jamacardio.2020.1286

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