Elseidy SA, Awad AK, Vorla M, Fatima A, Elbadawy MA, Mandal D, Mohamad T. Cardiovascular complications in the Post-Acute COVID-19 syndrome (PACS).
Int J Cardiol Heart Vasc 2022;
40:101012. [PMID:
35355927 PMCID:
PMC8958273 DOI:
10.1016/j.ijcha.2022.101012]
[Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/11/2022] [Accepted: 03/17/2022] [Indexed: 01/08/2023]
Abstract
The presence of stress-related (Takotsubo) cardiomyopathy has also been demonstrated in COVID-19.
The proposed mechanisms of cardiac damage during the acute phase of COVID-19 include both direct -viral penetration- and indirect routes -hypoxic injury and systemic inflammation.
SARS-CoV-2 infection, especially in its severe form, is associated with an increased risk for venous thromboembolism (VTE).
Unfractionated heparin (UFH) is the first-line treatment for hemodynamic instability and emergency reperfusion for PASC.
Further studies are needed to offer current screening for the occurrence of cardiovascular problems especially myocardial infarction and heart failure in COVID-19 patients.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) or coronavirus disease 2019 (COVID-19) initially surfaced in December 2019 from Wuhan, China, sweeping the world with various strains, forcing the WHO to declare a pandemic epidemic in March 2020. Furthermore, COVID-19 manifests with a wide array of presentations from fever and fatigue to severe respiratory and cardiovascular complications. Post-COVID-19 syndrome is poorly understood affecting COVID-19 survivors at all levels of disease severity. The disease is most associated with post-discharge dyspnea and fatigue. However, other persistent symptoms as chest pains, palpitations, smell, and taste dysfunctions. Patients with high concentrations of CRP and creatinine in the acute phase of Covid-19 are more prone to cardiac sequelae. Therefore, high levels of cardiac-sensitive troponin and hypokalaemia can also be used for risk stratification. Furthermore, Cardiac damage can manifest as myocarditis, pericarditis, rhythm abnormalities. The use of different diagnostic modalities like electrocardiogram (ECG), echocardiogram, and cardiac magnetic resonance imaging (MRI)(CMR) to evaluate the myocardial damage were studied. However, Cardiovascular complications are a common manifestation of PASC, classification of severity of cardiac symptoms and the emergence of CMR as a diagnostic tool needs more evidence.
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