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More than 20 million human beings got infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and suffered from coronavirus disease 2019 (COVID-19) disease in the current global pandemic. This disease flow showed a heterogeneous spectrum due to various personalized underlying causes and immunogenetics makeup of an individual. Substantial evidence suggests that the severity of pneumonia, acute respiratory distress syndrome, multi-organ failures, and deaths in COVID-19 is attributable to cytokine storm. Thus, in a cytokine storm, the dysregulated immune system is triggered by superantigen of SARS-CoV-2 to release various cytokines with high speed and increased blood circulation concentrations, leading to diverse clinical manifestations of massive multi-organ destruction and death due to exuberant hyperinflammation at a local and systemic level. SARS-CoV-2 can also significantly affect the cardiovascular system of the infected persons through a systemic outburst of the cytokine storm. SARS-CoV-2 infection accompanies many cardiovascular complications that include myocardial infarction, myocarditis, microangiopathy, venous thromboembolism, and a cytokine storm burden resulting in heart failure. This narrative review attempts to gather all recent evidence by Internet-based literature search with relevant keywords related to coronavirus disease with main objective and focus on possible mechanisms of pathophysiology of troponin elevation and cardiovascular complications, with its diagnosis and recent guidelines for its management.

Introduction The unpredictable course and sheer magnitude of coronavirus disease 2019 (COVID-19) have sparked a search for novel and repurposed pharmacological interventions. Non-pharmacological interventions may also play a role in the management of this multifaceted disease. This study aimed to evaluate the safety, feasibility, and effect of yoga in hospitalized patients with moderate COVID-19. Methods Twenty patients satisfying the inclusion criterion were randomized (1:1 ratio) into Intervention and Control groups. Patients in the intervention arm performed a one-hour yoga session that included pranayama and Gayatri mantra (GM) chant for up to 14 days. Sessions were fully supervised by a trained yoga trainer via an online platform. Patients in both groups received the normal treatment as per national guidelines. Outcome parameters were recorded on the 14th day/end of the hospital stay. Results Yoga is safe and feasible in hospitalized patients with COVID-19. The decline of high-sensitivity C-reactive protein (hs-CRP) levels was significantly greater in the Intervention Group. Quality of life (QOL), depression, anxiety, and fatigue severity scale (FSS) showed a decline in both groups with a significant decline observed in FSS scores of the Intervention Group. Median chest X-ray score values, duration of hospital stay, and reverse transcription-polymerase chain reaction (RT-PCR) conversion days were observed to be lower in the Intervention Group but were not significant (p>0.05). Conclusion The study found that incorporating pranayama and GM practices in hospitalized patients with moderate COVID-19 pneumonia was safe and feasible. It showed a notable reduction in hs-CRP levels and FSS scores in the Intervention Group, but the study was not powered to detect statistically significant results. Further research with larger sample sizes is needed for conclusive findings.

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