COVID-19 and its cardiovascular effects: a systematic review of prevalence studies

Abstract

BackgroundA small minority of people with coronavirus disease 2019 (COVID-19) develop a severe illness, characterised by inflammation, microvascular damage and coagulopathy, potentially leading to myocardial injury, venous thromboembolism (VTE) and arterial occlusive events. People with risk factors for or pre-existing cardiovascular disease may be at greater risk. ObjectivesTo assess the prevalence of pre-existing cardiovascular comorbidities associated with suspected or confirmed cases of COVID-19 in a variety of settings, including the community, care homes and hospitals. We also assessed the nature and rate of subsequent cardiovascular complications and clinical events in people with suspected or confirmed COVID-19. Search methodsWe conducted an electronic search from December 2019 to 24 July 2020 in the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, covid-19.cochrane.org, ClinicalTrials.gov and EU Clinical Trial Register. Selection criteriaWe included prospective and retrospective cohort studies, controlled before-and-a er, case-control and cross-sectional studies, and randomised controlled trials (RCTs). We analysed controlled trials as cohorts, disregarding treatment allocation. We only included peerreviewed studies with 100 or more participants, and excluded articles not written in English or only published in pre-print servers.COVID-19 and its cardiovascular e ects: a systematic review of prevalence studies (Review)

Guidelines: Discharge Instructions for Covid-19 Patients

“…Of foremost importance, for COVID-19 patients having been discharged to home, is diarying daily oxygen saturation levels, pulse rate, and body temperature. Specific details regarding consultation with a physician include oxygen saturation levels declining below 93%; 22 - 26 pulse rate >100 heart beats per min; 27 - 29 fever above 100.4° Fahrenheit (38° Celsius) or excessive chilling with or without tremor (rigors); 30 - 33 difficulty breathing with >24 respirations per min; 27 , 30 , 34 - 36 shortness of breath 30 ; worsening cough with our without productive sputum 30 , 37 - 39 ; development of nausea, vomiting or diarrhea or worsening of any of these signs 33 , 40 - 42 ; new onset chest pain or chest pressure that does not resolve; confusion 43 - 45 ; sleep disorder 46 ; evidence of cyanotic or erythematous skin discoloration of the oral labia or face or the skin of the toes or fingers 33 , 47 - 52 ; a generalized feeling of worsening 53 - 62 which may necessitate prompt remeasuring and dairying of the oxygen saturation level.…”

Treatment-Resistant Acute Upper Limb Ischemia in a Patient With Systemic Lupus Erythematous and Concomitant SARS-CoV-2 Infection: A Case Report

“…COVID-19 disease is a severe acute respiratory syndrome, characterized by symptoms involving the upper and lower airways, fever, cough, and dyspnea, which can evolve to acute respiratory distress syndrome, shock, and multiple organ failure. Moreover, the disease is associated with a state of hypercoagulability, increasing the incidence of venous and, less often, arterial thrombo-embolic events and cardiovascular complication 2 , 14 .…”

“…Inflammation, thrombosis and microvascular obstruction may lead to multi-organ dysfunction, including myocardial injury, regardless the presence of atherosclerotic coronary disease 2 . Several cardiovascular manifestations, including thrombosis, arrhythmias, heart failure and shock 3 , 4 are observed during COVID-19 infection.…”

Cardiovascular and Renal Risk Factors and Complications Associated With COVID-19

“…Moreover, in addition to the lungs, COVID-19 has been found to cause dysfunction of multiple organs affecting the heart, kidneys and liver (4,5), and it has also been postulated that SARS-CoV-2 may invade the central nervous system similar to other coronaviruses, although conclusive data are lacking (6). Emerging evidence clearly indicates complex interactions between COVID-19 and the cardiovascular system, with poorer outcomes for those with underlying comorbidities, and the possibility of direct and long-lasting cardiovascular damage (7,8).…”