SARS-CoV-2 Infection and Cardiovascular Disease: COVID-19 Heart

Dhakal, Bishnu P.; Sweitzer, Nancy K.; Indik, Julia H.; Acharya, Deepak; William, Preethi

doi:10.1016/j.hlc.2020.05.101

Cited by 164 publications

(160 citation statements)

References 106 publications

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“…The persistence of visual LGE at 3-month follow-up re ecting necrosis (persistent in ammation) or scar ( brosis) might be caused by COVID-19 and needs to be elucidated further 21 . Yet, visual LGE indicated that up to 30% COVID-19 patients have irreversible myocardial injury 22,23 , which is consistent with the ndings of the previous study and can con rm one of the main mechanisms of COVID-19 induced direct myocardial injury-myocarditis [24][25][26] . In addition, the presence of LGE has been proven to be an independent predictor of all-cause mortality and cardiac mortality in myocarditis 27,28 .…”

Section: Discussionsupporting

confidence: 91%

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Wang

Jiang

et al. 2020

Preprint

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Background: Coronavirus disease 2019 (COVID-19) induces myocardial injury, either direct myocarditis or indirect injury due to systemic inflammatory response. Myocardial involvement has been proved to be one of the primary manifestations of COVID-19 infection, according to laboratory test, autopsy, and cardiac magnetic resonance imaging (CMRI). However, the middle-term outcome of cardiac involvement after the patients were discharged from the hospital is yet unknown. The present study aimed to evaluate mid-term cardiac sequelae in recovered COVID-19 patients by CMRIMethods: A total of 47 recovered COVID-19 patients were prospectively recruited and underwent CMRI examination in this study. The CMRI protocol consisted of black blood fat-suppressed T2 weighted imaging (BB-T2WI), T2 star mapping, left ventricle cine imaging, pre- and post-contrast T1 mapping, and late gadolinium enhancement (LGE). Myocardium edema and LGE were assessed in recovered COVID-19 patients. The left ventricle (LV) and right ventricle (RV) function and LV mass were assessed and compared with normal controls.Results: Finally, 44 recovered COVID-19 patients and 31 normal controls were included in this study. No edema was observed in any patient. LGE was found in 13 patients. All LGE lesions were located in the middle myocardium and/or sub-epicardium with a scattered distribution. Further analysis showed that LGE-positive patients had significantly decreased left ventricle peak global circumferential strain (LVpGCS), right ventricle peak global circumferential strain (RVpGCS), right ventricle peak global longitudinal strain (RVpGLS) as compared to non-LGE patients (p＜0.05), while no difference was detected between the non-LGE patients and normal controls.Conclusion: Myocardium injury existed in about 30% of COVID-19 patients. These patients had peak right ventricle strain that decreased at the 3-month follow-up. Cardiac MRI can monitor the COVID-19-induced myocarditis progression, and CMR strain analysis is a sensitive tool to evaluate the recovery of left ventricle circumferential contraction dysfunction and right ventricular dysfunction.

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Section: Discussionsupporting

confidence: 91%

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Wang

Jiang

et al. 2020

Preprint

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“…Progression to severe disease may be marked by acute respiratory distress syndrome (ARDS), with pulmonary edema, bilateral diffuse alveolar damage and hyaline membrane formation (4)(5)(6). Although primarily a respiratory tract infection, extra-respiratory replication of SARS-CoV-2 has been observed in kidney, heart, liver and brain in fatal cases (7)(8)(9). Several experimental animal models for SARS-CoV-2 infection have been developed, including hamsters (10) ferrets (11) and non-human primate models (12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

K18-hACE2 mice develop respiratory disease resembling severe COVID-19

Yinda

Port

Bushmaker

et al. 2020

Preprint

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SARS-CoV-2 emerged in late 2019 and resulted in the ongoing COVID-19 pandemic. Several animal models have been rapidly developed that recapitulate the asymptomatic to moderate disease spectrum. Now, there is a direct need for additional small animal models to study the pathogenesis of severe COVID-19 and for fast-tracked medical countermeasure development. Here, we show that transgenic mice expressing the human SARS-CoV-2 receptor (angiotensin-converting enzyme 2 [hACE2]) under a cytokeratin 18 promoter (K18) are susceptible to SARS-CoV-2 and that infection resulted in a dose-dependent lethal disease course. After inoculation with either 104 TCID50 or 105 TCID50, the SARS-CoV-2 infection resulted in rapid weight loss in both groups and uniform lethality in the 105 TCID50 group. High levels of viral RNA shedding were observed from the upper and lower respiratory tract and intermittent shedding was observed from the intestinal tract. Inoculation with SARS-CoV-2 resulted in upper and lower respiratory tract infection with high infectious virus titers in nasal turbinates, trachea and lungs. The observed interstitial pneumonia and pulmonary pathology, with SARS-CoV-2 replication evident in pneumocytes, were similar to that reported in severe cases of COVID-19. SARS-CoV-2 infection resulted in macrophage and lymphocyte infiltration in the lungs and upregulation of Th1 and proinflammatory cytokines/chemokines. Extrapulmonary replication of SARS-CoV-2 was observed in the cerebral cortex and hippocampus of several animals at 7 DPI but not at 3 DPI. The rapid inflammatory response and observed pathology bears resemblance to COVID-19. Taken together, this suggests that this mouse model can be useful for studies of pathogenesis and medical countermeasure development.

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“…More extensive discussions about the cardiovascular aspects of COVID-19 are provided in some recent reviews [ 87 , 90 , 91 ]. For information on how to manage the various cardiovascular complications of the COVID-19 pandemic, see [ 92 , 93 ] and the guidance provided by the European Society of Cardiology https://www.escardio.org/static_file/Escardio/Education-General/Topic%20pages/Covid-19/ESC%20Guidance%20Document/ESC-Guidance-COVID-19-Pandemic.pdf .…”

Section: Cardiovascular Manifestationsmentioning

confidence: 99%

SARS-CoV-2/COVID-19: a primer for cardiologists

Vries

2020

Neth Heart J

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In the late autumn of 2019, a new potentially lethal human coronavirus designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The pandemic spread of this zoonotic virus has created a global health emergency and an unprecedented socioeconomic crisis. The severity of coronavirus disease 2019 (COVID-19), the illness caused by SARS-CoV‑2, is highly variable. Most patients (~85%) develop no or mild symptoms, while others become seriously ill, some succumbing to disease-related complications. In this review, the SARS-CoV‑2 life cycle, its transmission and the clinical and immunological features of COVID-19 are described. In addition, an overview is presented of the virological assays for detecting ongoing SARS-CoV‑2 infections and the serological tests for SARS-CoV-2-specific antibody detection. Also discussed are the different approaches to developing a COVID-19 vaccine and the perspectives of treating COVID-19 with antiviral drugs, immunomodulatory agents and anticoagulants/antithrombotics. Finally, the cardiovascular manifestations of COVID-19 are briefly touched upon. While there is still much to learn about SARS-CoV‑2, the tremendous recent advances in biomedical technology and knowledge and the huge amount of research into COVID-19 raise the hope that a remedy for this disease will soon be found. COVID-19 will nonetheless have a lasting impact on human society. Electronic supplementary material The online version of this article (10.1007/s12471-020-01475-1) contains supplementary material, which is available to authorized users.

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SARS-CoV-2 Infection and Cardiovascular Disease: COVID-19 Heart

Cited by 164 publications

References 106 publications

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

Cardiac involvement in COVID-19 patients: mid-term follow up by cardiac magnetic resonance imaging

K18-hACE2 mice develop respiratory disease resembling severe COVID-19

SARS-CoV-2/COVID-19: a primer for cardiologists

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