The Cardiovascular Manifestations of COVID-19

Louis, David; Saad, Marwan; Vijayakumar, Shilpa; Ilyas, Suleman; Kokkirala, Aravind; Aronow, Herbert D.

doi:10.1016/j.hfc.2022.08.001

Cited by 5 publications

(6 citation statements)

References 75 publications

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“…A hyperinflammatory state with plaque rupture events, as well as the upregulation of procoagulants and platelet activation, are proposed mechanisms for MI in COVID-19. MI is described more frequently in COVID-19 patients with preexisting cardiovascular disease [4]. At the beginning of the pandemic, high prevalences of MI, ranging from 5% to 38%, were reported [35] with increased mortality rates [36].…”

Section: Myocardial Infarction (Mi)mentioning

confidence: 99%

Evolving Clinical Manifestations and Outcomes in COVID-19 Patients: A Comparative Analysis of SARS-CoV-2 Variant Waves in a Romanian Hospital Setting

Briciu,

Leucuta,

Muntean

et al. 2023

Pathogens

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The aim of this study was to evaluate differences in the clinical manifestations and outcomes in hospitalized patients with COVID-19 in a single Romanian center during four pandemic waves determined by different SARS-CoV-2 variants of concern (VOCs). A retrospective study on 9049 consecutive hospitalized adult patients was performed between 27 February 2020 and 31 March 2023. The study interval was divided into waves based on national data on SARS-CoV-2 VOCs’ circulation. Multivariate logistic regression models were built, predicting death and complications as functions of comorbidities, therapy, wave, severity form, and vaccination status, and adjusted for ages ≥65 years. Pulmonary (pneumothorax/pneumomediastinum, pulmonary embolism) and extrapulmonary complications (liver injury, acute kidney injury, ischemic/hemorrhagic stroke, myocardial infarction, and gastrointestinal bleeding) were present, more frequently in ICU hospitalized patients and with differences between waves. The highest in-hospital mortality was found in patients presenting pneumothorax/pneumomediastinum. All of the evaluated risk factors were significantly associated with death, except for obesity and the Omicron wave. Our study highlights the changing nature of COVID-19 and acknowledges the impacts of viral mutations on disease outcomes. For all four waves, COVID-19 was a severe disease with a high risk of poor outcomes.

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Section: Myocardial Infarction (Mi)mentioning

confidence: 99%

Evolving Clinical Manifestations and Outcomes in COVID-19 Patients: A Comparative Analysis of SARS-CoV-2 Variant Waves in a Romanian Hospital Setting

Briciu,

Leucuta,

Muntean

et al. 2023

Pathogens

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“…This receptor facilitates viral entry into host cells, causing endothelial dysfunction, hypercoagulability, and inflammation [ 3 ]. Cardiovascular manifestations include acute coronary syndrome, arrythmias, cardiogenic shock, and cardiomyopathy [ 4 ]. The mechanisms involved are complex, involving an interplay between systematic inflammation, direct viral effects on myocardial cells, and vascular infection [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…The aim of this article is to summarize relevant data on the pathophysiology of COVID-19 and SCAD along with a review of the reported cases on ACS following SARS-CoV-2 infection and, thus, to provide insights about the relationship between COVID-19 and SCAD [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Coronary Artery Dissection and COVID-19: A Review of the Literature

Tsigkas,

Bozika,

Nastouli

et al. 2024

Life

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SARS-CoV-2 is responsible for the global coronavirus disease 2019 (COVID-19) pandemic. While the cardiovascular effects of COVID-19 have been thoroughly described, there are limited published studies in the literature establishing a connection between spontaneous coronary artery dissection (SCAD) and COVID-19. Cardiovascular manifestations include, among others, myocarditis, acute myocardial infraction, and thrombosis. In general, SCAD is an uncommon and underdiagnosed cause of acute myocardial infarction (AMI), particularly in younger women and in patients with underlying fibromuscular dysplasia (FMD). Many patients with SCAD often report significant emotional stress, especially in relation with job loss, during the week preceding their cardiac event. Moreover, the COVID-19 pandemic has led to societal stress and increased unemployment, factors that have been associated with cardiovascular morbidity. SCAD emerges as a rare manifestation of coronary artery disease, which a few recent case reports link to COVID-19. The aim of this article is to summarize the relevant data on the pathophysiology of COVID-19 and SCAD along with a review of the reported cases on acute coronary syndrome (ACS) following SARS-CoV2 infection and, thus, to provide insights about the relationship between COVID-19 and SCAD.

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“…4,5 Comorbidities noted to increase risk continue to include diabetes, hypertension (HTN), and chronic lung disease. 6 In patients with COVID-19, there was a higher prevalence of hypertension, diabetes mellitus, and cardiovascular disease. Additionally, direct cardiac manifestations of COVID-19 can be a contributing factor of patient mortality.…”

Section: Introductionmentioning

confidence: 99%

“…These cardiovascular manifestations include myocardial injury (MI) due to inflammation, nonischemic cardiomyopathy, pericarditis, coronary vasospasm, and stress cardiomyopathy. 6 Early outcome data from the US and China showed HTN to be among the most prevalent cardiovascular related comorbidities in COVID-19 patients. Hypertensive patients were more likely to be admitted to the hospital.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Hypertension in a STEMI-activated Subset of Patients from 2019 to 2021

Nguyen,

Lee,

Lantz

et al. 2023

Preprint

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About 47% US adults have hypertension(HTN).Prevalence is worse in certain distributions with top quartile in the Southeast.In a subset of patients who present with STEMI,prevalence is 30-40%.An interesting further subset of patients are those who presented as STEMI-alert during COVID-19.COVID-19 wreaked havoc on the world with its first confirmed case in 9January2020.International followed by national transport became limited,followed by announcement of a pandemic.Quarantines and lockdowns were set in place,especially in March2020,to prevent epidemiologic spread.We were interested to observe if STEMI-alerts during this period presented with worse background disease compared to years 2019 and 2021,years before and after COVID-lockdown and peak,including if prevalence of background HTN increased in the population. We obtained patient demographics and risk factors for 1001 adults who were STEMI-activated from 1January2019 to 31December2021 at five sites in Southwest Ohio and compared years 2019 and 2021 to 2020. For 1001 STEMI-alert patients,244 patients(72.6%) had HTN in 2019, 250(78.9%) in 2020 and 261(75.0%) in 2021.Overall prevalence over three years was 755(75.4%). Compared to 2020, 2019 prevalence was not significant(p=0.12)(OR 0.72)(CI 0.47,1.09).Neither was 2021(p=0.25)(OR 0.78)(CI 0.51,1.19). STEMI-alert patients at our institution appeared to have higher overall prevalence of HTN than reported nationally by the CDC,75.4% versus 47%.These may have self-selected for disease severity by STEMI-alert status.HTN may also be of higher prevalence here,associated with poor disease detection or patient compliance issues when antihypertensives are prescribed.HTN prevalence did not have statistical significance across observed years despite our hypothesis that patients would present with more background cardiac comorbidities such as HTN.

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The Cardiovascular Manifestations of COVID-19

Cited by 5 publications

References 75 publications

Evolving Clinical Manifestations and Outcomes in COVID-19 Patients: A Comparative Analysis of SARS-CoV-2 Variant Waves in a Romanian Hospital Setting

Evolving Clinical Manifestations and Outcomes in COVID-19 Patients: A Comparative Analysis of SARS-CoV-2 Variant Waves in a Romanian Hospital Setting

Spontaneous Coronary Artery Dissection and COVID-19: A Review of the Literature

Prevalence of Hypertension in a STEMI-activated Subset of Patients from 2019 to 2021

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