Description and Proposed Management of the Acute COVID-19 Cardiovascular Syndrome
Open accessAbstract
Coronavirus disease 2019 (COVID-19) is a rapidly expanding global pandemic caused by severe acute respiratory syndrome coronavirus 2, resulting in significant morbidity and mortality. A substantial minority of patients hospitalized develop an acute COVID-19 cardiovascular syndrome, which can manifest with a variety of clinical presentations but often presents as an acute cardiac injury with cardiomyopathy, ventricular arrhythmias, and hemodynamic instability in the absence of obstructive coronary artery disease. The cause of this injury is uncertain but is suspected to be related to myocarditis, microvascular injury, systemic cytokine-mediated injury, or stress-related cardiomyopathy. Although histologically unproven, severe acute respiratory syndrome coronavirus 2 has the potential to directly replicate within cardiomyocytes and pericytes, leading to viral myocarditis. Systemically elevated cytokines are also known to be cardiotoxic and have the potential to result in profound myocardial injury. Prior experience with severe acute respiratory syndrome coronavirus 1 has helped expedite the evaluation of several promising therapies, including antiviral agents, interleukin-6 inhibitors, and convalescent serum. Management of acute COVID-19 cardiovascular syndrome should involve a multidisciplinary team including intensive care specialists, infectious disease specialists, and cardiologists. Priorities for managing acute COVID-19 cardiovascular syndrome include balancing the goals of minimizing healthcare staff exposure for testing that will not change clinical management with early recognition of the syndrome at a time point at which intervention may be most effective. This article aims to review the best available data on acute COVID-19 cardiovascular syndrome epidemiology, pathogenesis, diagnosis, and treatment. From these data, we propose a surveillance, diagnostic, and management strategy that balances potential patient risks and healthcare staff exposure with improvement in meaningful clinical outcomes.
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Post-COVID-19 Syndrome Mechanisms, Prevention and Management
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Hydroxychloroquine use is not associated with QTc length in a large cohort of SLE and RA patients
Park, E., Giles, J. T., Perez-Recio, T., Piña, P., Depender, C., Gartshteyn, Y., Askanase, A., Bathon, J. M., & Geraldino-Pardilla, L. B. (2021) · Arthritis Research & Therapy · doi:10.1186/s13075-021-02646-0 · Cited by 36 · see citing works
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Shao, H., & Yin, R. (2024) · Molecular Medicine · doi:10.1186/s10020-024-00855-2 · Cited by 36 · see citing works
Peterson, E., Lo, K. B., DeJoy, R., Salacup, G., Pelayo, J., Bhargav, R., Gul, F., Albano, J., Azmaiparashvili, Z., Amanullah, A. M., et al. (2020) · Coronary Artery Disease · doi:10.1097/mca.0000000000000934 · Cited by 36 · see citing works
- Authors
- Hendren, N. S., Drazner, M. H., Bozkurt, B., & Cooper, L. T.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Michael E. DeBakey VA Medical Center (US)
- Mayo Clinic in Florida (US)
- Corresponding author
- Cooper, Leslie T.
- Venue
- Circulation
- Published
- 2020-06-09
- Volume
- 141
- Issue
- 23
- Pages
- 1903-1914
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC7314493
- OpenAlex
- W3016959086
- Cited by
- 576
- References
- 74
- Citations by year
- 2026: 6 · 2025: 20 · 2024: 24 · 2023: 58 · 2022: 117 · 2021: 183 · 2020: 165 · 2018: 1 · 2013: 1
- FWCI
- 6.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Takotsubo Cardiomyopathy and Associated Phenomena
- Keywords
- COVID-19 pandemic, myocarditis, cardiomyopathy, ventricular arrhythmias, hemodynamic instability, takotsubo cardiomyopathy, IL-6 inhibitors, convalescent serum, antiviral therapy, healthcare worker exposure, surveillance strategy, diagnosis, management
- MeSH terms
- Cytokine Release Syndrome, Angiotensin-Converting Enzyme 2, COVID-19, Interleukin-6 Inhibitors, COVID-19 Serotherapy, Antiviral Agents, Arrhythmias, Cardiac, Cardiovascular Diseases, Hemodynamics, Humans, Immunization, Passive, Peptidyl-Dipeptidase A, Myocarditis, Organ Specificity, Pneumonia, Viral, Receptors, Virus, Risk Factors, Serine Endopeptidases, Biomarkers, Interleukin-6, Cytokines, Immunoglobulins, Intravenous, Infectious Disease Transmission, Patient-to-Professional, Coronavirus Infections, Disease Management, Severe Acute Respiratory Syndrome, Viral Tropism, Pandemics, Molecular Targeted Therapy, Spike Glycoprotein, Coronavirus
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