Ahead of Print
DOI: https://doi.org/10.36660/abc.20200279
REVIEW ARTICLE
The Heart and COVID-19: What Cardiologists Need to Know
Isabela Bispo Santos da Silva Costa
Cristina Salvadori Bittar
Stephanie Itala Rizk
Antônio Everaldo de Araújo Filho
Karen Alcântara Queiroz Santos
Theuran Inahja Vicente Machado
Fernanda Thereza de Almeida Andrade
Thalita Barbosa González
Andrea Nataly Galarza Arévalo
Juliano Pinheiro de Almeida
Fernando Bacal
Gláucia Maria Moraes de Oliveira
Marcus Vinícius Guimarães de Lacerda
Silvio Henrique Barberato
Antonio Carlos Palandri Chagas
Carlos Eduardo Rochitte
José Antonio Franchini Ramires
Roberto Kalil Filho
Ludhmila Abrahão Hajjar
Figure 1 - Coronavirus and the heart. Patients with risk factors and/or cardiovascular disease are prone to develop severe forms of COVID-19 and its complications. Pulmonary impairment manifests initially as an influenza syndrome (cough and fever), progressing to pneumonia (dyspnea, hypoxemia, tachypnea) and, in some cases, to ARDS. Host response to the virus leads to systemic inflammation findings, with elevation of markers of inflammation (CRP, procalcitonin, d-dimer, IL-6, ferritin, LDH) and of myocardial injury / cardiac dysfunction (troponin/NT-proBNP), which predisposes to acute heart failure, myocarditis, thrombosis and arrhythmias. Cardiovascular complications hinder the host response to the virus, leading to shock, failure of multiple organs and death. CAD: coronary artery disease; LDH: lactate dehydrogenase; LVEF: left ventricular ejection fraction; CRP: C-reactive protein; IL-6: interleukin-6; ARDS: acute respiratory distress syndrome.
Keywords: Coronavirus; COVID-19; Cardiovascular Diseases/complications; Heart/physiopathology; Pandemics; Respiratory Distress Syndrome, Adult; Risk Factors; Patient Care.