SARS-CoV-2 and myocardial injury: Few answers, many questions

Abstract

Acute cardiac injury, defined as an elevated high-sensitivity troponin I or troponin T upon admission or during hospitalization, is common in patients with COVID-19, occurring in 10% to 35% of patients depending on the assay used and the population studied. Even though the mechanisms of SARS-CoV-2 myocardial injury are not well defined, type 1 myocardial infarction and fulminant myocarditis are rare. Often, acute cardiac injury occurs in patients with elevated inflammatory markers, and both are associated with worse outcomes. However, the extent to which treatments should differ for patients with acute cardiac injury, heightened systemic inflammation, or both, is unknown.