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Review
. 2022 Aug;364(2):139-147.
doi: 10.1016/j.amjms.2022.01.022. Epub 2022 Feb 11.

COVID-19 and the cardiovascular system: an update

Joshua K Salabei  1 , Zekarias T Asnake  2 , Zeeshan H Ismail  2 , Kipson Charles  2 , Gregory-Thomas Stanger  2 , Abdullahi H Abdullahi  2 , Andrew T Abraham  2 , Peters Okonoboh  2
Affiliations
Review

COVID-19 and the cardiovascular system: an update

Joshua K Salabei et al. Am J Med Sci. 2022 Aug.

Abstract

As COVID-19 continues to cause an increasing number of deaths worldwide, it is important that providers stay abreast with new research related to the pathophysiology of COVID-19 disease presentation states and clinical management. It is now well recognized that COVID-19 affects extrapulmonary organs, particularly the cardiovascular system. For example, cardiogenic shock has been increasingly observed in patients with COVID-19, owing to the various mechanisms involved and the affinity of the SARS-CoV-2 virus to cells comprising the cardiovascular system. In this review, we have briefly discussed the link between the cardiovascular system and COVID-19 infection, focusing on underlying mechanisms including but not limited to cytokine storm, direct virus-induced myocarditis, and ST-elevation myocardial infarction leading to cardiogenic shock. We have highlighted the cardiovascular risk factors associated with disease prognostication in COVID-19 patients. We have also briefly discussed vasopressors and inotropes used for treating shock and presented their mechanism of action, contraindications, and side effects in the hopes of providing a quick reference to help the provider optimize management of COVID-19 patients presenting with cardiovascular complications such as shock.

Keywords: COVID-19; Cardiovascular complications; Coronavirus; Inotropes; Myocarditis; SARS-CoV-2; Shock; Vaccine; Vasopressor.

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Conflict of interest statement

Declaration of Competing Interest None.

Figures

Figure 1:
Figure 1
Types of shock. In COVID-19 patients, similar to non-COVID-19 patients, the cause of shock can be multifactorial, and different shock types can occur simultaneously. Cardiogenic shock can result from a variety of causes given the systemic nature of COVID-19. The cause of shock can also be iatrogenic; hemorrhage can result from anticoagulation therapy while pneumothorax can be caused by barotrauma or has been associated with high dose corticosteroids use., The initial evaluation of critically ill COVID-19 patients supposedly in shock must take into consideration these potential causes.
See this image and copyright information in PMC

References

    1. Zhu N, Zhang D, Wang W, et al. China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382:727–733. - PMC - PubMed
    1. https://www.who.int/emergencies/diseases/novel-coronavirus-2019
    1. Gupta A, Madhavan MV, Sehgal K, et al. Extrapulmonary manifestations of COVID-19. Nat Med. 2020;26:1017–1032. - PMC - PubMed
    1. Ramos-Casals M, Brito-Zerón P, Mariette X. Systemic and organ-specific immune-related manifestations of COVID-19. Nat Rev Rheumatol. 2021;17:315–332. - PMC - PubMed
    1. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA. 2020;323:2052–2059. Erratum in: JAMA. 2020;323:2098. - PMC - PubMed