Cardiac Complications of COVID-19 Infection and the Role of Physical Activity

Abstract

Since December 2019, the newly emerging coronavirus has become a global pandemic with >250 million people infected and >5 million deaths worldwide. Infection with coronavirus disease-2019 (COVID-19) causes a severe immune response and hypercoagulable state leading to tissue injury, organ damage, and thrombotic events. It is well known that COVID-19 infection predominately affects the lungs; however, the cardiovascular complications of the disease have been a major cause of morbidity and mortality. In addition, patients with cardiovascular disease are vulnerable to contract a severe form of the illness and increased mortality. A significant number of patients who survived the disease may experience post-COVID-19 syndrome with a variety of symptoms and physical limitations. Here, we review the cardiac complications of COVID-19 infection and the results of cardiopulmonary exercise testing and guidelines for exercise training after infection.

Figure.

Summary of cardiac manifestations of COVID-19 infections. Primary involvement includes acute coronary syndromes, myocarditis, and brady- and tachyarrhythmias. Secondary involvement includes acute myocardial injury manifested with elevated cardiac troponin levels above the 99th percentile of upper reference limit. Heart failure and stress cardiomyopathy are also considered secondary complications of COVID-19 infection. This figure is available in color online (www.jcrpjournal.com).