From the Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Cardiol Rev. 2022;30(3):145-157. doi: 10.1097/CRD.0000000000000422.
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 and was first reported in December 2019 in Wuhan, China. Since then, it caused a global pandemic with 212,324,054 confirmed cases and 4,440,840 deaths worldwide as of August 22, 2021. The disease spectrum of COVID-19 ranges from asymptomatic subclinical infection to clinical manifestations predominantly affecting the respiratory system. However, it is now evident that COVID-19 is a multiorgan disease with a broad spectrum of manifestations leading to multiple organ injuries including the cardiovascular system. We review studies that have shown that the relationship between cardiovascular diseases and COVID-19 is indeed bidirectional, implicating that preexisting cardiovascular comorbidities increase the morbidity and mortality of COVID-19, and newly emerging cardiac injuries occur in the settings of acute COVID-19 in patients with no preexisting cardiovascular disease. We present the most up-to-date literature summary to explore the incidence of new-onset cardiac complications of coronavirus and their role in predicting the severity of COVID-19. We review the association of elevated troponin with the severity of COVID-19 disease, which includes mild compared to severe disease, in nonintensive care unit compared to intensive care unit patients and in those discharged from the hospital compared to those who die. The role of serum troponin levels in predicting prognosis are compared in survivors and non-survivors. The association between COVID-19 disease and myocarditis, heart failure and coagulopathy are reviewed. Finally, an update on beneficial treatments is discussed.
2019 年冠状病毒病（COVID-19）由严重急性呼吸系统综合征冠状病毒 2 引起，于 2019 年 12 月在中国武汉首次报告。自那时以来，它在全球范围内引发了大流行，截至 2021 年 8 月 22 日，全球已确诊 212,324,054 例，死亡 4,440,840 例。COVID-19 的疾病谱范围从无症状的亚临床感染到主要影响呼吸系统的临床症状。然而，现在很明显，COVID-19 是一种多器官疾病，其表现谱广泛，导致包括心血管系统在内的多个器官损伤。我们回顾了表明心血管疾病与 COVID-19 之间的关系确实是双向的研究，表明预先存在的心血管合并症会增加 COVID-19 的发病率和死亡率，并且在没有预先存在的心血管疾病的情况下，急性 COVID-19 患者会出现新出现的心脏损伤。我们提出了最新的文献综述，以探讨冠状病毒新发心脏并发症的发生率及其在预测 COVID-19 严重程度中的作用。我们回顾了肌钙蛋白升高与 COVID-19 疾病严重程度的相关性，包括与轻症相比的重症、与非重症监护病房相比的重症监护病房、与出院患者相比的死亡患者。在幸存者和非幸存者中比较了血清肌钙蛋白水平预测预后的作用。还回顾了 COVID-19 疾病与心肌炎、心力衰竭和凝血障碍之间的关系。最后，讨论了有益治疗方法的最新进展。
