IMR Press / RCM / Volume 21 / Issue 3 / DOI: 10.31083/j.rcm.2020.03.124
Open Access Systematic Review
Cardiovascular system and COVID-19: manifestations and therapeutics
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1 Community Heart and Vascular Hospital, Indianapolis, IN 46250, USA
2 Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
*Correspondence: jmahenthiran@ecommunity.com (Jo Mahenthiran)
Rev. Cardiovasc. Med. 2020, 21(3), 399–409; https://doi.org/10.31083/j.rcm.2020.03.124
Submitted: 2 July 2020 | Revised: 6 August 2020 | Accepted: 7 August 2020 | Published: 30 September 2020
(This article belongs to the Special Issue Utilizing Technology in the COVID 19 era)
Copyright: © 2020 Mahenthiran et al. Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

The world is currently in the midst of a daunting global pandemic due to SARS-CoV-2 viral infection and associated COVID-19 disease. Healthcare professionals are tasked with the challenge of managing diverse multisystem clinical manifestations of this infection. Although acute hypoxic respiratory failure is the hallmark of severe COVID-19 disease, there have been diverse manifestations within the cardiovascular (CV) system that each pose unique therapeutic challenges. Of these manifestations, myocardial injury and right ventricular dysfunction are the most common, however, heart failure, circulatory shock, cardiomyopathy, arrhythmia, and vascular thrombosis have been noted as well. Furthermore, these CV related manifestations portend greater morbidity and mortality, which requires clinicians to be familiar with the most recent information to provide informed patient care. Although there are limited treatment options available for COVID-19, it is imperative that the potential cardiovascular implications of these therapies are considered in these patients. This review highlights the pathophysiological mechanisms of and therapeutics for CV manifestations of COVID-19 as well as the CV implications of proposed COVID-19 therapies. Since our hospital-based providers are the frontline caregivers battling this pandemic, the aim of this review is to assist with clinical decision-making for optimal patient outcomes while maintaining a safe environment for healthcare personnel.

Keywords
Coronavirus
COVID-19
cardiovascular system
cardiac injury
heart failure
myocarditis
myocardial infarction
cardiac therapy
arrhythmia
thrombosis
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