Jenn‑Yeu Songa,b,c†, Jian‑You Huangc,d†, Yi‑Chiung Hsub, Men‑Tzung Lob, Chen Linb, Ta‑Chung Shena, Min‑Tser Liaoe,f,g*, Kuo‑Cheng Luh*
aDivisionof Cardiovascular Surgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan, bDepartment of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan, cSchool of Medicine, Tzu Chi University, Hualien, Taiwan, dDepartment of Anesthesiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan, eDepartment of Pediatrics, Taoyuan Armed Forces General Hospital Hsinchu Branch, Hsinchu, Taiwan, fDepartment of Pediatrics, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, gDepartment of Pediatrics, Tri‑Service General Hospital, National Defense Medical Center, Taipei, Taiwan, hDivision of Nephrology, Department of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
†Both authors contributed equally to this work
Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus behind the coronavirus disease 2019 (COVID‑19) pandemic, is a type of RNA virus that is nonsegmented. Cardiovascular diseases (CVDs) increase the mortality risk of patients. In this review article, we overview the existing evidence regarding the potential mechanisms of myocardial damage in coronavirus disease 2019 (COVID‑19) patients. Having a comprehensive knowledge of the cardiovascular damage caused by SARS‑CoV‑2 and its underlying mechanisms is essential for providing prompt and efficient treatment, ultimately leading to a reduction in mortality rates. Severe COVID‑19 causes acute respiratory distress syndrome and shock in patients. In addition, awareness regarding COVID‑19 cardiovascular manifestations has increased, including the adverse impact on prognosis with cardiovascular involvement. Angiotensin‑converting enzyme 2 receptor may play a role in acute myocardial injury caused by SARS‑CoV‑2 infection. COVID‑19 patients experiencing heart failure may have their condition exacerbated by various contributing factors and mechanisms. Increased oxygen demand, myocarditis, stress cardiomyopathy, elevated pulmonary pressures, and venous thrombosis are potential health issues. The combination of these factors may lead to COVID‑19‑related cardiogenic shock, resulting in acute systolic heart failure. Extracorporeal membrane oxygenation (ECMO) and left ventricular assist devices (LVADs) are treatment options when inotropic support fails for effective circulatory support. To ensure effective COVID‑19‑related cardiovascular disease (CVD) surveillance, it is crucial to closely monitor the future host adaptation, viral evolution, and transmissibility of SARS‑CoV‑2, given the virus’s pandemic potential.
Keywords: Angiotensin‑converting enzyme 2 receptor, Cardiovascular disease, Coronavirus disease 2019
