Severe Acute Respiratory Syndrome Coronavirus 2: The Importance of Prompt Detection of Cardiovascular Involvement

Increased morbidity and mortality are associated with coronavirus disease 2019 (COVID-19) when there is cardiovascular (CV) involvement. Due to the absence of prospective, well-designed, controlled studies, the exact mechanism responsible for cardiac injury among patients with COVID-19 remains uncertain. However, possible mechanisms described in observational studies can be considered. Non-ischemic events and ischemic myocardial involvement are the two main pathophysiological mechanisms of acute cardiac injury in COVID-19 patients. Non-ischemic myocardial injury is probably predominant and is secondary to multiple pathological mechanisms. Cardiac involvement is relatively common among hospitalized patients with COVID-19 and is associated with a greater risk of in-hospital mortality and ventricular arrhythmias. There was also a high and significantly positive linear correlation between troponin T and plasma high-sensitivity C-reactive protein levels. It is important to promptly detect CV involvement to avoid increased mortality in these patients. These findings highlight the importance of clinical surveillance and laboratory testing of serum troponin levels to ensure appropriate early identification and proceed with appropriate treatment. This should apply to patients with/without prior CV involvement. There are several possible mechanisms of myocardial tissue damage and the exact mechanisms involved need to be explored in well-designed studies.