Cardiac involvement and outcomes in patients with COVID-19 infection

Author(s): Antonio Vacca, Stefano Marcante, Sebastiano Cicco, Luca Bulfone, Laura Scandolin, Sabrina Vidoni, Gabriele Brosolo, Cristiana Catena, Leonardo A. Sechi

Cardiac involvement can be a prominent feature in patients hospitalized with SARS-CoV-2 infection and is associated with a greater risk of death. Moreover, clear evidence indicates that outcomes of COVID-19 infection are closely related with pre-existing cardiovascular conditions. A broad spectrum of clinical manifestations has been described during SARS-CoV-2 infection and multiple mechanisms could be involved in the pathogenesis of cardiac involvement including hypoxia, direct viral injury, cytokine storm, generalized endothelitis, and sympathetic activation. Biochemical and instrumental testing including cardiac imaging studies have been performed in these patients reporting different types of cardiac dysfunction. In this narrative review we overview the clinical spectrum of cardiac involvement with the related short-term outcomes of COVID-19 infection and the biochemical and instrumental findings that could be part of the diagnostic workup that might allow timely therapeutic interventions.