Sudden cardiac death in COVID-19 Patients

Author(s): Dur-e-Najaf, Rubab Tahir, Sajjad Ahmad

Sudden cardiac death has been one alarming outcome reported in patients infected by the novel SARS-CoV-2. Cardiac involvement in COVID-19 patients may manifest as myocarditis, arrhythmias, acute coronary artery syndrome, atherosclerosis, dilated cardiac myopathy, myocardial infarction, and congestive heart failure. Elderly, males, and individuals with previous medical history of comorbidities (hypertension, diabetes mellitus, dyslipidemia) are more likely to suffer severe outcomes, sudden cardiac death being one of them. In this review, we highlight the underlying pathophysiology of plausible causes for sudden cardiac death in both pre and post COVID patients keeping in view the presently known viral characteristics. We discuss multiple organ failure due to cytokine storm, electrophysiological, hemodynamic, microscopic, and macroscopic cardiovascular changes for each cardiac pathology presented in SARS-CoV-2 patients. This literature review also enlists possible management and treatment options with their mode of action, uses and adverse effects. 3 major data bases: PubMed, Wiley Online Library and Google Scholar were used to review case reports, case series, letters to editor, narrative reviews, systemic reviews, randomized control trials, observational studies, and meta-analysis. The COVID-19 pandemic has pressured nations and health workers worldwide to control both the spread and deleterious health effects associated with SARS-CoV-2. Comprehensive knowledge of peculiar cardiac manifestations, along with further epidemiological studies and clinical trials is needed for optimum management of patients.