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Cardiac Injury in COVID-19: A Systematic Review

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Clinical, Biological and Molecular Aspects of COVID-19

Part of the book series: Advances in Experimental Medicine and Biology ((PMISB,volume 1321))

Abstract

Coronavirus 2019 (COVID-19) is responsible for the current pandemic which has already resulted in considerable mortality worldwide. This systematic review was conducted to summarize the results of the published articles assessing the incidence of heart diseases in patients infected with COVID-19. The electronic databases Scopus, Web of Science, Pubmed, Science Direct, and ProQuest were used to search for potentially relevant articles. Articles published from Dec 2019 to April 2020 were included. All cross-sectional, retrospective or prospective observational cohort and case-control studies were selected which reported the incidence or prevalence of myocardial injury, myocardial infarction, or cardiovascular disease in patients with confirmed COVID-19 infection. Based on the inclusion criteria, 12 articles were selected. The incidence of cardiac injury was reported in 8 articles and 8 articles focused on the cardiovascular outcomes of COVID-19 infection. The incidence of new cardiac injury was reported to be 7.2–77% in live and dead patients, respectively. The results showed that patients with cardiac injury had worse outcomes including higher mortality than those without cardiac injury. The most common cardiac injury outcomes were shock and malignant arrhythmias. The most common radiographic findings in patients with cardiac injury were multiple mottling and ground-glass opacities in the lungs (64.6%). A significant number of patients with cardiac injury required noninvasive mechanical ventilation (46.3%) or invasive mechanical ventilation (22.0%). Acute respiratory distress syndrome was seen in 58.5%, acute kidney injury in 8.5%, electrolyte disturbances in 15.9%, hypoproteinemia in 13.4%, and coagulation disorders in 7.3% of patients with cardiac injuries. In addition, survival days were negatively correlated with cardiac troponin I levels (r = −0.42, 95%, p = 0.005). The results of this review showed that myocardial injury in patients with COVID 19 has a poor prognosis. Hence, cardiac investigation and management in these patients are crucial.

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Acknowledgments

Thanks to the guidance, and advice from the Clinical Research Development Unit of Baqiyatallah Hospital.

Author information

Authors and Affiliations

  1. Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran

    Malihe Sadat Moayed & Amir Vahedian-Azimi

  2. Anesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, Iran

    Farshid Rahimi-Bashar

  3. Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK

    Thozhukat Sathyapalan

  4. Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil

    Paul C. Guest

  5. Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran

    Tannaz Jamialahmadi

  6. Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Tannaz Jamialahmadi

  7. Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

  8. Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

  9. Halal Research Center of IRI, FDA, Tehran, Iran

    Amirhossein Sahebkar

  10. Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland

    Amirhossein Sahebkar

Authors
  1. Malihe Sadat Moayed
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  2. Farshid Rahimi-Bashar
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  3. Amir Vahedian-Azimi
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  4. Thozhukat Sathyapalan
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  5. Paul C. Guest
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  6. Tannaz Jamialahmadi
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  7. Amirhossein Sahebkar
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Corresponding authors

Correspondence to Amir Vahedian-Azimi or Amirhossein Sahebkar .

Editor information

Editors and Affiliations

  1. University of Campinas, São Paulo, Brazil

    Paul C. Guest

Appendix 1

Appendix 1

Scopus: 44 (TITLE-ABS-KEY ("Novel coronavirus" OR "Novel coronavirus 2019" OR "2019 novel coronavirus" OR "2019 nCoV" OR "Wuhan coronavirus" OR "Wuhan pneumonia" OR covid-19 OR "2019-nCoV" OR "SARS-CoV-2" OR "coronavirus 2019" OR "2019-nCoV") AND TITLE-ABSKEY (cardiovascular OR myocardial OR myocarditis OR myocardium OR heart OR cardiac OR hypotension OR tachycardia OR bradycardia OR fibrillation OR ventricular OR arrhythmia OR hypertension OR "blood pressure")

EMBASE: 65 ('novel coronavirus':ti,ab,kw OR 'novel coronavirus 2019':ti,ab,kw OR '2019 novel coronavirus':ti,ab,kw OR 'wuhan coronavirus':ti,ab,kw OR 'wuhan pneumonia':ti,ab,kw OR 'covid 19':ti,ab,kw OR 'sars cov 2':ti,ab,kw OR 'coronavirus 2019':ti,ab,kw OR '2019 ncov':ti,ab,kw) AND (cardiovascular:ti,ab,kw OR myocardial:ti,ab,kw OR myocarditis:ti,ab,kw OR myocardium:ti,ab,kw OR heart:ti,ab,kw OR cardiac:ti,ab,kw OR hypotension:ti,ab,kw OR tachycardia:ti,ab,kw OR bradycardia:ti,ab,kw OR fibrillation:ti,ab,kw OR ventricular:ti,ab,kw OR arrhythmia:ti,ab,kw OR hypertension:ti,ab,kw OR 'blood pressure':ti,ab,kw)

ProQuest: 94 ab ("Novel coronavirus" OR "Novel coronavirus 2019" OR "2019 novel coronavirus" OR "2019 nCoV" OR "Wuhan coronavirus" OR "Wuhan pneumonia" OR covid-19 OR "2019-nCoV" OR "SARS-CoV-2" OR "coronavirus 2019" OR "2019-nCoV" ) AND ab (cardiovascular OR myocardial OR myocarditis OR myocardium OR heart OR cardiac OR hypotension OR tachycardia OR bradycardia OR fibrillation OR ventricular OR arrhythmia OR hypertension OR "blood pressure" )

Web of science: 12 ("Novel coronavirus" OR "Novel coronavirus 2019" OR "2019 novel coronavirus" OR "2019 nCoV" OR "Wuhan coronavirus" OR "Wuhan pneumonia" OR covid-19 OR "2019-nCoV" OR "SARS-CoV-2" OR "coronavirus 2019" OR "2019-nCoV") AND TOPIC: (cardiovascular OR myocardial OR myocarditis OR myocardium OR heart OR cardiac OR hypotension OR tachycardia OR bradycardia OR fibrillation OR ventricular OR arrhythmia OR hypertension OR "blood pressure")

PubMed: 105 ("Novel coronavirus" [Title/Abstract] OR "Novel coronavirus 2019" [Title/Abstract] OR "2019 novel coronavirus" [Title/Abstract] OR "2019 nCoV" [Title/Abstract] OR "Wuhan coronavirus" [Title/Abstract] OR "Wuhan pneumonia" [Title/Abstract] OR covid-19 [Title/Abstract] OR "2019-nCoV" [Title/Abstract] OR "SARS-CoV-2" [Title/Abstract] OR "coronavirus 2019" [Title/Abstract] OR "2019-nCoV"[Title/Abstract])) AND (cardiovascular [Title/Abstract] OR myocardial [Title/Abstract] OR myocarditis [Title/Abstract] OR myocardium [Title/Abstract] OR heart [Title/Abstract] OR cardiac [Title/Abstract] OR hypotension [Title/Abstract] OR tachycardia [Title/Abstract] OR bradycardia [Title/Abstract] OR fibrillation [Title/Abstract] OR ventricular [Title/Abstract] OR arrhythmia [Title/Abstract] OR hypertension [Title/Abstract] OR "blood pressure"[Title/Abstract])

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Moayed, M.S. et al. (2021). Cardiac Injury in COVID-19: A Systematic Review. In: Guest, P.C. (eds) Clinical, Biological and Molecular Aspects of COVID-19. Advances in Experimental Medicine and Biology(), vol 1321. Springer, Cham. https://doi.org/10.1007/978-3-030-59261-5_29

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