The Pathogenesis and Long-Term Consequences of COVID-19 Cardiac Injury: State-of-the-Art Review.

Siripanthong, Bhurint; Asatryan, Babken; Hanff, Thomas C; Chatha, Salman R; Khanji, Mohammed Y; Ricci, Fabrizio; Muser, Daniele; Ferrari, Victor A; Nazarian, Saman; Santangeli, Pasquale; Deo, Rajat; Cooper, Leslie T; Mohiddin, Saidi A; Chahal, C Anwar A (2022). The Pathogenesis and Long-Term Consequences of COVID-19 Cardiac Injury: State-of-the-Art Review. JACC. Basic to translational science, 7(3), pp. 294-308. Elsevier 10.1016/j.jacbts.2021.10.011

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The mechanisms of coronavirus disease 2019 (COVID-19)-related myocardial injury comprise both direct viral invasion and indirect (hypercoagulability and immune-mediated) cellular injuries. Some patients with COVID-19 cardiac involvement have poor clinical outcomes, with preliminary data suggesting long-term structural and functional changes. These include persistent myocardial fibrosis, edema, and intraventricular thrombi with embolic events, while functionally, the left ventricle is enlarged, with a reduced ejection fraction and new-onset arrhythmias reported in a number of patients. Myocarditis post-COVID-19 vaccination is rare but more common among young male patients. Larger studies, including prospective data from biobanks, will be useful in expanding these early findings and determining their validity.

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