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COVID-19-Associated Myocardial Injury and Other Cardiovascular Diseases
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COVID-19-Associated Myocardial Injury and Other Cardiovascular Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (15 April 2024) | Viewed by 6694

Special Issue Editors

Dr. Allegra Battistoni

E-Mail Website
Guest Editor
Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00189 Rome, Italy
Interests: cardiovascular prevention; cardio-oncology; hypertension
Prof. Dr. Damiano Magrì

E-Mail Website
Guest Editor
Department of Clinical and Molecular Medicine, S. Andrea Hospital, Sapienza University of Rome, 00186 Rome, Italy
Interests: heart failure; CPET

Special Issue Information

Dear Colleagues,

The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the lives of billions of people and healthcare systems worldwide. Despite being caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), besides the lung, this infectious disease also has severe implications in the cardiovascular system. There is a growing body of evidence suggesting worse outcomes and increased mortality among COVID-19 patients with preexisting cardiovascular diseases.

Systemic inflammation and angiotensin-converting enzyme 2-involved signaling networking in SARS-CoV-2 infection and the cardiovascular system may contribute to the manifestation of cardiovascular diseases.

Indeed, SARS-CoV-2 infection can directly or indirectly cause a series of cardiac complications, including acute myocardial injury and myocarditis, acute myocardial infarction, heart failure, and cardiogenic shock and arrhythmias.

The aim of this Special Issue is to investigate different aspects of the relationship between COVID-19 and the cardiovascular system, to promote our understanding of the underlying mechanisms, which would aid in identifying and appropriately treating cardiovascular diseases in patients with COVID-19.

Dr. Allegra Battistoni
Prof. Dr. Damiano Magrì
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19
  • SARS-CoV-2
  • cardiovascular disease
  • myocardial injury
  • acute coronary syndromes
  • myocarditis

Published Papers (5 papers)

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Research

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11 pages, 1366 KiB  
Article
Comparison of Incidence and Prognosis of Myocardial Injury in Patients with COVID-19-Related Respiratory Failure and Other Pulmonary Infections: A Contemporary Cohort Study
by Manoela Astolfi Vivan, Vania Naomi Hirakata, Maria Antônia Torres Arteche, Débora Marques de Araujo, Sandra C. Fuchs and Flávio D. Fuchs
J. Clin. Med. 2023, 12(19), 6403; https://doi.org/10.3390/jcm12196403 - 08 Oct 2023
Cited by 1 | Viewed by 822
Abstract
Myocardial injury (MI) is frequent in critically ill patients with COVID-19, but its pathogenesis remains unclear. We hypothesized that MI is not solely due to viral infection by SARS-CoV-2 but rather due to the common pathophysiological mechanisms associated with severe pulmonary infections and [...] Read more.
Myocardial injury (MI) is frequent in critically ill patients with COVID-19, but its pathogenesis remains unclear. We hypothesized that MI is not solely due to viral infection by SARS-CoV-2 but rather due to the common pathophysiological mechanisms associated with severe pulmonary infections and respiratory failure. This contemporary cohort study was designed to compare the incidence of MI in patients with acute respiratory failure caused by COVID-19 to patients with other pulmonary infections. In addition, we aimed to investigate whether MI was a distinct risk factor for in-hospital mortality in patients with COVID-19 compared to those with non-COVID-19 infections. This study included 1444 patients with COVID-19 (55.5% men; age 58 (46;68) years) and 182 patients with other pulmonary infections (46.9% men; age 62 (44;73) years). The incidence of MI at ICU admission was lower in COVID-19 patients (36.4%) compared to non-COVID-19 patients (56%), and this difference persisted after adjusting for age, sex, coronary artery disease, heart failure, SOFA score, lactate, and C-reactive protein (RR 0.84 (95% CI, 0.71–0.99)). MI at ICU admission was associated with a 59% increase in mortality (RR 1.59 (1.36–1.86); p < 0.001), and there was no significant difference in the mortality between patients with COVID-19 and those with other pulmonary infections (p = 0.271). We concluded that MI is less frequent in patients with critical COVID-19 pneumonia and respiratory failure compared to those with other types of pneumonia. The occurrence of MI is a significant risk factor for in-hospital mortality, regardless of the etiology of the pulmonary infection. Full article
(This article belongs to the Special Issue COVID-19-Associated Myocardial Injury and Other Cardiovascular Diseases)
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14 pages, 281 KiB  
Article
Dyspnea in Post-Acute COVID-19: A Multi-Parametric Cardiopulmonary Evaluation
by Antonella Cecchetto, Gabriella Guarnieri, Gianpaolo Torreggiani, Andrea Vianello, Giulia Baroni, Chiara Palermo, Leonardo Bertagna De Marchi, Giulia Lorenzoni, Patrizia Bartolotta, Emanuele Bertaglia, Filippo Donato, Patrizia Aruta, Sabino Iliceto and Donato Mele
J. Clin. Med. 2023, 12(14), 4658; https://doi.org/10.3390/jcm12144658 - 13 Jul 2023
Viewed by 909
Abstract
Post-acute COVID-19 is characterized by the persistence of dyspnea, but the pathophysiology is unclear. We evaluated the prevalence of dyspnea during follow-up and factors at admission and follow-up associated with dyspnea persistence. After five months from discharge, 225 consecutive patients hospitalized for moderate [...] Read more.
Post-acute COVID-19 is characterized by the persistence of dyspnea, but the pathophysiology is unclear. We evaluated the prevalence of dyspnea during follow-up and factors at admission and follow-up associated with dyspnea persistence. After five months from discharge, 225 consecutive patients hospitalized for moderate to severe COVID-19 pneumonia were assessed clinically and by laboratory tests, echocardiography, six-minute walking test (6MWT), and pulmonary function tests. Fifty-one patients reported persistent dyspnea. C-reactive protein (p = 0.025, OR 1.01 (95% CI 1.00–1.02)) at admission, longer duration of hospitalization (p = 0.005, OR 1.05 (95% CI 1.01–1.10)) and higher body mass index (p = 0.001, OR 1.15 (95% CI 1.06–1.28)) were independent predictors of dyspnea. Absolute drop in SpO2 at 6MWT (p = 0.001, OR 1.37 (95% CI 1.13–1.69)), right ventricular (RV) global longitudinal strain (p = 0.016, OR 1.12 (95% CI 1.02–1.25)) and RV global longitudinal strain/systolic pulmonary artery pressure ratio (p = 0.034, OR 0.14 (95% CI 0.02–0.86)) were independently associated with post-acute COVID-19 dyspnea. In conclusion, dyspnea is present in many patients during follow-up after hospitalization for COVID-19 pneumonia. While higher body mass index, C-reactive protein at admission, and duration of hospitalization are predictors of persistent dyspnea, desaturation at 6MWT, and echocardiographic RV dysfunction are associated with this symptom during the follow-up period. Full article
(This article belongs to the Special Issue COVID-19-Associated Myocardial Injury and Other Cardiovascular Diseases)
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13 pages, 895 KiB  
Article
Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology?
by Federica Gentili, Giulio Calcagni, Nicoletta Cantarutti, Emma Concetta Manno, Giulia Cafiero, Eliana Tranchita, Annamaria Salvati, Paolo Palma, Ugo Giordano, Fabrizio Drago and Attilio Turchetta
J. Clin. Med. 2023, 12(6), 2375; https://doi.org/10.3390/jcm12062375 - 19 Mar 2023
Cited by 2 | Viewed by 1526
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a serious health condition that imposes a long-term follow-up. The purpose of our pilot study is to evaluate the usefulness of the cardiopulmonary stress test (CPET) in the follow-up after MIS-C. All patients admitted for MIS-C [...] Read more.
Multisystem inflammatory syndrome in children (MIS-C) is a serious health condition that imposes a long-term follow-up. The purpose of our pilot study is to evaluate the usefulness of the cardiopulmonary stress test (CPET) in the follow-up after MIS-C. All patients admitted for MIS-C in our hospital in the 12 months preceding the date of observation were considered for inclusion in the study. Pre-existing cardio-respiratory diseases and/or the lack of collaboration were the exclusion criteria. At enrolment, each subject passed a cardiological examination, rest ECG, echocardiogram, 24 h Holter-ECG, blood tests, and a CPET complete of spirometry. A total of 20 patients met the inclusion criteria (11.76 ± 3.29 years, 13 male). In contrast to the normality of all second-level investigations, CPET showed lower-than-expected peakVO2 and peak-oxygen-pulse values (50% of cases) and higher-than-expected VE/VCO2-slope values (95% of cases). A statistically significant inverse correlation was observed between P-reactive-protein values at admission and peakVO2/kg values (p = 0.034), uric acid values at admission, and peakVO2 (p = 0.011) or peak-oxygen-pulse expressed as a percentage of predicted (p = 0.021), NT-proBNP values at admission and peakVO2 expressed as a percentage of predicted (p = 0.046). After MIS-C (4–12 months) relevant anomalies can be observed at CPET, which can be a valuable tool in the follow-up after this condition. Full article
(This article belongs to the Special Issue COVID-19-Associated Myocardial Injury and Other Cardiovascular Diseases)
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14 pages, 1303 KiB  
Article
Cardiopulmonary Long-Term Sequelae in Patients after Severe COVID-19 Disease
by Julia Hanne Niebauer, Christina Binder-Rodriguez, Ahmet Iscel, Sarah Schedl, Christophe Capelle, Michael Kahr, Simona Cadjo, Simon Schamilow, Roza Badr-Eslam, Michael Lichtenauer, Aurel Toma, Alexander Zoufaly, Rosmarie Valenta, Sabine Hoffmann, Silvia Charwat-Resl, Christian Krestan, Wolfgang Hitzl, Christoph Wenisch and Diana Bonderman
J. Clin. Med. 2023, 12(4), 1536; https://doi.org/10.3390/jcm12041536 - 15 Feb 2023
Cited by 3 | Viewed by 1376
Abstract
We aimed to identify cardiopulmonary long-term effects after severe COVID-19 disease as well as predictors of Long-COVID in a prospective registry. A total of 150 consecutive, hospitalized patients (February 2020 and April 2021) were included six months post hospital discharge for a clinical [...] Read more.
We aimed to identify cardiopulmonary long-term effects after severe COVID-19 disease as well as predictors of Long-COVID in a prospective registry. A total of 150 consecutive, hospitalized patients (February 2020 and April 2021) were included six months post hospital discharge for a clinical follow-up. Among them, 49% experienced fatigue, 38% exertional dyspnea and 75% fulfilled criteria for Long-COVID. Echocardiography detected reduced global longitudinal strain (GLS) in 11% and diastolic dysfunction in 4%. Magnetic resonance imaging revealed traces of pericardial effusion in 18% and signs of former pericarditis or myocarditis in 4%. Pulmonary function was impaired in 11%. Chest computed tomography identified post-infectious residues in 22%. Whereas fatigue did not correlate with cardiopulmonary abnormalities, exertional dyspnea was associated with impaired pulmonary function (OR 3.6 [95% CI: 1.2–11], p = 0.026), reduced GLS (OR 5.2 [95% CI: 1.6–16.7], p = 0.003) and/or left ventricular diastolic dysfunction (OR 4.2 [95% CI: 1.03–17], p = 0.04). Predictors of Long-COVID included length of in-hospital stay (OR: 1.15 [95% CI: 1.05–1.26], p = 0.004), admission to intensive care unit (OR cannot be computed, p = 0.001) and higher NT-proBNP (OR: 1.5 [95% CI: 1.05–2.14], p = 0.026). Even 6 months after discharge, a majority fulfilled criteria for Long-COVID. While no associations between fatigue and cardiopulmonary abnormalities were found, exertional dyspnea correlated with impaired pulmonary function, reduced GLS and/or diastolic dysfunction. Full article
(This article belongs to the Special Issue COVID-19-Associated Myocardial Injury and Other Cardiovascular Diseases)
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Review

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11 pages, 959 KiB  
Review
SARS-CoV-2 Related Myocarditis: What We Know So Far
by Raffaella Mistrulli, Armando Ferrera, Melwyn Luis Muthukkattil, Massimo Volpe, Emanuele Barbato and Allegra Battistoni
J. Clin. Med. 2023, 12(14), 4700; https://doi.org/10.3390/jcm12144700 - 15 Jul 2023
Cited by 1 | Viewed by 1474
Abstract
A minority of patients with severe acute respiratory syndrome coronavirus 2 (COVID-19) develop cardiovascular complications, such as acute cardiac lesions with elevated troponins, de novo systolic heart failure, pericardial effusion and, rarely, acute myocarditis. The prevalence of COVID-19-related myocarditis ranges from 10 to [...] Read more.
A minority of patients with severe acute respiratory syndrome coronavirus 2 (COVID-19) develop cardiovascular complications, such as acute cardiac lesions with elevated troponins, de novo systolic heart failure, pericardial effusion and, rarely, acute myocarditis. The prevalence of COVID-19-related myocarditis ranges from 10 to 105 cases per 100,000 COVID-19-infected individuals, with a male predominance (58%) and a median age of 50 years. The etiopathogenetic mechanism is currently unclear, but may involve direct virus-mediated damage or an exaggerated immune response to the virus. Mortality is high, as fulminant myocarditis (FM) develops very often in the form of cardiogenic shock and ventricular arrhythmias. Hence, medical therapy with ACE inhibitors and beta-blockers may not always be sufficient, in which case inotropic and immunosuppressive drugs, most commonly corticosteroids, may be necessary. In this review we analyze the current data on COVID-19 myocarditis, management strategies and therapy, with a brief description of COVID-19 vaccine-associated myocarditis to help clinicians dealing with this peculiar form of myocarditis. Full article
(This article belongs to the Special Issue COVID-19-Associated Myocardial Injury and Other Cardiovascular Diseases)
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