Cardiovascular manifestations and mechanisms in patients with COVID-19

Dou, Qingyu; Wei, Xin; Zhou, Kehua; Shujuan,; Jia, Peng

COVID-19 patients with preexisting cardiovascular diseases or with cardiovascular complications have showed a higher risk of mortality. The main cardiovascular complications of COVID-19 include acute cardiac injury, acute myocardial infarction, myocarditis, arrhythmia, heart failure, shock, and venous thromboembolism/pulmonary embolism. COVID-19 could cause cardiovascular complications or deterioration of coexisting cardiovascular diseases through direct or indirect mechanisms, including viral toxicity, dysregulation of the renin–angiotensin–aldosterone system, endothelial cell damage and thromboinflammation, cytokine storm, and demand-supply mismatch of oxygen. This study systematically reviews cardiovascular manifestations, histopathology, and mechanisms of COVID-19, to help formulate future research goals and facilitate the development of therapeutic management strategies.