What should a cardiologist know about coronavirus disease 2019?

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is the cause of coronavirus disease 2019 (COVID‑19). The most common symptoms of COVID‑19 are: fever (81.8%–100%), cough (46.3%–86.2%), myalgia and fatigue (11%–50%), expectoration (4.4%–72%), and dyspnea (18.6%–59%). The most common laboratory abnormalities in COVID‑19 include decreased lymphocyte count (35%–82.1%), thrombocytopenia (17%–36.2%), elevated serum C‑reactive protein (60.7%–93%), lactate dehydrogenase (41%–76%), and D‑dimer concentrations (36%–46.4%). Among comorbidities in patients with COVID‑19, cardiovascular disease is most commonly found. In addition, patients with concomitant cardiovascular diseases have worse prognosis and more often require admission to the intensive care unit (ICU), compared with patients without such comorbidities. It is estimated that about 20% of patients with COVID‑19 develop cardiac injury. Cardiac injury is more prevalent among patients with COVID‑19 who require ICU care. In a group of critically ill patients, 27.5% had an elevated N‑terminal pro-B‑type natriuretic peptide concentration, and increased cardiac troponin level was found in 10% of patients. One of the life‑threatening cardiac manifestations is coronavirus fulminant myocarditis, which may also occur without accompanying symptoms of pulmonary involvement. Early recognition and treatment is crucial in these cases. So far, data on the incidence of arrhythmias in patients with COVID‑19 are limited. Coronavirus disease 2019 impacts patients with cardiovascular comorbidities and affects daily practice of cardiologists. Thus, it is important to know typical COVID‑19 symptoms, possible clinical manifestations, complications, and recommended treatment.