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Review

COVID-19-Associated Cardiovascular Complications

Division of Molecular & Clinical Medicine, School of Medicine, Ninewells Hospital & Medical School, University of Dundee, Dundee DD1 9SY, UK
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Author to whom correspondence should be addressed.
Academic Editor: Ian James Martins
Diseases 2021, 9(3), 47; https://doi.org/10.3390/diseases9030047
Received: 12 May 2021 / Revised: 17 June 2021 / Accepted: 24 June 2021 / Published: 29 June 2021
(This article belongs to the Special Issue COVID-19 and Global Chronic Disease)
Coronavirus disease 2019 (COVID-19) has been reported to cause cardiovascular complications such as myocardial injury, thromboembolic events, arrhythmia, and heart failure. Multiple mechanisms—some overlapping, notably the role of inflammation and IL-6—potentially underlie these complications. The reported cardiac injury may be a result of direct viral invasion of cardiomyocytes with consequent unopposed effects of angiotensin II, increased metabolic demand, immune activation, or microvascular dysfunction. Thromboembolic events have been widely reported in both the venous and arterial systems that have attracted intense interest in the underlying mechanisms. These could potentially be due to endothelial dysfunction secondary to direct viral invasion or inflammation. Additionally, thromboembolic events may also be a consequence of an attempt by the immune system to contain the infection through immunothrombosis and neutrophil extracellular traps. Cardiac arrhythmias have also been reported with a wide range of implicated contributory factors, ranging from direct viral myocardial injury, as well as other factors, including at-risk individuals with underlying inherited arrhythmia syndromes. Heart failure may also occur as a progression from cardiac injury, precipitation secondary to the initiation or withdrawal of certain drugs, or the accumulation of des-Arg9-bradykinin (DABK) with excessive induction of pro-inflammatory G protein coupled receptor B1 (BK1). The presenting cardiovascular symptoms include chest pain, dyspnoea, and palpitations. There is currently intense interest in vaccine-induced thrombosis and in the treatment of Long COVID since many patients who have survived COVID-19 describe persisting health problems. This review will summarise the proposed physiological mechanisms of COVID-19-associated cardiovascular complications. View Full-Text
Keywords: COVID-19; SARS-CoV-2; Long COVID; cardiovascular system COVID-19; SARS-CoV-2; Long COVID; cardiovascular system
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MDPI and ACS Style

Lee, C.C.E.; Ali, K.; Connell, D.; Mordi, I.R.; George, J.; Lang, E.M.; Lang, C.C. COVID-19-Associated Cardiovascular Complications. Diseases 2021, 9, 47. https://doi.org/10.3390/diseases9030047

AMA Style

Lee CCE, Ali K, Connell D, Mordi IR, George J, Lang EM, Lang CC. COVID-19-Associated Cardiovascular Complications. Diseases. 2021; 9(3):47. https://doi.org/10.3390/diseases9030047

Chicago/Turabian Style

Lee, Clement C.E., Kashan Ali, David Connell, Ify R. Mordi, Jacob George, Elizabeth M. Lang, and Chim C. Lang 2021. "COVID-19-Associated Cardiovascular Complications" Diseases 9, no. 3: 47. https://doi.org/10.3390/diseases9030047

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