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Cardiovascular Disease in the Era of COVID-19
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Cardiovascular Disease in the Era of COVID-19

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

Deadline for manuscript submissions: closed (20 August 2024) | Viewed by 8995

Special Issue Editor

Dr. Sophie I. Mavrogeni

E-Mail Website
Guest Editor
University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair in Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece
Interests: clinical cardiology; autoimmune diseases; non-ischemic cardiomyopathy; cardiovascular magnetic resonance imaging (CMR)
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In addition to involving the respiratory system, COVID-19 can also affect the cardiovascular system, causing acute and/or chronic myocardial injuries. COVID-19 patients may present cardiovascular involvement irrespective of the severity of COVID-19 illness. However, patients with known cardiovascular disease (CVD) and COVID-19 illness are likely to develop severe symptoms and are at a greater risk of death. Furthermore, there is no clear algorithm about how to address the adverse cardiac events due to COVID-19, except to treat patients’ symptoms as they appear. Understanding the pathophysiology of CVD due to COVID-19, as well as the underlying mechanisms of myocardial injury, the role of biomarkers/cardiac imaging and the related medical treatment/follow-up strategies is absolutely necessary to improve patient treatment/prognosis. However, there are many issues regarding diagnosis, treatment and the follow-up of these patients.

In this Special Issue of JCM, we intend to present publications regarding the prevalence of CVD, diagnosis using biomarkers/cardiovascular imaging, validation of treatment and the follow-up protocol. In addition, publications regarding the role of vaccination in the development of cardiovascular disease will be also included.

We strongly believe that this Special Issue will clarify questions regarding CVD due to COVID-19, and we invite you to submit your valuable contribution and provide an opportunity to build an exciting and useful issue about CVD in the era of COVID-19.

Dr. Sophie I. Mavrogeni
Guest Editor

Manuscript Submission Information

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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

  • cardiovascular disease
  • COVID-19
  • myocardial injuries
  • cardiovascular involvement
  • cardiac imaging

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Published Papers (5 papers)

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Research

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10 pages, 1641 KiB  
Article
Cardiovascular Magnetic Resonance Reveals Cardiac Inflammation and Fibrosis in Symptomatic Patients with Post-COVID-19 Syndrome: Findings from the INSPIRE-CMR Multicenter Study
by George Markousis-Mavrogenis, Vasiliki Vartela, Alessia Pepe, Lilia Sierra-Galan, Emmanouil Androulakis, Anna Perazzolo, Aikaterini Christidi, Antonios Belegrinos, Aikaterini Giannakopoulou, Maria Bonou, Agathi-Rosa Vrettou, Fotini Lazarioti, Vasilios Skantzos , Emilio Quaia, Raad Mohiaddin and Sophie I. Mavrogeni
J. Clin. Med. 2024, 13(22), 6919; https://doi.org/10.3390/jcm13226919 - 17 Nov 2024
Viewed by 1827
Abstract
Introduction. Post-coronavirus disease-2019 (COVID-19) patients may develop cardiac symptoms. We hypothesized that cardiovascular magnetic resonance (CMR) can assess the background of post-COVID-19 cardiac symptoms using multi-parametric evaluation. We aimed to conduct an investigation of symptomatic patients with post-COVID-19 syndrome using CMR (INSPIRE-CMR). [...] Read more.
Introduction. Post-coronavirus disease-2019 (COVID-19) patients may develop cardiac symptoms. We hypothesized that cardiovascular magnetic resonance (CMR) can assess the background of post-COVID-19 cardiac symptoms using multi-parametric evaluation. We aimed to conduct an investigation of symptomatic patients with post-COVID-19 syndrome using CMR (INSPIRE-CMR). Methods. INSIPRE-CMR is a retrospective multicenter study including 174 patients from five centers referred for CMR due to cardiac symptoms. CMR was performed using 3.0 T/1.5 T system (24%/76%, respectively). Myocardial inflammation was determined by the updated Lake Louise criteria. Results. Further, 174 patients with median age of 40 years (IQR: 26–54), 72 (41%) were women, and 17 (9.7%) had a history of autoimmune disease, muscular dystrophy, or cancer. In total, 149 (86%) patients were late gadolinium enhanced (LGE)-positive with a non-ischemic pattern, and of those evaluated with the updated Lake Louise criteria, 141/145 (97%) had ≥1 pathologic T1 index. Based on the T2-criterion, 62/173 (36%) patients had ≥1 pathologic T2 index. Collectively, 48/145 (33%) patients had both positive T1- and T2-criterion. A positive T2-criterion or a combination of a positive T1- and T2-criterion were significantly more common amongst patients with severe COVID-19 [45 (31%) vs. 17 (65%), p = 0.001 and 32 (27%) vs. 16 (64%), p < 0.001, respectively]. During the one-year evaluation, available for 65/174 patients, shortness of breath, chest pain, and arrhythmia were identified in 7 (4%), 15 (8.6%), and 43 (24.7%), respectively. CMR evaluation, available in a minority of them, showed mildly reduced LVEF, while nat T1 mapping and EVC remained at levels higher than the normal values of the local MRI units. Conclusions. The majority of post-COVID-19 patients with cardiac symptoms presented non-ischemic LGE and abnormalities in T1 and T2-based indices. Multi-parametric CMR reveals important information on post-COVID-19 patients, supporting its role in short/long-term evaluation. Full article
(This article belongs to the Special Issue Cardiovascular Disease in the Era of COVID-19)
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20 pages, 1088 KiB  
Article
Sex Differences in Long-Term Cardiovascular Outcomes and Mortality After COVID-19 Hospitalization During Alpha, Delta and Omicron Waves
by Kristen Kopp, Lukas J. Motloch, Michael Lichtenauer, Elke Boxhammer, Uta C. Hoppe, Alexander E. Berezin, Diana Gareeva, Irina Lakman, Alexander Agapitov, Liana Sadikova, Venera Timiryanova, Paruir Davtyan, Elena Badykova and Naufal Zagidullin
J. Clin. Med. 2024, 13(22), 6636; https://doi.org/10.3390/jcm13226636 - 5 Nov 2024
Cited by 1 | Viewed by 1121
Abstract
Background: Increased mortality and occurrence of cardiovascular (CV) outcomes during hospitalization and in short-term follow-up for moderate to severe SARS-CoV-2 infection have been associated with male sex, yet data regarding long-term outcomes by sex and COVID-19 variant (Alpha, Delta, and Omicron) are limited. [...] Read more.
Background: Increased mortality and occurrence of cardiovascular (CV) outcomes during hospitalization and in short-term follow-up for moderate to severe SARS-CoV-2 infection have been associated with male sex, yet data regarding long-term outcomes by sex and COVID-19 variant (Alpha, Delta, and Omicron) are limited. Methods: This prospective study of 4882 patients examines potential differences by sex in the occurrence of primary combined cardiovascular outcomes (CV death, CV hospitalization, myocardial infarction (MI), stroke, pulmonary embolism) as well as secondary outcomes (CV death, cardiovascular hospitalizations, myocardial infarction, stroke, pulmonary embolism) at 18-month follow-up after urgent hospitalization for SARS-CoV-2-associated pneumonia, as well as evaluating for differences during the three COVID-19 waves. Survival rate was analyzed for the entire cohort by sex and SARS-CoV-2 variant and adjusted for age using the multiple Kaplan–Meier method. To compare survival in groups of men and women for each wave, the Gehan–Wilcoxon test was applied with significance p < 0.05. Univariate Cox proportional hazards models were used to search for potential risk factors of CV death at 18-months follow-up separately for men and women in each COVID-19 wave. Results: Men had significantly higher 18-month CV mortality compared to women in the Delta wave (6.13% men vs. 3.62% women, p = 0.017). Although men had higher percentages of all other CV endpoints (excepting pulmonary embolism) at follow-up during the Delta wave, none were significant compared with women, except for the combined CV endpoint (16.87% men vs. 12.61% women, p = 0.017). No significant differences by sex in CV outcomes were seen during the Alpha and Omicron variants. Discrepancies in CV outcomes in demographical data and concomitant disease between the COVID-19 variants of concern existed. Conclusions: Higher male mortality and higher but non-significant incidences of CV outcomes occurred during the Delta wave of the COVID-19 pandemic, with the lowest incidence of CV outcomes observed during the Omicron variant. Full article
(This article belongs to the Special Issue Cardiovascular Disease in the Era of COVID-19)
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8 pages, 496 KiB  
Article
The Trends in Atrial Fibrillation-Related Mortality before, during, and after the COVID-19 Pandemic Peak in the United States
by Inon Dimri, Ariel Roguin, Nashed Hamuda, Rami Abu Fanne, Maguli Barel, Eran Leshem, Ofer Kobo and Gilad Margolis
J. Clin. Med. 2024, 13(16), 4813; https://doi.org/10.3390/jcm13164813 - 15 Aug 2024
Cited by 1 | Viewed by 1610
Abstract
Background: During the first months of the COVID-19 outbreak, an increase was observed in atrial fibrillation (AF)-related mortality in the United States (U.S). We aimed to investigate AF-related mortality trends in the U.S. before, during, and after the COVID-19 pandemic peak, stratified [...] Read more.
Background: During the first months of the COVID-19 outbreak, an increase was observed in atrial fibrillation (AF)-related mortality in the United States (U.S). We aimed to investigate AF-related mortality trends in the U.S. before, during, and after the COVID-19 pandemic peak, stratified by sociodemographic factors. Methods: using the Wide-Ranging Online Data for Epidemiologic Research database of the Centers for Disease Control and Prevention, we compared the AF-related age-adjusted mortality rate (AAMR) among different subgroups in the two years preceding, during, and following the pandemic peak (2018–2019, 2020–2021, 2022–2023). Result: By analyzing a total of 1,267,758 AF-related death cases, a significant increase of 24.8% was observed in AF-related mortality during the pandemic outbreak, followed by a modest significant decrease of 1.4% during the decline phase of the pandemic. The most prominent increase in AF-related mortality was observed among males, among individuals younger than 65 years, and among individuals of African American and Hispanic descent, while males, African American individuals, and multiracial individuals experienced a non-statistically significant decrease in AF-related mortality during the pandemic decline period. Conclusions: Our findings suggest that in future healthcare crises, targeted healthcare policies and interventions to identify AF, given its impact on patients’ outcomes, should be developed while addressing disparities among different patient populations. Full article
(This article belongs to the Special Issue Cardiovascular Disease in the Era of COVID-19)
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12 pages, 918 KiB  
Article
Elevated Troponins after COVID-19 Hospitalization and Long-Term COVID-19 Symptoms: Incidence, Prognosis, and Clinical Outcomes—Results from a Multi-Center International Prospective Registry (HOPE-2)
by Ravi Vazirani, Gisela Feltes, Rafael Sánchez-del Hoyo, María C. Viana-Llamas, Sergio Raposeiras-Roubín, Rodolfo Romero, Emilio Alfonso-Rodríguez, Aitor Uribarri, Francesco Santoro, Víctor Becerra-Muñoz, Martino Pepe, Alex F. Castro-Mejía, Jaime Signes-Costa, Adelina Gonzalez, Francisco Marín, Javier Lopez-País, Enrico Cerrato, Olalla Vázquez-Cancela, Carolina Espejo-Paeres, Álvaro López Masjuan, Lazar Velicki, Ibrahim El-Battrawy, Harish Ramakrishna, Antonio Fernandez-Ortiz and Ivan J. Nuñez-Giladd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(9), 2596; https://doi.org/10.3390/jcm13092596 - 28 Apr 2024
Cited by 3 | Viewed by 2117
Abstract
Background: Acute cardiac injury (ACI) after COVID-19 has been linked with unfavorable clinical outcomes, but data on the clinical impact of elevated cardiac troponin on discharge during follow-up are scarce. Our objective is to elucidate the clinical outcome of patients with elevated [...] Read more.
Background: Acute cardiac injury (ACI) after COVID-19 has been linked with unfavorable clinical outcomes, but data on the clinical impact of elevated cardiac troponin on discharge during follow-up are scarce. Our objective is to elucidate the clinical outcome of patients with elevated troponin on discharge after surviving a COVID-19 hospitalization. Methods: We conducted an analysis in the prospective registry HOPE-2 (NCT04778020). Only patients discharged alive were selected for analysis, and all-cause death on follow-up was considered as the primary endpoint. As a secondary endpoint, we established any long-term COVID-19 symptoms. HOPE-2 stopped enrolling patients on 31 December 2021, with 9299 patients hospitalized with COVID-19, of which 1805 were deceased during the acute phase. Finally, 2382 patients alive on discharge underwent propensity score matching by relevant baseline variables in a 1:3 fashion, from 56 centers in 8 countries. Results: Patients with elevated troponin experienced significantly higher all-cause death during follow-up (log-rank = 27.23, p < 0.001), and had a higher chance of experiencing long-term COVID-19 cardiovascular symptoms. Specifically, fatigue and dyspnea (57.7% and 62.8%, with p-values of 0.009 and <0.001, respectively) are among the most common. Conclusions: After surviving the acute phase, patients with elevated troponin on discharge present increased mortality and long-term COVID-19 symptoms over time, which is clinically relevant in follow-up visits. Full article
(This article belongs to the Special Issue Cardiovascular Disease in the Era of COVID-19)
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Review

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15 pages, 7839 KiB  
Review
Complications of Multisystem Inflammatory Syndrome Associated with SARS-CoV-2 Infection—Many Facets of One Disease—A Literature Review Based on a Case Report
by Aleksandra Stasiak, Piotr Kędziora and Elżbieta Smolewska
J. Clin. Med. 2024, 13(14), 4146; https://doi.org/10.3390/jcm13144146 - 16 Jul 2024
Viewed by 1569
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a disease that made its mark in the early days of the COVID-19 pandemic due to the diverse course and symptoms affecting multiple body systems. It is a condition that develops in pediatric patients about 2–6 [...] Read more.
Multisystem inflammatory syndrome in children (MIS-C) is a disease that made its mark in the early days of the COVID-19 pandemic due to the diverse course and symptoms affecting multiple body systems. It is a condition that develops in pediatric patients about 2–6 weeks after contact with a person infected with the SARS-CoV-2 virus. In many instances, MIS-C has caused multiple organ failure, with particularly severe complications involving the cardiovascular system and manifesting as hypotension, various cardiac arrhythmias, myocarditis or coronary artery lesions resembling those seen in Kawasaki disease. Currently, the incidence of MIS-C is about 1–3 per 1000 children, with a decreasing trend in recent years due to the introduction of immunization against the SARS-CoV-2 virus for children as young as 6 months. In our paper, we present the case of a patient with a severe course of MIS-C with numerous cardiovascular and neurological complications, in whom the symptoms of the disease were managed by administering biological treatment. We also present a review of the literature on the subject, which shows how many different facets this disease can have and that physicians still need to remain alert, as there are cases of severe MIS-C, especially in unvaccinated patients. Full article
(This article belongs to the Special Issue Cardiovascular Disease in the Era of COVID-19)
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