The Pathogenesis and Long-Term Consequences of COVID-19 Cardiac Injury
Bhurint Siripanthong, Babken Asatryan, Thomas C. Hanff, Salman Chatha, Mohammed Y Khanji, Fabrizio Ricci, Daniele Muser, Victor A. Ferrari, Saman Nazarian, Pasquale Santangeli, Rajat Deo, Leslie T. Cooper, Saidi Mohiddin, C. Anwar A. Chahal
Abstract
The mechanisms of coronavirus disease-2019 (COVID-19)-related myocardial injury comprise both direct viral invasion and indirect (hypercoagulability and immune-mediated) cellular injuries. Some patients with COVID-19 cardiac involvement have poor clinical outcomes, with preliminary data suggesting long-term structural and functional changes. These include persistent myocardial fibrosis, edema, and intraventricular thrombi with embolic events, while functionally, the left ventricle is enlarged, with a reduced ejection fraction and new-onset arrhythmias reported in a number of patients. Myocarditis post-COVID-19 vaccination is rare but more common among young male patients. Larger studies, including prospective data from biobanks, will be useful in expanding these early findings and determining their validity.