In face of the pandemic of the novel coronavirus disease 2019 (COVID-19), the management of patients with cardiovascular risk factors and/or disease is challenging. The cardiovascular complications evidenced in patients with COVID-19 derive from several mechanisms, ranging from direct viral injury to complications secondary to the inflammatory and thrombotic responses to the infection. The proper care of patients with COVID-19 requires special attention to the cardiovascular system aimed at better outcomes.
The Heart and COVID-19: What Cardiologists Need to Know
CostaIBSS, BittarCS, RizkSI, Araújo FilhoAE, SantosKAQ, MachadoTIV, AndradeFTA, et al. The Heart and COVID-19: What Cardiologists Need to Know. Arq. Bras. Cardiol. 2020;114(5):805-16.
Costa,Isabela Bispo Santos da Silva; Bittar,Cristina Salvadori; Rizk,Stephanie Itala; Araújo Filho,Antônio Everaldo de; Santos,Karen Alcântara Queiroz; Machado,Theuran Inahja Vicente; Andrade,Fernanda Thereza de Almeida; González,Thalita Barbosa; Arévalo,Andrea Nataly Galarza; Almeida,Juliano Pinheiro de; Bacal,Fernando; Oliveira,Gláucia Maria Moraes de; Lacerda,Marcus Vinícius Guimarães de; Barberato,Silvio Henrique; Chagas,Antonio Carlos Palandri; Rochitte,Carlos Eduardo; Ramires,José Antonio Franchini; Kalil Filho,Roberto; Hajjar,Ludhmila Abrahão. The Heart and COVID-19: What Cardiologists Need to Know. Arq. Bras. Cardiol., v. 114, n. 5, p. 805-816, May. 2020.
Costa,I.B.S.S., Bittar,C.S., Rizk,S.I., Araújo Filho,A.E. , Santos,K.A.Q., Machado,T.I.V., Andrade,F.T.A., González,T.B., Arévalo,A.N.G., Almeida,J.P. , Bacal,F., Oliveira,G.M.M. , Lacerda,M.V.G. , Barberato,S.H., Chagas,A.C.P., Rochitte,C.E., Ramires,J.A.F., Kalil Filho,R., & Hajjar,L.A. (2020). The Heart and COVID-19: What Cardiologists Need to Know. Arq. Bras. Cardiol.,114(5), 805-816.
Costa,Isabela Bispo Santos da Silva and Bittar,Cristina Salvadori and Rizk,Stephanie Itala and Araújo Filho,Antônio Everaldo de and Santos,Karen Alcântara Queiroz and Machado,Theuran Inahja Vicente and Andrade,Fernanda Thereza de Almeida and González,Thalita Barbosa and Arévalo,Andrea Nataly Galarza and Almeida,Juliano Pinheiro de and Bacal,Fernando and Oliveira,Gláucia Maria Moraes de and Lacerda,Marcus Vinícius Guimarães de and Barberato,Silvio Henrique and Chagas,Antonio Carlos Palandri and Rochitte,Carlos Eduardo and Ramires,José Antonio Franchini and Kalil Filho,Roberto and Hajjar,Ludhmila Abrahão. The Heart and COVID-19: What Cardiologists Need to Know. Arq. Bras. Cardiol. [online]. 2020, vol. 114, n. 5, [cited 2025-10-24], pp.805-816. Available from: <https://abccardiol.org/en/article/the-heart-and-covid-19-what-cardiologists-need-to-know/>. ISSN 0066-782X.
Figure 1
Coronavirus and the heart. Patients with risk factors and/or cardiovascular disease are prone to develop severe forms of COVID-19 and its complications. Pulmonary impairment manifests initially as an influenza syndrome (cough and fever), progressing to pneumonia (dyspnea, hypoxemia, tachypnea) and, in some cases, to ARDS. Host response to the virus leads to systemic inflammation findings, with elevation of markers of inflammation (CRP, procalcitonin, d-dimer, IL-6, ferritin, LDH) and of myocardial injury / cardiac dysfunction (troponin/NT-proBNP), which predisposes to acute heart failure, myocarditis, thrombosis and arrhythmias. Cardiovascular complications hinder the host response to the virus, leading to shock, failure of multiple organs and death.CAD: coronary artery disease; LDH: lactate dehydrogenase; LVEF: left ventricular ejection fraction; CRP: C-reactive protein; IL-6: interleukin-6; ARDS: acute respiratory distress syndrome.