Abstract
Purpose of review: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in the coronavirus 2019 (COVID-19) global pandemic. While primarily a respiratory virus, SARS-CoV-2 can cause myocardial injury. The pattern of injury, referred to as acute COVID-19 cardiovascular syndrome (ACovCS), is defined by cardiac troponin leak in the absence of obstructive coronary artery disease. Although the etiology of the injury is unknown, many speculate that a cytokine release syndrome (CRS) may be an important factor. We aim to review recent data concerning markers of cardiac injury in ACovCS and its relation to the CRS.
Recent findings: Cardiac injury was common in patients hospitalized for COVID-19, with both cardiac troponin and B-type natriuretic peptide (BNP) being elevated in this population. Biomarkers were correlated with illness severity and increased mortality. Cytokines such as IL-6 were more often elevated in patients with ACovCS. Myocarditis evident on cardiac MR following COVID-19 may be associated with cardiac troponin levels. The impact of dexamethasone and remdesivir, two therapies shown to have clinical benefit in COVID-19, on myocardial injury is unknown. Biomarkers of cardiac stress and injury in COVID-19 may be used to stratify risk in the future. Currently, there is no evidence that inhibition of cytokine release will reduce myocardial injury in patients with COVID-19.
Keywords: BNP; COVID-19; cardiac biomarkers; coronavirus; cytokine release syndrome; troponin.
【저자키워드】 COVID-19, coronavirus, troponin, Cardiac biomarkers, Cytokine release syndrome, BNP, 【초록키워드】 Dexamethasone, SARS-CoV-2, coronavirus, therapy, Biomarkers, Cytokines, Stress, IL-6, peptide, Remdesivir, risk, troponin, cytokine, severe acute respiratory syndrome Coronavirus, Cytokine release syndrome, cardiac troponin, Coronary artery disease, global pandemic, cardiac injury, myocardial injury, respiratory virus, myocarditis, Patient, Coronavirus 2019, respiratory, etiology, pattern, marker, CRS, Evidence, Injury, Illness severity, referred to, Coronary artery, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, clinical benefit, syndrome, increased mortality, acute COVID-19, cytokine release, while, Obstructive, recent, defined, shown, elevated, absence, correlated, reduce, concerning, patients hospitalized, patients with COVID-19, 【제목키워드】 Release, review, cardiac,