COVID-19-related cardiac lesion: The questions of pathogenesis and diagnostics

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Abstract

Coronavirus infection is still a topic of interest in the medical community today. Among the heterogeneous clinical manifestations of this disease, lesions of cardiac structures often occur. They are mainly inflammatory in nature and can be acute or delayed. Aside from myocarditis, coronavirus infection can induce cardiac injuries, including acute coronary syndrome, thromboembolic events, heart failure, and heart rhythm disturbances. It is well known that the prognosis for patients with cardiac lesions significantly worsens; timely diagnosis and treatment initiation play an important role in preventing severe complications.

This review presents the most recent literature data on the pathogenesis of cardiac lesions in COVID-19 patients and discusses the rational diagnosis of this pathology using modern techniques, such as laboratory, functional imaging (cardiac magnetic resonance is the most important of these), and invasive ones. It is now established that diagnosing myocarditis caused by coronavirus infection differs fundamentally from diagnosing other types of myocarditis. Furthermore, the main aspects of inflammatory heart lesions associated with COVID-19 vaccination are discussed, as this complication occurs more frequently than is commonly believed. It is often used as a rationale for refusing vaccination; however, this decision may severely affect the individual and the population.

About the authors

Daria A. Filatova

Lomonosov Moscow State University

Email: dariafilatova.msu@mail.ru
ORCID iD: 0000-0002-0894-1994
SPIN-code: 2665-5973
Russian Federation, Moscow

Elena A. Mershina

Lomonosov Moscow State University; Medical Research and Education Center of Lomonosov Moscow State University

Email: elena_mershina@mail.ru
ORCID iD: 0000-0002-1266-4926
SPIN-code: 6897-9641

MD, Cand. Sci. (Med), Associate Professor

Russian Federation, Moscow; Moscow

Valentin E. Sinitsyn

Lomonosov Moscow State University; Medical Research and Education Center of Lomonosov Moscow State University

Author for correspondence.
Email: vsini@mail.ru
ORCID iD: 0000-0002-5649-2193
SPIN-code: 8449-6590

MD, Dr. Sci. (Med), Professor

Russian Federation, Moscow; Moscow

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2. Fig. 1. Main mechanisms of structural damage in the heart of patients with COVID-19 and the clinical manifestations they cause.

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