COVID-19 and myocardial injury

AS Herrey, SA Mohiddin, p Letuka, NAB Ntusi


The 2019 coronavirus pandemic (COVID-19), caused by SARS-CoV-2, has affected millions globally and has accounted for a multitude of deaths. Cardiovascular involvement with myocardial injury is common and is associated with severe morbidity and mortality. The pathophysiology of acute myocardial injury is complex and may include type I and type II myocardial infarction, direct damage to the cardiomyocytes, systemic inflammation, myocardial interstitial fibrosis, interferon mediated immune response, exaggerated cytokine response by Type 1 and 2 helper T cells, in addition to hypoxia. Angiotensin converting enzyme-2 receptors (ACE2-R) play a pivotal role in mediating viral entry into cells. Disruption of receptor signalling may also be the principal mechanism facilitating viral pathogenicity and altered ACE2-R biology may be a reason why patients with cardiovascular disease are more likely to be infected with SARS-CoV-2 and more likely to develop severe symptoms. New-onset hypertension, arrhythmia, myocarditis, heart failure, cardiomyopathy and coronary heart disease are among major cardiovascular disease comorbidities and complications seen in severe cases of COVID-19. As a surrogate for myocardial injury, multiple studies have shown increased cardiac biomarkers, mainly cardiac troponins I and T, in the infected patients – especially those with severe disease. Myocarditis is another cause of morbidity among COVID-19 patients.


COVID-19; myocardial injury

Full Text:




  • There are currently no refbacks.

ISSN: 2071-4602 (online) ISSN: 1996-6741 (print)

Copyright © 2017 SA Heart Journal

Hosted by Stellenbosch University Library and Information Service since 2017.

Creative Commons License -CC BY-NC-ND 4.0

This journal is hosted by the SU LIS on request of the journal owner/editor. The SU LIS takes no responsibility for the content published within this journal, and disclaim all liability arising out of the use of or inability to use the information contained herein. We assume no responsibility, and shall not be liable for any breaches of agreement with other publishers/hosts.