Coronavirus disease 2019 (COVID-19) is known to present with respiratory symptoms, which can lead to severe pneumonia and respiratory failure. However, it can have multisystem complications such as cardiovascular manifestations. The cardiovascular manifestations reported comprise myocarditis, cardiogenic shock, arrhythmias, pulmonary embolism, deep vein embolism, acute heart failure, and myocardial infarction. There is also an indirect impact of the pandemic on the management of cardiovascular care that has been shown clearly in multiple publications. In this review, we summarize the deadly relation of COVID-19 with cardiovascular events and the wider impact on several cardiovascular care areas by the pandemic situation.

Arrhythmia Advanced Therapy Center AOI Universal Hospital Kawasaki 210 0822 Japan

Department of Cardiology Centro Hospitalar de Gaia Gaia 4400 020 Portugal

Department of Cardiology Hôpital Erasme Université Libre de Bruxelles Brussels 1070 Belgium

Department of Surgery and Physiology Faculty of Medicine of the University of Porto Porto 4200 319 Portugal

Heart Center Leipzig University of Leipzig Leipzig 04289 Germany

Intensive Care Unit Department of Cardiology Institute for Clinical and Experimental Medicine Prague Prague 14021 Czech Republic

Servicio de Cardiología Unidad de Imagen y Función Cardíaca Complexo Hospitalario Universitario A Coruña Centro de Investigación Biomédica en Red Instituto de Salud Carlos 3 A Coruña 15006 Spain

Unit of Cardiac Sciences Department of Medicine Campus Bio Medico University of Rome Rome 00128 Italy

Unit of Cardiology Policlinico Tor Vergata Rome 00133 Italy

See more in PubMed

COVID-19 Excess Mortality Collaborators. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020-21. Lancet. 2022;399:1513–1536. PubMed PMC

Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, Brown TS, Der Nigoghossian C, Zidar DA, Haythe J, Brodie D, Beckman JA, Kirtane AJ, Stone GW, Krumholz HM, Parikh SA. Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic. J Am Coll Cardiol. 2020;75:2352–2371. PubMed PMC

Li B, Yang J, Zhao F, Zhi L, Wang X, Liu L, Bi Z, Zhao Y. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020;109:531–538. PubMed PMC

Burger AL, Kaufmann CC, Jäger B, Pogran E, Ahmed A, Wojta J, Farhan S, Huber K. Direct cardiovascular complications and indirect collateral damage during the COVID-19 pandemic : A review. Wien Klin Wochenschr. 2021;133:1289–1297. PubMed PMC

Rusu I, Turlacu M, Micheu MM. Acute myocardial injury in patients with COVID-19: Possible mechanisms and clinical implications. World J Clin Cases. 2022;10:762–776. PubMed PMC

Lodigiani C, Iapichino G, Carenzo L, Cecconi M, Ferrazzi P, Sebastian T, Kucher N, Studt JD, Sacco C, Bertuzzi A, Sandri MT, Barco S Humanitas COVID-19 Task Force. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020;191:9–14. PubMed PMC

Piazza G, Campia U, Hurwitz S, Snyder JE, Rizzo SM, Pfeferman MB, Morrison RB, Leiva O, Fanikos J, Nauffal V, Almarzooq Z, Goldhaber SZ. Registry of Arterial and Venous Thromboembolic Complications in Patients With COVID-19. J Am Coll Cardiol. 2020;76:2060–2072. PubMed PMC

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–1062. PubMed PMC

Coronavirus Disease 2019 (COVID-19) Treatment Guidelines Bethesda (MD), 2021. [cited 20 April 2022]. Available from: https://www.covid19treatmentguidelines.nih.gov/

Belani P, Schefflein J, Kihira S, Rigney B, Delman BN, Mahmoudi K, Mocco J, Majidi S, Yeckley J, Aggarwal A, Lefton D, Doshi AH. COVID-19 Is an Independent Risk Factor for Acute Ischemic Stroke. AJNR Am J Neuroradiol. 2020;41:1361–1364. PubMed PMC

Katsoularis I, Fonseca-Rodríguez O, Farrington P, Lindmark K, Fors Connolly AM. Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study. Lancet. 2021;398:599–607. PubMed PMC

Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, Mehra MR, Schuepbach RA, Ruschitzka F, Moch H. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020;395:1417–1418. PubMed PMC

Hamadeh A, Aldujeli A, Briedis K, Tecson KM, Sanz-Sánchez J, Al Dujeili M, Al-Obeidi A, Diez JL, Žaliūnas R, Stoler RC, McCullough PA. Characteristics and Outcomes in Patients Presenting With COVID-19 and ST-Segment Elevation Myocardial Infarction. Am J Cardiol. 2020;131:1–6. PubMed PMC

Task Force for the management of COVID-19 of the European Society of Cardiology. ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2-care pathways, treatment, and follow-up. Eur Heart J. 2022;43:1059–1103. PubMed PMC

Jabri A, Kalra A, Kumar A, Alameh A, Adroja S, Bashir H, Nowacki AS, Shah R, Khubber S, Kanaa'N A, Hedrick DP, Sleik KM, Mehta N, Chung MK, Khot UN, Kapadia SR, Puri R, Reed GW. Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic. JAMA Netw Open. 2020;3:e2014780. PubMed PMC

Sokolski M, Reszka K, Suchocki T, Adamik B, Doroszko A, Drobnik J, Gorka-Dynysiewicz J, Jedrzejczyk M, Kaliszewski K, Kilis-Pstrusinska K, Konopska B, Kopec A, Larysz A, Lis W, Matera-Witkiewicz A, Pawlik-Sobecka L, Rosiek-Biegus M, Sokolska JM, Sokolowski J, Zapolska-Tomasiewicz A, Protasiewicz M, Madziarska K, Jankowska EA. History of Heart Failure in Patients Hospitalized Due to COVID-19: Relevant Factor of In-Hospital Complications and All-Cause Mortality up to Six Months. J Clin Med. 2022;11 PubMed PMC

Zhang Y, Coats AJS, Zheng Z, Adamo M, Ambrosio G, Anker SD, Butler J, Xu D, Mao J, Khan MS, Bai L, Mebazaa A, Ponikowski P, Tang Q, Ruschitzka F, Seferovic P, Tschöpe C, Zhang S, Gao C, Zhou S, Senni M, Zhang J, Metra M. Management of heart failure patients with COVID-19: a joint position paper of the Chinese Heart Failure Association & National Heart Failure Committee and the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2020;22:941–956. PubMed

DeFilippis EM, Reza N, Donald E, Givertz MM, Lindenfeld J, Jessup M. Considerations for Heart Failure Care During the COVID-19 Pandemic. JACC Heart Fail. 2020;8:681–691. PubMed PMC

Lippi G, Lavie CJ, Sanchis-Gomar F. Cardiac troponin I in patients with coronavirus disease 2019 (COVID-19): Evidence from a meta-analysis. Prog Cardiovasc Dis. 2020;63:390–391. PubMed PMC

Basso C, Leone O, Rizzo S, De Gaspari M, van der Wal AC, Aubry MC, Bois MC, Lin PT, Maleszewski JJ, Stone JR. Pathological features of COVID-19-associated myocardial injury: a multicentre cardiovascular pathology study. Eur Heart J. 2020;41:3827–3835. PubMed PMC

Tomasoni D, Italia L, Adamo M, Inciardi RM, Lombardi CM, Solomon SD, Metra M. COVID-19 and heart failure: from infection to inflammation and angiotensin II stimulation. Searching for evidence from a new disease. Eur J Heart Fail. 2020;22:957–966. PubMed PMC

Andersson C, Gerds T, Fosbøl E, Phelps M, Andersen J, Lamberts M, Holt A, Butt JH, Madelaire C, Gislason G, Torp-Pedersen C, Køber L, Schou M. Incidence of New-Onset and Worsening Heart Failure Before and After the COVID-19 Epidemic Lockdown in Denmark: A Nationwide Cohort Study. Circ Heart Fail. 2020;13:e007274. PubMed

Bromage DI, Cannatà A, Rind IA, Gregorio C, Piper S, Shah AM, McDonagh TA. The impact of COVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic. Eur J Heart Fail. 2020;22:978–984. PubMed PMC

Creel-Bulos C, Hockstein M, Amin N, Melhem S, Truong A, Sharifpour M. Acute Cor Pulmonale in Critically Ill Patients with Covid-19. N Engl J Med. 2020;382:e70. PubMed PMC

Kim J, Volodarskiy A, Sultana R, Pollie MP, Yum B, Nambiar L, Tafreshi R, Mitlak HW, RoyChoudhury A, Horn EM, Hriljac I, Narula N, Kim S, Ndhlovu L, Goyal P, Safford MM, Shaw L, Devereux RB, Weinsaft JW. Prognostic Utility of Right Ventricular Remodeling Over Conventional Risk Stratification in Patients With COVID-19. J Am Coll Cardiol. 2020;76:1965–1977. PubMed PMC

Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med. 2022;28:583–590. PubMed PMC

Zeymer U, Gitt A, Thiele H. COVID-19 pandemic : Effects on clinical care of cardiovascular patients in spring 2020. Herz. 2021;46:115–119. PubMed PMC

Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, Dixon S, Rade JJ, Tannenbaum M, Chambers J, Huang PP, Henry TD. Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States During COVID-19 Pandemic. J Am Coll Cardiol. 2020;75:2871–2872. PubMed PMC

Mafham MM, Spata E, Goldacre R, Gair D, Curnow P, Bray M, Hollings S, Roebuck C, Gale CP, Mamas MA, Deanfield JE, de Belder MA, Luescher TF, Denwood T, Landray MJ, Emberson JR, Collins R, Morris EJA, Casadei B, Baigent C. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Lancet. 2020;396:381–389. PubMed PMC

Mohammad MA, Koul S, Olivecrona GK, Gӧtberg M, Tydén P, Rydberg E, Scherstén F, Alfredsson J, Vasko P, Omerovic E, Angerås O, Fröbert O, Calais F, Völz S, Ulvenstam A, Venetsanos D, Yndigegn T, Oldgren J, Sarno G, Grimfjärd P, Persson J, Witt N, Ostenfeld E, Lindahl B, James SK, Erlinge D. Incidence and outcome of myocardial infarction treated with percutaneous coronary intervention during COVID-19 pandemic. Heart. 2020;106:1812–1818. PubMed PMC

Solomon MD, McNulty EJ, Rana JS, Leong TK, Lee C, Sung SH, Ambrosy AP, Sidney S, Go AS. The Covid-19 Pandemic and the Incidence of Acute Myocardial Infarction. N Engl J Med. 2020;383:691–693. PubMed

Xiang D, Xiang X, Zhang W, Yi S, Zhang J, Gu X, Xu Y, Huang K, Su X, Yu B, Wang Y, Fang W, Huo Y, Ge J. Management and Outcomes of Patients With STEMI During the COVID-19 Pandemic in China. J Am Coll Cardiol. 2020;76:1318–1324. PubMed PMC

Kiss P, Carcel C, Hockham C, Peters SAE. The impact of the COVID-19 pandemic on the care and management of patients with acute cardiovascular disease: a systematic review. Eur Heart J Qual Care Clin Outcomes. 2021;7:18–27. PubMed PMC

De Luca G, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Zimbakov Z, Cercek M, Jensen LO, Loh PH, Calmac L, Roura-Ferrer G, Quadros A, Milewski M, Scotto di Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Wong ASL, Kala P, Diez Gil JL, Carrillo X, Dirksen MT, Becerra-Muñoz VM, Kang-Yin Lee M, Juzar DA, de Moura Joaquim R, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld AO, Galasso G, Lux A, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac A, Ugur Mert K, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Lozano Martìnez-Luengas I, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Fores J, Vignali L, Pereira H, Manzo-Silberman S, Ordonez S, Özkan AA, Scheller B, Lehtola H, Teles R, Mantis C, Ylitalo A, Brum Silveira JA, Zoni R, Bessonov I, Savonitto S, Kochiadakis G, Alexopoulos D, Uribe C, Kanakakis J, Faurie B, Gabrielli G, Gutiérrez A, Bachini JP, Rocha A, Tam FC, Rodriguez A, Lukito A, Saint-Joy V, Pessah G, Tuccillo B, Cortese G, Parodi G, Bouraghda MA, Kedhi E, Lamelas P, Suryapranata H, Nardin M, Verdoia M ISACS-STEMI COVID-19; Collaborators. COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction. Heart. 2022;108:458–466. PubMed

Kwok CS, Gale CP, Kinnaird T, Curzen N, Ludman P, Kontopantelis E, Wu J, Denwood T, Fazal N, Deanfield J, de Belder MA, Mamas M. Impact of COVID-19 on percutaneous coronary intervention for ST-elevation myocardial infarction. Heart. 2020;106:1805–1811. PubMed

Chieffo A, Stefanini GG, Price S, Barbato E, Tarantini G, Karam N, Moreno R, Buchanan GL, Gilard M, Halvorsen S, Huber K, James S, Neumann FJ, Möllmann H, Roffi M, Tavazzi G, Ferré JM, Windecker S, Dudek D, Baumbach A. EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic. EuroIntervention. 2020;16:233–246. PubMed

Welt FGP, Shah PB, Aronow HD, Bortnick AE, Henry TD, Sherwood MW, Young MN, Davidson LJ, Kadavath S, Mahmud E, Kirtane AJ American College of Cardiology’s Interventional Council and the Society for Cardiovascular Angiography and Interventions. Catheterization Laboratory Considerations During the Coronavirus (COVID-19) Pandemic: From the ACC's Interventional Council and SCAI. J Am Coll Cardiol. 2020;75:2372–2375. PubMed PMC

Bollmann A, Hohenstein S, Meier-Hellmann A, Kuhlen R, Hindricks G. Emergency hospital admissions and interventional treatments for heart failure and cardiac arrhythmias in Germany during the Covid-19 outbreak: insights from the German-wide Helios hospital network. Eur Heart J Qual Care Clin Outcomes. 2020;6:221–222. PubMed PMC

Woolf SH, Chapman DA, Sabo RT, Weinberger DM, Hill L, Taylor DDH. Excess Deaths From COVID-19 and Other Causes, March-July 2020. JAMA. 2020;324:1562–1564. PubMed PMC

Scholz KH, Lengenfelder B, Thilo C, Jeron A, Stefanow S, Janssens U, Bauersachs J, Schulze PC, Winter KD, Schröder J, Vom Dahl J, von Beckerath N, Seidl K, Friede T, Meyer T. Impact of COVID-19 outbreak on regional STEMI care in Germany. Clin Res Cardiol. 2020;109:1511–1521. PubMed PMC

Rashid Hons M, Gale Hons CP, Curzen Hons N, Ludman Hons P, De Belder Hons M, Timmis Hons A, Mohamed Hons MO, Lüscher Hons TF, Hains Hons J, Wu J, Shoaib A, Kontopantelis E, Roebuck C, Denwood T, Deanfield J, Mamas MA. Impact of Coronavirus Disease 2019 Pandemic on the Incidence and Management of Out-of-Hospital Cardiac Arrest in Patients Presenting With Acute Myocardial Infarction in England. J Am Heart Assoc. 2020;9:e018379. PubMed PMC

Wu J, Mamas MA, Mohamed MO, Kwok CS, Roebuck C, Humberstone B, Denwood T, Luescher T, de Belder MA, Deanfield JE, Gale CP. Place and causes of acute cardiovascular mortality during the COVID-19 pandemic. Heart. 2021;107:113–119. PubMed

Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nat Rev Cardiol. 2020;17:543–558. PubMed PMC

Cenko E, Badimon L, Bugiardini R, Claeys MJ, De Luca G, de Wit C, Derumeaux G, Dorobantu M, Duncker DJ, Eringa EC, Gorog DA, Hassager C, Heinzel FR, Huber K, Manfrini O, Milicic D, Oikonomou E, Padro T, Trifunovic-Zamaklar D, Vasiljevic-Pokrajcic Z, Vavlukis M, Vilahur G, Tousoulis D. Cardiovascular disease and COVID-19: a consensus paper from the ESC Working Group on Coronary Pathophysiology & Microcirculation, ESC Working Group on Thrombosis and the Association for Acute CardioVascular Care (ACVC), in collaboration with the European Heart Rhythm Association (EHRA) Cardiovasc Res. 2021;117:2705–2729. PubMed PMC

Pirzada A, Mokhtar AT, Moeller AD. COVID-19 and Myocarditis: What Do We Know So Far? CJC Open. 2020;2:278–285. PubMed PMC

Caforio AL, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, Fu M, Heliö T, Heymans S, Jahns R, Klingel K, Linhart A, Maisch B, McKenna W, Mogensen J, Pinto YM, Ristic A, Schultheiss HP, Seggewiss H, Tavazzi L, Thiene G, Yilmaz A, Charron P, Elliott PM European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2013;34:2636–2648. PubMed

Tavazzi G, Pellegrini C, Maurelli M, Belliato M, Sciutti F, Bottazzi A, Sepe PA, Resasco T, Camporotondo R, Bruno R, Baldanti F, Paolucci S, Pelenghi S, Iotti GA, Mojoli F, Arbustini E. Myocardial localization of coronavirus in COVID-19 cardiogenic shock. Eur J Heart Fail. 2020;22:911–915. PubMed PMC

Boehmer TK, Kompaniyets L, Lavery AM, Hsu J, Ko JY, Yusuf H, Romano SD, Gundlapalli AV, Oster ME, Harris AM. Association Between COVID-19 and Myocarditis Using Hospital-Based Administrative Data - United States, March 2020-January 2021. MMWR Morb Mortal Wkly Rep. 2021;70:1228–1232. PubMed PMC

Witberg G, Barda N, Hoss S, Richter I, Wiessman M, Aviv Y, Grinberg T, Auster O, Dagan N, Balicer RD, Kornowski R. Myocarditis after Covid-19 Vaccination in a Large Health Care Organization. N Engl J Med. 2021;385:2132–2139. PubMed PMC

Patone M, Mei XW, Handunnetthi L, Dixon S, Zaccardi F, Shankar-Hari M, Watkinson P, Khunti K, Harnden A, Coupland CAC, Channon KM, Mills NL, Sheikh A, Hippisley-Cox J. Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection. Nat Med. 2022;28:410–422. PubMed PMC

Heymans S, Cooper LT. Myocarditis after COVID-19 mRNA vaccination: clinical observations and potential mechanisms. Nat Rev Cardiol. 2022;19:75–77. PubMed PMC

Dorward DA, Russell CD, Um IH, Elshani M, Armstrong SD, Penrice-Randal R, Millar T, Lerpiniere CEB, Tagliavini G, Hartley CS, Randle NP, Gachanja NN, Potey PMD, Dong X, Anderson AM, Campbell VL, Duguid AJ, Al Qsous W, BouHaidar R, Baillie JK, Dhaliwal K, Wallace WA, Bellamy COC, Prost S, Smith C, Hiscox JA, Harrison DJ, Lucas CD. Tissue-Specific Immunopathology in Fatal COVID-19. Am J Respir Crit Care Med. 2021;203:192–201. PubMed PMC

Lavelle MP, Desai AD, Wan EY. Arrhythmias in the COVID-19 patient. Heart Rhythm O2. 2022;3:8–14. PubMed PMC

Kunutsor SK, Laukkanen JA. Cardiovascular complications in COVID-19: A systematic review and meta-analysis. J Infect. 2020;81:e139–e141. PubMed PMC

Lazzerini PE, Boutjdir M, Capecchi PL. COVID-19, Arrhythmic Risk, and Inflammation: Mind the Gap! Circulation. 2020;142:7–9. PubMed

Si D, Du B, Ni L, Yang B, Sun H, Jiang N, Liu G, Massé S, Jin L, Nanthakumar J, Bhaskaran A, Yang P, Nanthakumar K. Death, discharge and arrhythmias among patients with COVID-19 and cardiac injury. CMAJ. 2020;192:E791–E798. PubMed PMC

Baldi E, Sechi GM, Mare C, Canevari F, Brancaglione A, Primi R, Klersy C, Palo A, Contri E, Ronchi V, Beretta G, Reali F, Parogni P, Facchin F, Rizzi U, Bussi D, Ruggeri S, Oltrona Visconti L, Savastano S Lombardia CARe researchers. COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests. Eur Heart J. 2020;41:3045–3054. PubMed PMC

Li X, Pan X, Li Y, An N, Xing Y, Yang F, Tian L, Sun J, Gao Y, Shang H. Cardiac injury associated with severe disease or ICU admission and death in hospitalized patients with COVID-19: a meta-analysis and systematic review. Crit Care. 2020;24:468. PubMed PMC

Chen Q, Xu L, Dai Y, Ling Y, Mao J, Qian J, Zhu W, Di W, Ge J. Cardiovascular manifestations in severe and critical patients with COVID-19. Clin Cardiol. 2020;43:796–802. PubMed PMC

McCullough SA, Goyal P, Krishnan U, Choi JJ, Safford MM, Okin PM. Electrocardiographic Findings in Coronavirus Disease-19: Insights on Mortality and Underlying Myocardial Processes. J Card Fail. 2020;26:626–632. PubMed PMC

Schwab JO, Wiese J, Hauser T. The influence of the 2020 COVID-19 pandemic on the implantation rates of cardiac implantable electronic devices in Germany: changes between 2020 Q1-Q3 and 2019 Q1-Q3. Eur Heart J Qual Care Clin Outcomes. 2022;8:104–112. PubMed PMC

Simovic S, Providencia R, Barra S, Kircanski B, Guerra JM, Conte G, Duncker D, Marijon E, Anic A, Boveda S. The use of remote monitoring of cardiac implantable devices during the COVID-19 pandemic: an EHRA physician survey. Europace. 2022;24:473–480. PubMed PMC

Buicu AL, Cernea S, Benedek I, Buicu CF, Benedek T. Systemic Inflammation and COVID-19 Mortality in Patients with Major Noncommunicable Diseases: Chronic Coronary Syndromes, Diabetes and Obesity. J Clin Med. 2021;10 PubMed PMC

Basille D, Plouvier N, Trouve C, Duhaut P, Andrejak C, Jounieaux V. Non-steroidal Anti-inflammatory Drugs may Worsen the Course of Community-Acquired Pneumonia: A Cohort Study. Lung. 2017;195:201–208. PubMed

Douglas I, Evans S, Smeeth L. Effect of statin treatment on short term mortality after pneumonia episode: cohort study. BMJ. 2011;342:d1642. PubMed PMC

Xu L, Liu J, Lu M, Yang D, Zheng X. Liver injury during highly pathogenic human coronavirus infections. Liver Int. 2020;40:998–1004. PubMed PMC

Task Force for the management of COVID-19 of the European Society of Cardiology. European Society of Cardiology guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1-epidemiology, pathophysiology, and diagnosis. Cardiovasc Res. 2021 PubMed PMC

Barbeito-Caamaño C, Bouzas-Mosquera A, Peteiro J, López-Vázquez D, Quintas-Guzmán M, Varela-Cancelo A, Martínez-Ruiz D, Yañez-Wonenburger JC, Piñeiro-Portela M, Vázquez-Rodríguez JM. Exercise testing in COVID-19 era: Clinical profile, results and feasibility wearing a facemask. Eur J Clin Invest. 2021;51:e13509. PubMed PMC

Pillai A, Lawson B. Coronavirus disease 2019 and cardiovascular diseases: collateral damage? Curr Opin Anaesthesiol. 2022;35:5–11. PubMed PMC

Bhatt AS, Jering KS, Vaduganathan M, Claggett BL, Cunningham JW, Rosenthal N, Signorovitch J, Thune JJ, Vardeny O, Solomon SD. Clinical Outcomes in Patients With Heart Failure Hospitalized With COVID-19. JACC Heart Fail. 2021;9:65–73. PubMed PMC

Rumery K, Seo A, Jiang L, Choudhary G, Shah NR, Rudolph JL, Wu WC, Erqou S. Outcomes of coronavirus disease-2019 among veterans with pre-existing diagnosis of heart failure. ESC Heart Fail. 2021;8:2338–2344. PubMed PMC

Bocchi EA, Lima IGCV, Biselli B, Salemi VMC, Ferreira SMA, Chizzola PR, Munhoz RT, Pessoa RS, Cardoso FAM, Bello MVO, Hajjar LA, Gomes BR. Worsening of heart failure by coronavirus disease 2019 is associated with high mortality. ESC Heart Fail. 2021;8:943–952. PubMed PMC

Vaduganathan M, Vardeny O, Michel T, McMurray JJV, Pfeffer MA, Solomon SD. Renin-Angiotensin-Aldosterone System Inhibitors in Patients with Covid-19. N Engl J Med. 2020;382:1653–1659. PubMed PMC

Furuhashi M, Moniwa N, Mita T, Fuseya T, Ishimura S, Ohno K, Shibata S, Tanaka M, Watanabe Y, Akasaka H, Ohnishi H, Yoshida H, Takizawa H, Saitoh S, Ura N, Shimamoto K, Miura T. Urinary angiotensin-converting enzyme 2 in hypertensive patients may be increased by olmesartan, an angiotensin II receptor blocker. Am J Hypertens. 2015;28:15–21. PubMed

Lafaurie M, Martin-Blondel G, Delobel P, Charpentier S, Sommet A, Moulis G. Outcome of patients hospitalized for COVID-19 and exposure to angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers in France: results of the ACE-CoV study. Fundam Clin Pharmacol. 2021;35:194–203. PubMed

Seferovic PM, Ponikowski P, Anker SD, Bauersachs J, Chioncel O, Cleland JGF, de Boer RA, Drexel H, Ben Gal T, Hill L, Jaarsma T, Jankowska EA, Anker MS, Lainscak M, Lewis BS, McDonagh T, Metra M, Milicic D, Mullens W, Piepoli MF, Rosano G, Ruschitzka F, Volterrani M, Voors AA, Filippatos G, Coats AJS. Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail. 2019;21:1169–1186. PubMed

Indolfi C, Barillà F, Basso C, Ciccone MM, Curcio A, Mancone M, Mercuro G, Muscoli S, Nodari S, Pedrinelli R, Romeo F, Sinagra G, Filardi PP. Position paper of the Italian Society of Cardiology (SIC) on COVID-19 vaccine priority in patients with cardiovascular diseases. G Ital Cardiol (Rome) 2021;22:363–375. PubMed

Kubica J, Ostrowska M, Stolarek W, Kasprzak M, Grzelakowska K, Kryś J, Kubica A, Adamski P, Podhajski P, Navarese EP, Anielska-Michalak E, Brycht O, Curzytek A, Dudek A, Gromadziński L, Grzelakowski P, Kamiński L, Kleinrok A, Kostkiewicz M, Koziński M, Król P, Kulawik T, Minczew G, Mindykowski M, Pawlak A, Prokopczuk J, Skonieczny G, Sobkowicz B, Sowiński S, Stankala S, Szymański P, Wester A, Wilczewski P, Bartuś S, Budaj A, Gąsior M, Gruchała M, Drożdż J, Jaguszewski M, Jankowski P, Legutko J, Lesiak M, Leszek P, Mitkowski P, Nessler J, Tomaszuk-Kazberuk A, Tycińska A, Zdrojewski T, Kaźmierczak J. Impact of COVID-19 pandemic on acute heart failure admissions and mortality: a multicentre study (COV-HF-SIRIO 6 study) ESC Heart Fail. 2022;9:721–728. PubMed PMC

Severino P, D'Amato A, Saglietto A, D'Ascenzo F, Marini C, Schiavone M, Ghionzoli N, Pirrotta F, Troiano F, Cannillo M, Mennuni M, Rognoni A, Rametta F, Galluzzo A, Agnes G, Infusino F, Pucci M, Lavalle C, Cacciotti L, Mather PJ, Grosso Marra W, Ugo F, Forleo G, Viecca M, Morici N, Patti G, De Ferrari GM, Palazzuoli A, Mancone M, Fedele F. Reduction in heart failure hospitalization rate during coronavirus disease 19 pandemic outbreak. ESC Heart Fail. 2020;7:4182–8. PubMed PMC

Sokolski M, Trenson S, Sokolska JM, D'Amario D, Meyer P, Poku NK, Biering-Sørensen T, Højbjerg Lassen MC, Skaarup KG, Barge-Caballero E, Pouleur AC, Stolfo D, Sinagra G, Ablasser K, Muster V, Rainer PP, Wallner M, Chiodini A, Heiniger PS, Mikulicic F, Schwaiger J, Winnik S, Cakmak HA, Gaudenzi M, Mapelli M, Mattavelli I, Paul M, Cabac-Pogorevici I, Bouleti C, Lilliu M, Minoia C, Dauw J, Costa J, Celik A, Mewton N, Montenegro CEL, Matsue Y, Loncar G, Marchel M, Bechlioulis A, Michalis L, Dörr M, Prihadi E, Schoenrath F, Messroghli DR, Mullens W, Lund LH, Rosano GMC, Ponikowski P, Ruschitzka F, Flammer AJ. Heart failure in COVID-19: the multicentre, multinational PCHF-COVICAV registry. ESC Heart Fail. 2021;8:4955–4967. PubMed PMC

Oseran AS, Afari ME, Barrett CD, Lewis GD, Thomas SS. Beyond the stethoscope: managing ambulatory heart failure during the COVID-19 pandemic. ESC Heart Fail. 2021;8:999–1006. PubMed PMC

Afonso Nogueira M, Ferreira F, Raposo AF, Mónica L, Simões Dias S, Vasconcellos R, Proença G. Impact of telemedicine on the management of heart failure patients during coronavirus disease 2019 pandemic. ESC Heart Fail. 2021;8:1150–1155. PubMed PMC

Cammalleri V, Muscoli S, Benedetto D, Stifano G, Macrini M, Di Landro A, Di Luozzo M, Marchei M, Mariano EG, Cota L, Sergi D, Bezzeccheri A, Bonanni M, Baluci M, De Vico P, Romeo F. Who Has Seen Patients With ST-Segment-Elevation Myocardial Infarction? J Am Heart Assoc. 2020;9:e017126. PubMed PMC

Wood DA, Sathananthan J. "Minimalist" transcatheter aortic valve implantation during the COVID-19 pandemic: previously optional but now a necessity. EuroIntervention. 2020;16:e451–e452. PubMed

Dvir D. Severe valvular heart disease and COVID-19: results from the multicenter international valve disease registry. [cited 20 April 2022]. Available from: https://www.tctmd.com/news/valve-disease-plus-covid-19-often-lethal-combination-registry-shows . PubMed PMC

Mohamed MO, Banerjee A, Clarke S, de Belder M, Patwala A, Goodwin AT, Kwok CS, Rashid M, Gale CP, Curzen N, Mamas MA. Impact of COVID-19 on cardiac procedure activity in England and associated 30-day mortality. Eur Heart J Qual Care Clin Outcomes. 2021;7:247–256. PubMed PMC

Shah PB, Welt FGP, Mahmud E, Phillips A, Kleiman NS, Young MN, Sherwood M, Batchelor W, Wang DD, Davidson L, Wyman J, Kadavath S, Szerlip M, Hermiller J, Fullerton D, Anwaruddin S. Triage considerations for patients referred for structural heart disease intervention during the COVID-19 pandemic: An ACC/SCAI position statement. Catheter Cardiovasc Interv. 2020;96:659–663. PubMed

Wood DA, Sathananthan J, Gin K, Mansour S, Ly HQ, Quraishi AU, Lavoie A, Lutchmedial S, Nosair M, Bagai A, Bainey KR, Boone RH, Liu S, Krahn A, Virani S, Mehta SR, Natarajan MK, Velianou JL, Dehghani P, Wijeysundera HC, Asgar AW, Virani A, Welsh RC, Webb JG, Cohen EA. Precautions and Procedures for Coronary and Structural Cardiac Interventions During the COVID-19 Pandemic: Guidance from Canadian Association of Interventional Cardiology. Can J Cardiol. 2020;36:780–783. PubMed PMC

Costa G, Barbanti M, Picci A, Todaro D, La Spina K, Di Simone E, D'Arrigo P, Criscione E, Valvo R, Reddavid C, Deste W, Sgroi C, Tamburino C, Giuffrida A, Garretto V, Privitera G, Cannizzaro MT, Inserra C, Veroux P. Predictors and safety of next-day discharge in patients undergoing transfemoral transcatheter aortic valve implantation. EuroIntervention. 2020;16:e494–e501. PubMed

Sathananthan J, Webb JG, Polderman J, Achtem L, Hensey M, Murdoch D, Moss R, Shook A, Bruce S, Blanke P, Bancroft C, Andrews H, Leipsic J, Wood D, Lauck S. Safety of Accelerated Recovery on a Cardiology Ward and Early Discharge Following Minimalist TAVR in the Catheterization Laboratory: The Vancouver Accelerated Recovery Clinical Pathway. Structural Heart. 2019;3:229–235.

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129–2200. PubMed

Roffi M, Capodanno D, Windecker S, Baumbach A, Dudek D. Impact of the COVID-19 pandemic on interventional cardiology practice: results of the EAPCI survey. EuroIntervention. 2020;16:247–250. PubMed

Marmagkiolis K, Kilic ID, Ates I, Kose G, Iliescu C, Cilingiroglu M. Feasibility of Same-Day Discharge Approach After Transcatheter Mitral Valve Repair Procedures. J Invasive Cardiol. 2021;33:E123–E126. PubMed

Chowdhury M, Buttar R, Rai D, Tahir MW, Tan BE, Thakkar S, Ali H, Patel HP, Bhatt DL, Depta JP. Same-day discharge after transcatheter mitral valve repair using MitraClip in a tertiary community hospital: a case series. Eur Heart J Case Rep. 2021;5:ytab397. PubMed PMC

Romeo F, Cammalleri V, Ruvolo G, Quadri A, De Vico P, Muscoli S, Marchei M, Meloni S, Conti F, Ussia GP. Trans-catheter mitral valve implantation for mitral regurgitation: clinical case description and literature review. J Cardiovasc Med (Hagerstown) 2016;17:85–91. PubMed

Skulstad H, Cosyns B, Popescu BA, Galderisi M, Salvo GD, Donal E, Petersen S, Gimelli A, Haugaa KH, Muraru D, Almeida AG, Schulz-Menger J, Dweck MR, Pontone G, Sade LE, Gerber B, Maurovich-Horvat P, Bharucha T, Cameli M, Magne J, Westwood M, Maurer G, Edvardsen T. COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel. Eur Heart J Cardiovasc Imaging. 2020;21:592–598. PubMed PMC

Fazzari F, Mantovani R, Donghi V, Curzi M, Bragato RM. From EACVI recommendations to the real-world experience: safety of performing echocardiography in the pandemic era. Eur Heart J Cardiovasc Imaging. 2021;22:e82–e83. PubMed

Williams MC, Shaw L, Hirschfeld CB, Maurovich-Horvat P, Nørgaard BL, Pontone G, Jimenez-Heffernan A, Sinitsyn V, Sergienko V, Ansheles A, Bax JJ, Buechel R, Milan E, Slart RHJA, Nicol E, Bucciarelli-Ducci C, Pynda Y, Better N, Cerci R, Dorbala S, Raggi P, Villines TC, Vitola J, Malkovskiy E, Goebel B, Cohen Y, Randazzo M, Pascual TNB, Dondi M, Paez D, Einstein AJ INCAPS COVID Investigators Group. Impact of COVID-19 on the imaging diagnosis of cardiac disease in Europe. Open Heart. 2021;8 PubMed PMC

Dondi M, Milan E, Pontone G, Hirschfeld CB, Williams M, Shaw LJ, Pynda Y, Raggi P, Cerci R, Vitola J, Better N, Villines TC, Dorbala S, Pascual TNB, Giubbini R, Einstein AJ, Paez D INCAPS COVID Investigators Group. Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID) Int J Cardiol. 2021;341:100–106. PubMed PMC

Joshi SS, Stankovic I, Demirkiran A, Haugaa K, Maurovich-Horvat P, Popescu BA, Cosyns B, Edvardsen T, Petersen SE, Carvalho RF, Cameli M, Dweck MR. EACVI survey on burnout amongst cardiac imaging specialists during the 2019 coronavirus disease pandemic. Eur Heart J Cardiovasc Imaging. 2022;23:441–446. PubMed PMC

Picano E, Scali MC, Ciampi Q, Lichtenstein D. Lung Ultrasound for the Cardiologist. JACC Cardiovasc Imaging. 2018;11:1692–1705. PubMed

Gargani L, Soliman-Aboumarie H, Volpicelli G, Corradi F, Pastore MC, Cameli M. Why, when, and how to use lung ultrasound during the COVID-19 pandemic: enthusiasm and caution. Eur Heart J Cardiovasc Imaging. 2020;21:941–948. PubMed PMC

Barrios V, Cosín-Sales J, Bravo M, Escobar C, Gámez JM, Huelmos A, Ortiz Cortés C, Egocheaga I, García-Pinilla JM, Jiménez-Candil J, López-de-Sá E, Torres Llergo J, Obaya JC, Pallares-Carratalá V, Sanmartín M, Vidal-Pérez R, Cequier Á. Telemedicine consultation for the clinical cardiologists in the era of COVID-19: present and future. Consensus document of the Spanish Society of Cardiology. Rev Esp Cardiol (Engl Ed) 2020;73:910–918. PubMed PMC

Gorodeski EZ, Goyal P, Cox ZL, Thibodeau JT, Reay RE, Rasmusson K, Rogers JG, Starling RC. Virtual Visits for Care of Patients with Heart Failure in the Era of COVID-19: A Statement from the Heart Failure Society of America. J Card Fail. 2020;26:448–456. PubMed PMC

Kerr B, Pharithi RB, Barrett M, Halley C, Gallagher J, Ledwidge M, McDonald K. Changing to remote management of a community heart failure population during COVID-19 - Clinician and patient perspectives'. Int J Cardiol Heart Vasc. 2020;31:100665. PubMed PMC

Sayer G, Horn EM, Farr MA, Axsom K, Kleet A, Gjerde C, Latif F, Sobol I, Kelley N, Lancet E, Halik C, Takeda K, Naka Y, Yuzefpolskaya M, Kumaraiah D, Colombo PC, Maurer MS, Uriel N. Transition of a Large Tertiary Heart Failure Program in Response to the COVID-19 Pandemic: Changes That Will Endure. Circ Heart Fail. 2020;13:e007516. PubMed

Nolan RP, Ross HJ, Farkouh ME, Huszti E, Chan S, Toma M, D'Antono B, White M, Thomas S, Barr SI, Perreault S, McDonald M, Zieroth S, Isaac D, Wielgosz A, Mielniczuk LM. Automated E-Counseling for Chronic Heart Failure: CHF-CePPORT Trial. Circ Heart Fail. 2021;14:e007073. PubMed

Giacalone A, Marin L, Febbi M, Franchi T, Tovani-Palone MR. eHealth, telehealth, and telemedicine in the management of the COVID-19 pandemic and beyond: Lessons learned and future perspectives. World J Clin Cases. 2022;10:2363–2368. PubMed PMC