Generic placeholder image



ISSN (Print): 2666-7967
ISSN (Online): 2666-7975

Mini-Review Article

A Mini-Review on Cardiovascular and Hematological Complications of COVID-19

Author(s): Moein Masjedi* and Pegah Jafari

Volume 2, Issue 2, 2021

Published on: 26 October, 2020

Page: [204 - 208] Pages: 5

DOI: 10.2174/2666796701999201026211142


Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is named as the coronavirus disease of 2019 (COVID-19). Patients with SARS-CoV-2 infection experience a wide range of symptoms and they are at the risk of various systemic complications. Besides the pulmonary complications, COVID-19 cases may develop cardiovascular and hematological complications. This study aimed to review the most important hematological and cardiovascular complications caused by SARS-CoV-2 infection.

Methods: The English databases, including Pubmed, ScienceDirect, Cochrane Library, Scopus, and Google Scholar, were searched. The published papers were selected and reviewed based on the subject of this study.

Results: The review of the literature showed that several cardiovascular complications related to COVID-19, including acute myocardial infarction, cardiomyopathy, acute heart failure, and venous thromboembolic events due to coagulation abnormalities, have been reported. COVID-19 associated hematological complications include elevated levels of hematological factors including C-reactive protein, lactate dehydrogenase, procalcitonin, and ferritin. Furthermore, the levels of blood cells, including lymphocytes and thrombocytes, can be reduced.

Conclusion: This study reviewed COVID-19-associated cardiovascular and hematopoietic complications. In conclusion, the patients may experience a wide range of cardiovascular and hematological issues during the illness. These complications are often associated with the need for ICU support and care which imposes further costs to the healthcare system. So the healthcare team must consider the possible complications when treating COVID-19 patients to reduce the treatment costs and mortality of patients.

Keywords: Cardiovascular complications, hematological complications, COVID-19, SARS-CoV-2, C-reactive protein, thromboembolic events.

Zheng Y-Y, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol 2020; 17(5): 259-60.
[] [PMID: 32139904]
World Health Organization, Coronavirus disease 2019 (COVID-19):situation report
Zhang X, Cai H, Hu J, et al. Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings. Int J Infect Dis 2020; 94: 81-7.
[] [PMID: 32205284]
Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic. J Am Coll Cardiol 2020; 75(18): 2352-71.
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[] [PMID: 31986264]
Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med 2020; 46: 846-8.
Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA 2020; 323(11): 1061-9.
[] [PMID: 32031570]
Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 2020; 180(7): 934-43.
[] [PMID: 32167524]
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395(10229): 1054-62.
[] [PMID: 32171076]
Li T, Lu H, Zhang W. Clinical observation and management of COVID-19 patients. Emerg Microbes Infect 2020; 9(1): 687-90.
[] [PMID: 32208840]
Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol 2020; 95(6): E131-4.
[] [PMID: 32129508]
Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. Hematological findings and complications of COVID-19. Am J Hematol 2020; 95(7): 834-47.
[] [PMID: 32282949]
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395(10229): 1033-4.
[] [PMID: 32192578]
Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost 2020; 18(4): 844-7.
[] [PMID: 32073213]
Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol 2020; 5(7): 831-40.
[] [PMID: 32219363]
Tan L, Wang Q, Zhang D, et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther 2020; 5(1): 33.
[] [PMID: 32296069]
Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis. Clin Chim Acta 2020; 506: 145-8.
[] [PMID: 32178975]
Kwong JC, Schwartz KL, Campitelli MA, et al. Acute myocardial infarction after laboratory-confirmed influenza infection. N Engl J Med 2018; 378(4): 345-53.
[] [PMID: 29365305]
Davis MM, Taubert K, Benin AL, et al. A science advisory from the American Heart Association/American College of Cardiology. J Am Coll Cardiol 2006; 48(7): 1498-502.
[] [PMID: 17010820]
Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323(13): 1239-42.
[] [PMID: 32091533]
Li B, Yang J, Zhao F, et al. Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China. Clin Res Cardiol 2020; 109(5): 531-8.
[] [PMID: 32161990]
Murthy S, Gomersall C, Fowler R. Care for critically Ill patients with Covid-19. JAMA 323(15): 1499-500.
Aggarwal S, Gollapudi S, Gupta S. Increased TNF-α-induced apoptosis in lymphocytes from aged humans: changes in TNF-α receptor expression and activation of caspases. J Immunol 1999; 162(4): 2154-61.
[PMID: 9973490]
Guo T, Fan Y, Chen M, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020; 5(7): 811-8.
[] [PMID: 32219356]
Corrales-Medina VF, Alvarez KN, Weissfeld LA, et al. Association between hospitalization for pneumonia and subsequent risk of cardiovascular disease. JAMA 2015; 313(3): 264-74.
[] [PMID: 25602997]
Welt FGP, Shah PB, Aronow HD, et al. Catheterization laboratory considerations during the coronavirus (COVID-19) pandemic: from ACC’s Interventional Council and SCAI. J Am Coll Cardiol 2020; 75(18): 2372-5.
[] [PMID: 32199938]
Chen T, Wu D, Chen H, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020; 368: m1091.
[] [PMID: 32217556]
Alhogbani T. Acute myocarditis associated with novel Middle east respiratory syndrome coronavirus. Ann Saudi Med 2016; 36(1): 78-80.
[] [PMID: 26922692]
Buzon J, Roignot O, Lemoine S, et al. Takotsubo cardiomyopathy triggered by influenza A virus. Intern Med 2015; 54(16): 2017-9.
[] [PMID: 26278294]
Liu K, Fang YY, Deng Y, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl) 2020; 133(9): 1025-31.
[] [PMID: 32044814]
Xie Y, Wang X, Yang P, Zhang S. COVID-19 complicated by acute pulmonary embolism. Radiology. Cardiothoracic Imaging 2020; 2(2)e200067
Danzi GB, Loffi M, Galeazzi G, Gherbesi E. Acute pulmonary embolism and COVID-19 pneumonia: a random association? Eur Heart J 2020; 41(19): 1858.
[] [PMID: 32227120]
Chen J, Wang X, Zhang S, Liu B. Findings of acute pulmonary embolism in COVID-19 patients. SSRN Electron J 2020; 2020: 1.
Deng Y, Wei L, Kui L, et al. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study. Chin Med J (Engl) 2020.
Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost 2020; 18(5): 1094-9.
[] [PMID: 32220112]
Guan WJ, Ni ZY, Hu Y, et al. China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382(18): 1708-20.
[] [PMID: 32109013]
Fan BE, Chong VCL, Chan SSW, et al. Hematologic parameters in patients with COVID‐19 infection. Am J Hematol 2020; 95(6): E131-4.
Xu H, Zhong L, Deng J, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci 2020; 12(1): 8.
[] [PMID: 32094336]
Singh S, Sharma A, Arora SK. High producer haplotype (CAG) of-863C/A,-308G/A and-238G/A polymorphisms in the promoter region of TNF-α gene associate with enhanced apoptosis of lymphocytes in HIV-1 subtype C infected individuals from North India. PLoS One 2014; 9(5): 1.
Liao Y-C, Liang WG, Chen FW, Hsu JH, Yang JJ, Chang MS. IL-19 induces production of IL-6 and TNF-α and results in cell apoptosis through TNF-α. J Immunol 2002; 169(8): 4288-97.
[] [PMID: 12370360]
Chan JF-W, Zhang AJ, Yuan S, et al. Simulation of the clinical and pathological manifestations of Coronavirus disease 2019 (COVID-19) in golden Syrian hamster model: implications for disease pathogenesis and transmissibility. Clin Infect Dis 2020; 71(9): 2428-46.
[] [PMID: 32215622]
Young BE, Ong SWX, Kalimuddin S, et al. Singapore 2019 Novel Coronavirus outbreak research team. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA 2020; 323(15): 1488-94.
[] [PMID: 32125362]
Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020; 8(5): 475-81.
[] [PMID: 32105632]
Arentz M, Yim E, Klaff L, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020; 323(16): 1612-4.
[] [PMID: 32191259]
Bhatraju PK, Ghassemieh BJ, Nichols M, et al. Covid-19 in critically ill patients in the Seattle region—case series. N Engl J Med 2020; 382(21): 2012-22.
[] [PMID: 32227758]
Qu R, Ling Y, Zhang YH, et al. Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19. J Med Virol 2020; 92(9): 1533-41.
[] [PMID: 32181903]

© 2022 Bentham Science Publishers | Privacy Policy