Review Article

Getting to the Heart of the Matter: Myocardial Injury, Coagulopathy, and Other Potential Cardiovascular Implications of COVID-19

Table 3

Vascular complications and pathology.

StudyTotal populationHearts studiedMean/range age (years)Cardiac comorbiditiesMean time to deathCardiac enlargementOther findingsCardiac interstitial fibrosisEpicardial mononuclear infiltrateMyocardial infarctionElevated D-dimerNeurological vascular lesionsVenous thromboembolismOther

Bryce et al. [93]672569 (range 34-94)Hypertension (62.7%), coronary artery disease (31.3%), heart failure (14.9%), atrial fibrillation (13.4%)9.5 days (range 0-61) from admissionLeft ventricular hypertrophy (100%)Myocyte hypertrophy and interstitial fibrosis100%60%80.6%Cerebral infarct (30%)6%Intravascular fibrin thrombi (25%), CD61 platelet aggregates or thrombi (31%), large pulmonary emboli (6%)
Fox et al. [95]10 (African American)9Range 44-78Hypertension (70%), atrial fibrillation (10%), heart failure (10%)8.2 days (range 0-25) from admission; 11.6 days from symptom onsetRight ventricular dilationScattered myocyte necrosis; no significant lymphocytic infiltration90%Small, firm thrombi in peripheral parenchyma (100%)
Tian et al. [121]42Range 59-81Hypertension (25%)15-52 days from disease onset100%
Rapkiewicz et al. [100]74Range 44-65Hypertension (85%), coronary artery disease (14%)12.9 days (range 3-25) from symptom onset; mean 4.4 days from admissionMegakaryocytes with fibrin microthrombi in cardiac microvasculature (7/7)25%25%100%Pulmonary arterial thrombi (57%), venous thrombosis (29%), CD61 platelet aggregates or thrombi (100%)
Bradley et al. [96]121270.47 days (range 1-14) from symptom onsetMyocyte hypertrophy (12/12)83%Subsegmental pulmonary emboli (17%)
Giacca et al. [102]4130Male -77; female -84Cardiomyocyte damage suggestive of hypoxic injury (54%)24%Pulmonary thrombosis (77%)
Edler et al. [97]8080Mean 79.2Cardiomyopathy (11.25%), arrhythmia (1.25%), cardiac insufficiency (38.75%), atrial fibrillation (18.75%), hypertension (31.25%)40%Pulmonary embolism (21%)
Lax et al. [94]1111Mean 80.5 (range 66-91)Hypertension (81.8%), coronary artery disease (27.27%)8.55 days (range 4-18) from symptom onsetBiventricular hypertrophy (100%), biventricular dilation (91%)90.90%86%Pulmonary arterial thrombosis
Wichmann et al. [98]1212Mean 73 (range 52-87)Coronary/ischemic heart disease (50%)Biventricular hypertrophy (25%)50%71%58%Pulmonary embolism