The Cardiac Implications of Novel Coronavirus

Recent clinical bulletin addressing the cardiac implications of the novel coronavirus (COVID-19, 2019-nCoV and Wuhan Coronavirus. The key message to clinicians is that patients with underlying cardiovascular disease may have a potential increased risk if they contract coronavirus

The bulletin provides background on the epidemic, which was first reported in late December 2019, and looks at early cardiac implications from case reports. It also provides information on the potential cardiac implications from analog viral respiratory pandemics and offers early clinical guidance given current 2019-nCoV uncertainty. It stresses the importance for cardiovascular disease patients to remain current with vaccinations, including the pneumococcal vaccine given the increased risk of secondary bacterial infection and suggests encouraging the influenza vaccination to prevent another source of fever which could be initially confused with coronavirus infection.

Cardiac Implications of Novel Coronavirus:

The following points regarding early cardiac implications from case reports on Wuhan Coronavirus.

   • Early case reports suggest patients with underlying conditions are at higher risk for complications or mortality from COVID-19; up to 50 percent of hospitalized patients have a chronic medical illness.

   • 40 percent of hospitalized patients with confirmed COVID-19 patients have cardiovascular or cerebrovascular disease.

   • In a recent case report on 138 hospitalized COVID-19 patients, 19.6 percent of patients developed acute respiratory distress syndrome.

   • 16.7 percent of patients developed arrhythmia; 7.2 percent developed acute cardiac injury.

   • 8.7 percent of patients developed shock; 3.6% developed acute kidney injury.

   • Rates of complication were universally higher for ICU patients.

   • The first reported death was a 61-year-old male, with a long history of smoking, who succumbed to acute respiratory distress, heart failure and cardiac arrest.

   • Early, unpublished first-hand reports suggest at least some patients develop myocarditis

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