Myocardial Injury in Covid-19 and Heart Rhythm Disorders in the Acute and Late Periods

Epidemiological data show that up to 30% of people who survive the acute phase of COVID-19 experience long-term cardiovascular symptoms (shortness of breath, chest pain and discomfort, palpitations, exercise intolerance, fatigue, sleep disturbances). Numerous studies conducted in different regions of the world have found that after recovery from COVID-19, patients, regardless of age, race, gender and cardiovascular risk factors, are at increased risk of developing cardiovascular complications, including new or progressive inflammatory heart disease, heart failure, myocardial infarction, coronary artery disease, cardiomyopathy, thromboembolism, arrhythmias and ischemic stroke. The SARS-CoV-2 virus causes not only direct damage to cardiomyocytes and other cells of the cardiovascular system, but also systemic inflammation and coagulopathy, which can aggravate comorbid cardiovascular diseases. The use of functional and instrumental research methods revealed various types of subclinical and clinical cardiac damage in most patients with post-COVID syndrome (regardless of the severity of the acute phase of COVID-19 and concomitant conditions). The high prevalence of post-COVID syndrome of the cardiovascular type requires a comprehensive multidisciplinary approach to diagnosis, treatment and rehabilitation of patients. All authors of published studies, meta-analyses and systematic reviews emphasize the importance of continuous monitoring of the cardiovascular system for at least one year after the infection has resolved. The aim of our review article is to justify the need to study the pathophysiology of post-COVID cardiovascular syndrome to discover therapeutic targets and develop targeted treatments.