Cardiac Implications of Coronavirus -COVID-19
ACC Clinical Bulletin
Cardiac Implications of Coronavirus (COVID-19)
Background on Coronavirus epidemic i,ii
• COVID-19 was first reported in late December 2019, originating inWuhan, China
• COVID-19 is a betacoronavirus, like SARS and MERS, presenting as viralpneumonia with a wide range of acuity
• As of February 12, there are 45,204 confirmed cases and 1,117 confirmeddeaths across 28 countries; COVID-19 appears to have greater infectivityand a lower case fatality rate when compared to SARS and MERS
• 99% of all cases are in mainland China, where despite aggressive con-tainment efforts, case counts continue to rise rapidly
Early cardiac implications from case reports on Wuhan Coronavirusiii
• Early c ase r eports suggest p atients w ith u nderlying c onditions a re a thigher risk for complications or mortality from COVID-19; up to 50% ofhospitalized patients have a chronic medical illness
• 40% of hospitalized patients with confirmed COVID-19 patients havecardiovascular or cerebrovascular di sease
• In a recent case report on 138 hospitalized COVID-19 patients, 19.6% ofpatients developed acute respiratory distress syndromeiv
○16.7% of patients developed arrhythmia; 7.2% developed acutecardiac injury
○8.7% of patients developed shock; 3.6% developed acute kidneyinjury
○Rates of complication were universally higher for ICU patients
•The first reported death was a 61-year-old male, with a long history of smok-ing, who succumbed to acute respiratory distress, heart failure, and cardiacarrest
•Early, unpublished first-hand reports suggest at least some patients developmyocarditis
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