The Clinical Practices and Post-Treatment Care for COVID-19 Patients With Heart Complications

Introduction:

COVID 19: On March 11, 2020, the World Health Organization (WHO) declared the coronavirus disease, which first emerged in China's Wuhan province, as a worldwide pandemic (Rawat et al., 2020). Covid-19 is declared as the sixth public health emergency of international concern by the WHO (Gumber, 2021). The global spread of Covid-19 has presented significant challenges in the areas of health, economy, environment, society and have psychological consequences, causing significant disruption to the world's order (Ganatra et al., 2020). With no effective drugs or vaccines available, the only means of combating the virus is through preventative measures such as social distancing, wearing masks, and maintaining proper hygiene (Van der Werf et al., 2021). The Covid Virus has an inner core made up of RNA and phosphorylated nucleocapsid protein, which is surrounded by layers of phospholipids and topped with spike glycoprotein trimmers (Gumber, 2021). COVID‐19 is a systemic illness characterized by hyperinflammation and cytokine storm. The close association between COVID‐19 and cardiovascular disease has been observed in many studies. Cardiovascular disease, such as hypertension, hyperlipidemia, and coronary heart disease, are the common comorbidity in patients with COVID‐19. Those patients with cardiovascular comorbidity are at increased risk of morbidity and mortality. Those cardiovascular co‐morbidities may be related to cardiac injury in COVID‐19. Recent evidence also showed that COVID‐19 can damage the heart directly. Consistently, our multivariable analyses showed that elevated troponin release is independently predicted all‐cause death after adjusted for clinical confounding, including cardiac cardiovascular co‐morbidity. Cardiovascular manifestations, such as myocarditis, heart failure, arrhythmia, may occur with COVID‐19. More recently, there is increasing awareness of the cardiac injury in patients with COVID‐19 disease (Fu et al., 2021).

Heart Complications: The heart, which is approximately the size of a closed fist and weighs between 250 and 350 grams, beats around 100,000 times per day and 2.5 billion times during an average lifetime. Comprised of two atria and two ventricles, the muscular heart receives returning venous blood in the upper atria and pumps blood into the lungs and arteries through the lower ventricles. Blood without oxygen enters the right atrium, moves into the right ventricle, and is then pushed to the lungs through the pulmonary arteries. Here, it gets rid of waste and receives oxygen. The oxygen-rich blood then travels back to the heart through the pulmonary veins and enters the left atrium. It then goes into the left ventricle, which contracts to send the blood out through the aorta and into the arterial system (Marieb et al., 2013; Tortora & Derrickson, 2014; Shaffer et al., 2014).

Heart Complications are the primary reason for mortality and illness in various developed and developing nations (Minino et al., 2002). They are a significant concern globally, both from a medical and financial perspective, as a considerable portion (1-2%) of healthcare expenditure is allocated towards addressing this issue (Lesyuk et al., 2018). Heart diseases claimed the lives of about half a million people in the US alone in 2002, with millions more living with the condition (Minino et al., 2002). Heart complications are responsible for the deaths of over 7 million individuals annually across the globe, making it the leading cause of mortality (Mackay et al., 2004). It has been estimated that 0.4–2.2% of the population in industrialized countries suffer from Heart Complications (Go et al., 2014). According to estimates, the cost associated with heart disease including health expenses and reduced productivity amounted to over $258 billion in the United States in 2006 (Nakamura et al., 2006). Numerous factors that increase the likelihood of experiencing heart complications have been recognized, however, a substantial portion of these complications cannot be accounted for by conventional risk factors. In recent times, various forms of evidence have linked chronic inflammation to the origins of heart complications and cardiovascular disease (Ridker et al., 2000; Humphrey et al., 2008).