Cardiovascular complications of COVID-19

SARS-CoV-2 infection is associated with a broad spectrum of cardiovascular manifestations that significantly increase morbidity and mortality. Acute myocardial injury, detected by elevated cardiac troponins, occurs in 10-25% of hospitalized patients and serves as an independent predictor of mortality, particularly in critically ill patients and those with pre-existing cardiovascular disease. Acute complications include acute myocarditis, rhythm disorders, heart failure, and cor pulmonale. The pathophysiology is multifactorial, involving direct viral damage via ACE2 receptors, oxygen supply-demand mismatch, and the «cytokine storm». In the post-acute phase (≥ 4 weeks), an elevated risk of arrhythmic events, heart failure, and coagulation disorders persists. The cardiovascular safety profile of current antiviral and immunomodulatory therapies varies, ranging from an increased risk of arrhythmias to a reduction in long-term cardiac complications. Cardiovascular complications of COVID-19 are frequent and heterogeneous. Close monitoring of biomarkers and echocardiographic evaluation are essential for timely management, both in the critical stage and during the long-term follow-up of survivors.