COVID-19 in patients with pre-existing cardiovascular disease: a series of cases during the fourth epidemiologic wave in Mexico City

Celso Mendoza-González, Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Neftalí E. Antonio-Villa, Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Mireya B. Contreras-Alanis, Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
María F. Fernández-Sandoval, Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Jimena Castillo-Macías, Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Daniel E. Sandoval-Colin, Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Jacobo S. Vera-Chávez, Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Víctor A. Quiroz-Martínez, Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Karina Del Valle-Zamora, Cardiología Adultos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México

Objective: SARS-CoV-2 infection induces an immune response that causes excessive inflammation damaging cardiac tissue and vascular endothelium. The objective of this study is to review a series of cases of hospitalized patients with pre-existing cardiac disease to describe the clinical behavior and highlight the low frequency of morbidity and mortality. Method: Retrospective study of 17 patients with a confirmed diagnosis of COVID-19 by polymerase chain reaction test or antigen test, a history of cardiovascular disease with or without comorbidities, and a history of at least one dose of the vaccine for COVID-19, during the period between December 30, 2021 and March 17, 2022 at the Ignacio Chávez National Institute of Cardiology in Mexico City. Results: The most frequent cardiac pathology was acute myocardial infarction (31.25%) and the most common arrhythmia was atrial fibrillation (25%). The median number of days of hospital stay was 10 days (interquartile range: 4-14). Regarding the outcomes, 94% of the patients were discharged due to clinical improvement, and only one patient died during his hospitalization. Conclusions: It is crucial to continue investigating SARS-CoV-2 effects in patients pre-existing heart disease and in those with persistent symptoms after infection. This will allow the development of more effective strategies for the treatment and prevention of cardiovascular complications associated with COVID-19.

Keywords: COVID-19. Acute myocardial infarction. Myocarditis. Pericarditis. Viral RNA.