Cardiac involvement in COVID-19

The destructive effect of coronavirus disease 2019 (COVID-19) on healthcare and global economy will be remembered as one of the major catastrophes of human history. The acute impact of COVID-19 waves has been unprecedented, with critical issues regarding resource allocation, hospital reorganization and prioritization of patients and diseases. In times of paucity of medical resources and persistent pressure on health systems, the topic of risk stratification became central for frontline physicians. On this basis we conducted a research study on the prognostic value of cardiac biomarkers in hospitalized patients with COVID-19. Moreover, during the first COVID-19 waves, concerns arose around possible interactions between renin-angiotensin-aldosterone inhibitors and SARS-CoV-2 infectivity and virulence. To address the urgent need of evidence regarding this controversy, we studied the in-hospital prognostic role of continuation of ACE-inhibitors or angiotensin-receptor antagonists in this population with informative results. However, the impact of COVID-19 persists nowadays with the long-term consequences of SARS-CoV-2 infections on the millions of survivors of COVID-19, who are facing an increased risk of incident cardiovascular events or the persistence of long-COVID symptoms. In this phase we investigated the prognostic role of myocardial subclinical dysfunction as assessed by advanced echocardiography, to improve the risk stratification strategy for COVID-19 survivors. Finally, we studied the autoimmune mechanisms underlying the long-term cardiovascular implications of COVID-19 using a translational approach from the patients to bench and mice experiments.