Impact of COVID-19 on the Cardiovascular System: A Review of Available Reports

Cardiovasc Drugs Ther. 2021 Jun;35(3):411-425. doi: 10.1007/s10557-020-07073-y. Epub 2020 Sep 14.


The recent emergence of the coronavirus disease 19 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China is now a global health emergency. The transmission of SARS-CoV-2 is mainly via human-to-human contact. This virus is expected to be of zoonotic origin and has a high genome identity to that of bat derived SARS-like coronavirus. Various stringent measures have been implemented to lower person-to-person transmission of COVID-19. Particular observations and attempts have been made to reduce transmission in vulnerable populations, including older adults, children, and healthcare providers. This novel CoV enters the cells through the angiotensin-converting enzyme 2 (ACE2) receptor. There is a higher risk of COVID-19 infection among those with preexisting cardiovascular diseases (CVD), and it has been connected with various direct and indirect complications, including myocarditis, acute myocardial injury, venous thromboembolism, and arrhythmias. This article summarizes the various cardiovascular complications and mechanisms responsible for the same with COVID-19 infection. For the benefit of the scientific community and public, the effect of COVID-19 on major vital organs such as the kidneys, liver, and intestines has been briefly discussed. In this review, we also discuss drugs in different stages of clinical trials and their associated complications, as well as the details of vaccines in various stages of development.

Keywords: Angiotensin-converting enzyme 2; COVID-19; Cardiovascular diseases; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Angiotensin-Converting Enzyme 2 / physiology
  • Antiviral Agents / adverse effects
  • COVID-19 / complications*
  • COVID-19 / immunology
  • COVID-19 Drug Treatment
  • Cardiovascular Diseases / complications*
  • Cytokine Release Syndrome / etiology
  • Endothelial Cells / physiology
  • Humans
  • Hypertension / complications
  • Immunity, Innate
  • Myocardial Infarction / complications
  • SARS-CoV-2*
  • Sex Characteristics
  • Thrombophilia / etiology


  • Antiviral Agents
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2