Impact of acute covid-19 on cardiac function in the long term: a systematic review
DOI:
https://doi.org/10.21527/2176-7114.2025.50.16375Palabras clave:
Biomarkers, Troponin, Brain Natriuretic Peptide, Myocardium, COVID-19Resumen
The present study aimed to evaluate the relationship between elevated biomarkers due to COVID-19 infection and possible permanent damage to the heart muscle. This is a systematic review including studies with eligible randomized clinical trials and case-control studies. Papers’ eligibility criteria were adults diagnosed and treated for COVID-19 and assessment of cardiac biomarkers during the acute phase of COVID-19 infection, with symptoms or not, without previous structural or functional changes related to the cardiovascular system and who, after a minimum of after 30 days, cardiac structural assessment was obtained through imaging tests, either echocardiogram or cardiac magnetic resonance. The findings were not robust when analyzing the association between the elevation of secondary cardiac biomarkers to COVID-19 and the presence of late cardiac sequelae. Based on the cost-effectiveness ratio for adopting such strategy, it becomes unjustifiable to perform it routinely in the Brazilian Unified Health System. It is more appropriate and less costly to adopt health promotion strategies, individualized attention, multidisciplinary therapeutic approach, frequent clinical surveillance and specialized assessment when affected by COVID- 19, reducing damage caused to the cardiocirculatory system, minimizing spending on public health exams and better effectiveness in collective health with care practices.
Citas
1. Tanni SE, Silvinato A, Floriano I, Bacha HA, Barbosa AN, Bernardo WM. Uso de remdesivir em pacientes com COVID-19: revisão sistemática e meta-análise. J Bras Pneumol. 2022;48:e20210393.
2. Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, Marelli-Berg FM, et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020;116(10):1666–87.
3. Gao YP, Zhou W, Huang PN, Liu HY, Bi XJ, Zhu Y, et al. Normalized Cardiac Structure and Function in COVID-19 Survivors Late After Recovery. Front Cardiovasc Med. 2021;8:756790.
4. Zhao Y, Patel J, Huang Y, Yin L, Tang L. Cardiac markers of multisystem inflammatory syndrome in children (MIS-C) in COVID-19 patients: A meta-analysis. Am J Emerg Med. 2021;49:62–70.
5. Sabanoglu C, Inanc IH, Polat E, Peker SA. Long-term predictive value of cardiac biomarkers in patients with COVID-19 infection. Eur Rev Med Pharmacol Sci. 2022;26(17):6396–403.
6. Pelà G, Goldoni M, Cavalli C, Perrino F, Tagliaferri S, Frizzelli A, et al. Long-Term Cardiac Sequelae in Patients Referred into a Diagnostic Post-COVID-19 Pathway: The Different Impacts on the Right and Left Ventricles. Diagn Basel Switz. 2021;11(11):2059.
7. Eka Ginanjar, Valerie Hirsy Putri. Elevation of Cardiac Biomarkers in COVID-19 As a Major Determinant for Mortality: A Systematic Review Tracy Anabella Hermansyah, Acta Med Indones. 2021;53(4):385-396.
8. Raymond P, Ian H, Michael AL, Emir Y, Rachel V, Antonia AL, et al. Elevated De Ritis Ratio Is Associated With Poor Prognosis in COVID-19: A Systematic Review and Meta-Analysis, Front Med (Lausanne). 2021;22:8:676581.
9. Puntmann VO, Martin S, Shchendrygina A, Hoffmann J, Ka MM, Giokoglu E, et al. Long-term cardiac pathology in individuals with mild initial COVID-19 illness. Nat Med.2022;28(10):2117–23.
10. Kotecha T, Knight DS, Razvi Y, Kumar K, Vimalesvaran K, Thornton G, et al. Patterns of myocardial injury in recovered troponin-positive COVID-19 patients assessed by cardiovascular magnetic resonance. Eur Heart J. 2021;42(19):1866–78.
11. Van den Heuvel FMA, Vos JL, van Bakel B, Duijnhouwer AL, van Dijk APJ, Dimitriu-Leen AC, et al. Comparison between myocardial function assessed by echocardiography during hospitalization for COVID-19 and at 4 months follow-up. Int J Cardiovasc Imaging. 2021;37(12):3459–67.
12. Joy G, Artico J, Kurdi H, Seraphim A, Lau C, Thornton GD, et al. Prospective Case-Control Study of Cardiovascular Abnormalities 6 Months Following Mild COVID-19 in Healthcare Workers. Jacc Cardiovasc Imaging. 2021;14(11):2155–66.
13. Myhre PL, Heck SL, Skranes JB, Prebensen C, Jonassen CM, Berge T, et al. Cardiac pathology 6 months after hospitalization for COVID-19 and association with the acute disease severity. Am Heart J. 2021;242:61–70.
14. Huang L, Zhao P, Tang D, Zhu T, Han R, Zhan C, et al. Cardiac Involvement in Patients Recovered From COVID-2019 Identified Using Magnetic Resonance Imaging. Jacc Cardiovasc Imaging. 2020;13(11):2330–9.
15. Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 2020;5(11):1265–73.
16. Italia L, Ingallina G, Napolano A, Boccellino A, Belli M, Cannata F, et al. Subclinical myocardial dysfunction in patients recovered from COVID-19. Echocardiogr Mt Kisco N. 2021;38(10):1778–86.
17. Gul M, Ozyilmaz S, Bastug Gul Z, Kacmaz C, Satilmisoglu MH. Evaluation of cardiac injury with biomarkers and echocardiography after COVID-19 infection. J Physiol Pharmacol Off J Pol Physiol Soc. 2022;73(1).
18. The COVID Heart—One Year After SARS-CoV-2 Infection, Patients Have an Array of Increased Cardiovascular Risks | Infectious Diseases | JAMA | JAMA Network [Internet]. Accessed December 12 2023. Available at: https://jamanetwork.com/journals/jama/fullarticle/2789793
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2025 Revista Contexto & Saúde

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Ao publicar na Revista Contexto & Saúde, os autores concordam com os seguintes termos:
Os trabalhos seguem a licença Creative Commons Atribuição 4.0 Internacional (CC BY 4.0), que permite:
Compartilhar — copiar e redistribuir o material em qualquer meio ou formato;
Adaptar — remixar, transformar e criar a partir do material para qualquer fim, inclusive comercial.
Essas permissões são irrevogáveis, desde que respeitados os seguintes termos:
Atribuição — os autores devem ser devidamente creditados, com link para a licença e indicação de eventuais alterações realizadas.
Sem restrições adicionais — não podem ser aplicadas condições legais ou tecnológicas que restrinjam o uso permitido pela licença.
Avisos:
A licença não se aplica a elementos em domínio público ou cobertos por exceções legais.
A licença não garante todos os direitos necessários para usos específicos (ex.: direitos de imagem, privacidade ou morais).
A revista não se responsabiliza pelas opiniões expressas nos artigos, que são de exclusiva responsabilidade dos autores. O Editor, com o apoio do Comitê Editorial, reserva-se o direito de sugerir ou solicitar modificações quando necessário.
Somente serão aceitos artigos científicos originais, com resultados de pesquisas de interesse que não tenham sido publicados nem submetidos simultaneamente a outro periódico com o mesmo objetivo.
A menção a marcas comerciais ou produtos específicos destina-se apenas à identificação, sem qualquer vínculo promocional por parte dos autores ou da revista.
Contrato de Licença (para artigos publicados a partir de setembro/2025): Os autores mantém os direitos autorais sobre seu artigo, e concedem à Revista Contexto & Saúde o direito de primeira publicação.