Cardiovascular Outcomes and Potential Treatment Options in COVID-19 Patients: Role of Inflammation and Cytokine Storm: A Brief Review

Author(s): Muhammad Waqas Nasir, Yong Gao

The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has rapidly evolved into a global pandemic, resulting in more than 770 million confirmed cases and over 7 million deaths worldwide to date. A substantial proportion of COVID-19 related deaths are linked to cardiovascular complications, either as pre-existing co-morbidities or as newly developed manifestations during infection. Evidence suggests that cardiovascular risk factors, rather than established cardiovascular disease itself, play a greater role in adverse outcomes among critically ill patients. Moreover, myocardial injury has been frequently reported in COVID-19, occurring independently of pre-existing cardiovascular conditions, and is primarily associated with systemic inflammation and multiorgan damage. In severe cases, pathological mechanisms such as cytokine storm, lymphopenia, and elevated cardiac biomarkers (particularly cardiac troponin) contribute to cardiovascular dysfunction. The cytokine storm, in particular, drives cytokine release syndrome (CRS), exacerbating myocardial injury and increasing mortality. Recent data indicate that the incidence of myocardial injury is approximately 7% among SARS-CoV-2 infected individuals, underscoring its clinical significance. This review highlights the central role of inflammation in COVID-19 associated cardiovascular complications, including myocardial injury, thrombosis, and vascular dysfunction. By summarizing current evidence, we aim to provide insights into underlying mechanisms and propose considerations for optimizing cardiovascular care in COVID-19 patients.