COVID-19 mainly affects the respiratory system; however, cardiovascular complication is not uncommon. Given the high mortality of COVID-19, it is mandatory to understand the pathogenesis and the mechanism of how it attacks the cardiovascular system. Pre-existing cardiovascular diseases have shown higher morbidity and mortality among COVID-19 patients. There are higher chances of myocardium damage among preexisting cardiovascular diseases patients compared to no cardiac-related risk factors patients. There are multiple ways coronavirus attacks the heart. It has been thought to be driven by direct virulence of coronavirus causing cardiac injury, ACE2 down-regulation leading to RAS imbalance, hypoxemic cardiac injury, inflammatory response related injuries, endothelial injury and micro thrombosis, stress-induced cardiac injury. The heart-related disorder includes myocardial injury defining increased troponin levels, arrhythmias, new-onset acute coronary syndrome, myocardial infarction, hypercoagulability due to endothelial damage, and diastolic heart failure. The literature advocated heart-related screening among pre-existing cardiovascular disease patients earlier in the course with or without higher severity of respiratory illness. Facts also imply the long-term sequelae of cardiovascular-related diseases in coronavirus-2 positive patients. Multiple studies have shown risen cardiac biomarkers including Troponin I and Troponin T in severe disease. We as proponents of health care and practicing evidence-based medicine, it is crucial to be heedful about any upcoming encounters and sequelae of COVID-19 in the future. The clear mechanism of COVID-19 and cardiovascular involvement has not been understood. The projected mechanism may include direct virulence causing cardiac injury, inflammatory mediated damage, endothelial injury and microthrombosis, hypoxia-induced cardiac injury, and pre-existing cardiac diseases as risk factors.

COVID-19, SARS-CoV-2 infection, Cardiovascular injury, Myocardial damage