The disease caused by Coronavirus 2019 (COVID-19) is associated with significant mortality and morbidity, including pulmonary and cardiac adverse sequelae. It began in December 2019 in the city of Wuhan, and quickly became a pandemic, declared by the World Health Organization (WHO) on March 11 of 2019. By early September 2020, more than 28 million patients have been confirmed infected by COVID-19 in more than 200 countries. Infection by COVID-19 can develop with severe acute respiratory syndrome (SARS-CoV-2), acute respiratory distress syndrome (ARDS), neurological, cardiac and vascular manifestations being not unusual, and are associated with increased mortality. The pattern of COVID-19 infection and its late sequelae has its pathogenesis only partially elucidated. Most individuals infected with COVID-19 will be either asymptomatic or will have mild to moderate symptoms. The highest mortality rates are observed in patients over 60 years old and with comorbidities, especially cardiovascular diseases, obesity, and diabetes. Patients with worst outcomes also had high serum levels of ultra-sensitive troponin (Tus) and other inflammatory markers, such as interleukin 6 and ferritin. Notably, the lungs are the main organs involved by COVID-19, and angiotensin-converting enzyme 2 (ACE2) is part of the virus pathway into the lung cell. ACE2 is not only found in the lungs, but also in several other organs, including the heart, the endothelium of the cardiovascular system, the small intestine and the nervous system. The inflammatory response described as "cytokine storm" seems to be responsible for ARDS, vascular/endothelial inflammation, myocarditis, and related events such as arrhythmias, ventricular dysfunction, and sudden death. Based on Chinese data, cardiac injury appears to be a relevant feature of the disease, occurring in 20 to 30% of hospitalized patients and contributing to 40% of deaths. Cardiovascular complications have been described, such as: myocardial injury (20%), arrhythmias (16%), myocarditis (10%), acute heart failure (HF) and shock (up to 5% of cases), sometimes with a dysfunction similar to Takotsubo's disease. These data may vary depending on the authors.
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