The interrelationship between Covid-19 and heart failure

Infections from the novel coronavirus (severe acute respiratory syndrome-Coronavirus 2, SARS-CoV2) and the associated disease (coronavirus disease 19, COVID-19) have heart failure (HF) as a risk factor and complication. As an independent predictor of poor prognosis, the presence of chronic HF may lead to increased morbidity and mortality in patients with COVID-19. This is achieved through multiple pathophysiologic mechanisms (inflammation, endothelial dysfunction, dysregulated coagulation), causing functional status deterioration in patients with chronic HF, combined with thrombotic and arrhythmic complications. De-novo HF in patients with COVID-19 is another frequent complication, often associated with right ventricular dysfunction. Beyond the acute manifestations of COVID-19, the long-term consequences of SARS-CoV-2 infection on the heart should not be neglected. Myocardial injury may be identified in a significant proportion of recovered individuals, with uncertain prognostic implications. Finally, vaccination against SARS-CoV2 is of great importance in patients with HF since it may lead to reduced morbidity and mortality.