Corona, meaning “crown” or “garland” in Latin was used to describe this virus when it was first seen due to it's spike-like capsid. However, there are also more lethal forms including Severe Acute Respiratory Syndrome coronavirus, Middle East Respiratory Syndrome coronavirus (MERS-CoV), and of course the current SARS-CoV-2. Since the 1960s, multiple human coronaviruses have been identified, which usually cause mild, self-limiting disease. Currently, evidence has suggested gastrointestinal and hepatic involvement as well as cardiac complications such as myocarditis from SARS-CoV-2, ,, ]. However, much is unknown about the extrapulmonary manifestations of the disease. The range includes asymptomatic subclinical infection, or mild upper respiratory tract illness to nonlife-threatening pneumonia to severe pneumonia progressing to acute respiratory distress syndrome (ARDS) requiring intensive care, mechanical ventilation, and extracorporeal membrane oxygenation. At this point, the organ involvement of COVID-19 appears to be primarily respiratory with a range of disease severity. According to the Johns Hopkins COVID-19 Resource Center, 2 million people worldwide have been infected with the virus as of 16 April 2020 since its origin in December 2019. As of April 2020, very few countries remain unfamiliar with the devastation of the virion's consequences. The current outbreak of the novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the cause of Coronavirus Disease 2019 (COVID-19) has quickly progressed to a global health emergency. The proposed mechanisms of myocardial injury are direct damage to the cardiomyocytes, systemic inflammation, myocardial interstitial fibrosis, interferon mediated immune response, exaggerated cytokine response by Type 1 and 2 helper T cells, in addition to coronary plaque destabilization, and hypoxia.
![cid episode 1286 cid episode 1286](https://ytimg.googleusercontent.com/vi/pw50-I8NdXI/mqdefault.jpg)
The exact mechanisms of how SARS-CoV-2 can cause myocardial injury are not clearly understood. Myocarditis is depicted as another cause of morbidity amongst COVID-19 patients. As a surrogate for myocardial injury, multiple studies have shown increased cardiac biomarkers mainly cardiac troponins I and T in the infected patients especially those with severe disease.
![cid episode 1286 cid episode 1286](https://www.distantorigin.co.uk/img/episodes/panel/episodes_259821_4717103.jpg)
Myocardial injury is one of the important pathogenic features of COVID-19.
![cid episode 1286 cid episode 1286](https://www.distantorigin.co.uk/img/episodes/panel/episodes_259821_4854710.jpg)
There is growing literature exploring cardiac involvement in SARS-CoV-2. Hypertension, arrhythmia, cardiomyopathy and coronary heart disease are amongst major cardiovascular disease comorbidities seen in severe cases of COVID-19. Patients with cardiovascular disease are more likely to be infected with SARS-CoV-2 and they are more likely to develop severe symptoms. Disruption of this receptor leads to cardiomyopathy, cardiac dysfunction, and heart failure. Angiotensin Converting Enzyme-2 receptors play a pivotal role in the pathogenesis of the virus. There is growing evidence describing pathophysiological resemblance of SARS-CoV-2 infection with other coronavirus infections such as Severe Acute Respiratory Syndrome coronavirus and Middle East Respiratory Syndrome coronavirus (MERS-CoV). Respiratory illness is the major cause of morbidity and mortality in these patients with the disease spectrum ranging from asymptomatic subclinical infection, to severe pneumonia progressing to acute respiratory distress syndrome. Coronavirus Disease 2019 (COVID-19) has quickly progressed to a global health emergency.