Cardiovascular Manifestations in COVID-19
Peer Review


Cardiovascular manifestations

How to Cite

Konar, N., Saha, P., Moseley, A., Denman, J., Hatahintwali, F., Ali, R., Zatorska, A., & Chakravorty, I. (2020). Cardiovascular Manifestations in COVID-19: Analysis of a Case Series of Hospital Admissions with Laboratory Confirmed SARS-CoV-2 PCR tests. The Physician, 6(3), 1-7.


Novel COVID-19 pandemic presented primarily as a severe acute respiratory distress syndrome however, in addition to respiratory features there were many with cardiovascular presentations, not ‘typical’ of COVID-19 that caused confusion in diagnosis and management in frontline units.

A case-series was undertaken in a large London Hospital to describe cardiovascular manifestations and outcomes (discharge vs death) of all patients with a laboratory-confirmed SARS-CoV-2 infection, admitted from March-May 2020.


In this cohort (n=855) there were 295 deaths (standardised mortality 345 per thousand admissions). Patients who had died were older; age 72.2 (SD 16.3) vs 64.8 (18.7) years, p<0.001, had similar length of stay - 12.3 (SD 9.7) vs 11.9 (SD 11.7) days. Almost 50% had pre-existing hypertension, ischaemic heart disease, or atrial fibrillation, 45% had radiographic changes. Ventilatory support was required in 20% of the group who were discharged versus 44% in those who died. Patients who were male, older, with palpitations, or pulmonary infiltrates and raised inflammatory markers were more likely to die. Following recovery, over 50% had abnormal findings on echocardiography.

Therefore follow up should include a repeat echocardiogram and cardio-pulmonary assessment to explore long term sequelae.
Peer Review


Chakravorty S. Risk Stratification in COVID-19: A Review. Phy [Internet]. 2020 May 19 [cited 2020 May 23];6(1). Available from:

Coronavirus (COVID-19) action plan [Internet]. GOV.UK. [cited 2020 Jul 16]. Available from:

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020 Feb 15;395(10223):497–506.

Nightingale Hospital - Barts Health NHS Trust [Internet]. [cited 2020 Jul 18]. Available from:

Zheng KI, Feng G, Liu W-Y, Targher G, Byrne CD, Zheng M-H. Extra-pulmonary complications of COVID-19: a multi-system disease? J Med Virol. 2020 Jul 10;

Zheng Y-Y, Ma Y-T, Zhang J-Y, Xie X. COVID-19 and the cardiovascular system. Nature Reviews Cardiology. 2020 May;17(5):259–60.

Moores LK, Tritschler T, Brosnahan S, Carrier M, Collen JF, Doerschug K, et al. Prevention, Diagnosis, and Treatment of VTE in Patients With COVID-19: CHEST Guideline and Expert Panel Report. Chest [Internet]. 2020 Jun 2 [cited 2020 Jul 16]; Available from:

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med [Internet]. 2020 Feb 28 [cited 2020 Jul 20]; Available from:

Collaborative TO, Williamson E, Walker AJ, Bhaskaran KJ, Bacon S, Bates C, et al. OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. medRxiv. 2020 May 7;2020.05.06.20092999.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright (c) 2020 Array