Expert Consensus for Management of Myocardial Injury, Myocarditis, and Post-infection Condition with Coronavirus Disease 2019 (Second Edition)

doi:10.12114/j.issn.1007-9572.2023.0083

Abstract

Abstract:

Evidence shows that coronavirus disease 2019 (COVID-19) can impact multiple bodily systems, with the cardiovascular system being commonly affected. In order to guide healthcare providers in diagnosing and managing cardiovascular issues related to COVID-19, the consensus group recommends: (1) Routine cardiac troponin testing is necessary for patients who are hospitalized or exhibit symptoms related to heart conditions after COVID-19 infection to evaluate potential myocardial injury and help detect any cardiac complications. Patients with myocardial injury not related to heart issues tend to have a poorer outcome. (2) Relatively few cases of acute myocarditis linked to COVID-19 have been reported, and individuals suspected of having myocarditis should be evaluated and managed based on risk stratification. (３) COVID-19 infection should be considered a risk factor for increasing the incidence of cardiovascular disease. All individuals who have been infected should adhere to a healthy lifestyle more strictly and implement appropriate primary or secondary preventive measures for cardiovascular disease. (4) For individuals who experience the persistence or emergence of new symptoms 3 months after the initial COVID-19 infection and have been experiencing these symptoms for at least 2 months, with no clear diagnosis of a cardiovascular disease through standard diagnostic tests, it is advisable to consider the possibility of "post COVID-19 condition". Rehabilitation should be given top priority for these patients.

Key words: COVID-19, Cardiomyopathies, Myocardial injury, Myocarditis, Post COVID-19 condition, Expert consensus, Guidebook

摘要： 新型冠状病毒感染（COVID-19）已被证实可累及全身多个系统，其中心血管系统受累很常见。为帮助临床医师合理诊治COVID-19相关心血管问题，共识组建议：（1）对于因COVID-19住院或伴有心脏相关症状的患者，应常规检测心肌肌钙蛋白，以评估心肌损伤，判断有无心脏并发症；非心脏原因所致心肌损伤的患者预后较差；（2）COVID-19相关急性心肌炎较为罕见，对怀疑心肌炎的患者应根据危险分层进行诊治；（3）COVID-19可增加心血管事件风险，所有感染者应更加严格遵循健康生活方式，接受规范的心血管疾病一级或二级预防；（4）COVID-19后3个月时有持续心脏相关症状或新发相关症状，且至少持续2个月，但心血管相关检查未见异常，可考虑为"COVID-19后状态"，此类患者应以康复治疗为主。

关键词: 新型冠状病毒感染, 心肌疾病, 心肌损伤, 心肌炎, 新型冠状病毒感染后状态, 专家共识, 指南

National Center of Gerontology,Electrocardiology and Cardiac Function Branch of Chinese Geriatric Society,Imaging Group of Cardiovascular Department, Beijing Medical Association, et al. Expert Consensus for Management of Myocardial Injury, Myocarditis, and Post-infection Condition with Coronavirus Disease 2019 (Second Edition)[J]. Chinese General Practice, 2023, 26(14): 1692-1702. DOI: 10.12114/j.issn.1007-9572.2023.0083.
国家老年医学中心,中国老年医学学会心电与心功能分会,北京医学会心血管病学分会影像学组等. 新型冠状病毒感染相关心肌损伤、心肌炎和感染后状态管理专家共识（第二版）[J]. 中国全科医学, 2023, 26(14): 1692-1702. DOI: 10.12114/j.issn.1007-9572.2023.0083.

Figures/Tables 2

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