Influence of COVID-19 Pandemic on Early-Onset Myocardial Infarction in Adults

Authors

  • Tanishq Gouniyal Research Scholar, Department of Zoology, Daulat Ram College, University of Delhi, Delhi -110007, INDIA.
  • Shreya Chaudhary Research Assistant, Department of Zoology, Daulat Ram College, University of Delhi, Delhi -110007, INDIA.
  • Pradeep Kumar Assistant Professor (Guest Faculty), Department of Public Health, Maa Shakumbhari University, Punwarka, Saharanpur, Uttar Pradesh - 247120, INDIA.

DOI:

https://doi.org/10.55544/jrasb.5.2.19

Keywords:

Myocardial Infarction, COVID-19, Cardiac Troponin, Cardiovascular Complications, SARS-CoV-2

Abstract

Myocardial infarction (MI) is one of the leading causes of morbidity and mortality worldwide and has shown a significant increase following the COVID-19 pandemic. Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection is strongly associated with cardiovascular complications such as myocarditis, arrhythmia, thromboembolism, stroke, and heart failure. The present review revealed the relationship between COVID-19 and cardiovascular injury, focusing on the role of cardiac troponin as a rapid and reliable biomarker for myocardial infarction diagnosis. Elevated troponin levels were found to be closely associated with disease severity and mortality risk, particularly among hospitalized and ICU-admitted patients. Comparative analysis demonstrated that troponin I/T possesses higher sensitivity and specificity than CK-MB and ECG for diagnosing myocardial injury. The review further discusses the major mechanisms responsible for cardiovascular damage that is cytokine storm, endothelial dysfunction, oxidative stress, hypoxia, and hypercoagulability. Graphical and tabular analyses also revealed increased long-term cardiovascular risks following COVID-19 infection, especially among elderly individuals and critically ill patients. Also, myocarditis risk after COVID-19 infection was significantly higher than after vaccination.

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References

[1] Al-Aly, Z., et al. (2021). Long-term cardiovascular outcomes after COVID-19. Nature Medicine, 27, 45–52.

[2] Apple, F. S., & Sandoval, Y. (2020). High-sensitivity cardiac troponin: A clinical update. Clinical Chemistry, 66(1), 50–60.

[3] Atherosclerosis An Inflammatory Disease Ross, R. (1999). Atherosclerosis—An inflammatory disease. New England Journal of Medicine, 340, 115–126.

[4] Barda, N., Dagan, N., Ben-Shlomo, Y., et al. (2021). Safety of the BNT162b2 mRNA COVID-19 vaccine in a nationwide setting. New England Journal of Medicine, 385(12), 1078–1090.

[5] Basso, C., Leone, O., Rizzo, S., et al. (2020). Pathological features of COVID-19-associated myocardial injury. Cardiovascular Pathology, 49, 107–125.

[6] Becker, R. C. (2020). COVID-19-associated coagulopathy. Journal of Thrombosis and Thrombolysis, 50, 54–67.

[7] Bonow, R. O., Fonarow, G. C., O’Gara, P. T., & Yancy, C. W. (2020). Association of COVID-19 with myocardial injury and cardiovascular complications. JAMA Cardiology, 5(7), 751–753.

[8] Bozkurt, B., Kamat, I., & Hotez, P. J. (2021). Myocarditis with COVID-19 mRNA vaccines. Circulation, 144(6), 471–484.

[9] Buja, L. M., Wolf, D. A., Zhao, B., et al. (2020). The emerging spectrum of cardiopulmonary pathology of COVID-19. Cardiovascular Pathology, 47, 107–124.

[10] Cardiology Apple, F. S., Collinson, P. O., IFCC Task Force. (2012). Analytical characteristics of cardiac biomarkers. Clinica Chimica Acta, 413(1–2), 1–14.

[11] CDC. (2022). COVID-19 vaccination recommendations and myocarditis surveillance report.

[12] Chapman, A. R., Lee, K. K., Anand, A., et al. (2017). High-sensitivity cardiac troponin and myocardial infarction. New England Journal of Medicine, 376, 1333–1343.

[13] Chou, O. H. I., et al. (2021). Molecular mimicry in vaccine-associated myocarditis. Nature Reviews Cardiology, 18, 1–3.

[14] Clerkin, K. J., Fried, J. A., Raikhelkar, J., et al. (2020). COVID-19 and cardiovascular disease. Circulation, 141(20), 1648–1655.

[15] Collinson, P. O., et al. (2017). Cardiac biomarkers in acute coronary syndrome. Heart, 103(3), 196–202.

[16] Connors, J. M., & Levy, J. H. (2020). COVID-19 and its implications for thrombosis. Blood, 135(23), 2033–2040.

[17] European Society of Cardiology Ibanez, B., et al. (2018). 2017 ESC guidelines for STEMI management. European Heart Journal, 39, 119–177.

[18] Fox, S. E., et al. (2020). Pulmonary and cardiac pathology in COVID-19. The Lancet Respiratory Medicine, 8(12), 1076–1078.

[19] Guo, T., Fan, Y., Chen, M., et al. (2020). Cardiovascular implications of fatal outcomes of COVID-19. JAMA Cardiology, 5(7), 811–818.

[20] Gupta, A., et al. (2020). Extrapulmonary manifestations of COVID-19. Nature Medicine, 26, 1017–1032.

[21] Halushka, M. K., & Vander Heide, R. S. (2021). Myocarditis is rare in COVID-19 autopsies. JAMA Cardiology, 6(11), 1242–1243.

[22] Hansson, G. K., & Libby, P. (2019). The immune response in atherosclerosis. Nature Reviews Immunology, 19, 447–462.

[23] Hansson, G. K., Robertson, A. K. L., & Söderberg-Nauclér, C. (2015). Inflammation and atherosclerosis. Annual Review of Pathology, 10, 195–228.

[24] Huang, C., Wang, Y., Li, X., et al. (2020). Clinical features of COVID-19. The Lancet, 395(10223), 497–506.

[25] Huang, L., et al. (2021). Long-term consequences of COVID-19. The Lancet, 398, 747–758.

[26] Husby, A., Hansen, J. V., Fosbøl, E., et al. (2022). Myocarditis following mRNA vaccination. JAMA Internal Medicine, 182(5), 488–498.

[27] Jaffe, A. S., et al. (2018). Troponin testing in acute coronary syndrome. Journal of the American College of Cardiology, 72, 1003–1018.

[28] Jha, P., et al. (2022). Post-COVID renal dysfunction and systemic complications. Indian Journal of Nephrology, 32, 112–118.

[29] Katsoularis, I., et al. (2021). Risk of myocardial infarction after COVID-19. New England Journal of Medicine, 384, 2177–2187.

[30] Katus, H. A., et al. (2017). Cardiac troponin testing in myocardial infarction. European Heart Journal, 38, 2459–2467.

[31] Keller, T., et al. (2020). Troponin elevation in COVID-19. European Heart Journal, 41, 1810–1812.

[32] Knight, S. R., et al. (2021). Risk of long-term COVID-19 complications. BMJ, 373, n1088.

[33] Libby, P., Ridker, P. M., & Hansson, G. K. (2020). COVID-19 and cardiovascular disease. Nature Reviews Cardiology, 17, 234–237.

[34] Lindner, D., et al. (2020). Myocardial infection by SARS-CoV-2. JAMA Cardiology, 5(11), 1281–1283.

[35] Madjid, M., Safavi-Naeini, P., Solomon, S. D., & Vardeny, O. (2020). Potential effects of coronaviruses on cardiovascular system. JAMA Cardiology, 5(7), 831–840.

[36] Mevorach, D., et al. (2021). Myocarditis after BNT162b2 vaccination. New England Journal of Medicine, 385, 2140–2149.

[37] Mueller, C., et al. (2019). High-sensitivity troponin in diagnosis. European Heart Journal, 40, 354–356.

[38] Nishiga, M., Wang, D. W., Han, Y., Lewis, D. B., & Wu, J. C. (2020). COVID-19 and cardiovascular disease. Nature Reviews Cardiology, 17, 543–558.

[39] Oster, M. E., Shay, D. K., Su, J. R., et al. (2022). Myocarditis cases after mRNA COVID-19 vaccination. JAMA, 327(4), 331–340.

[40] Patone, M., et al. (2021). Risks of myocarditis after COVID-19 vaccination and infection. Nature Medicine, 27, 1438–1447.

[41] Reichlin, T., et al. (2012). Early diagnosis of myocardial infarction using troponin. New England Journal of Medicine, 361, 858–867.

[42] Shi, S., Qin, M., Shen, B., et al. (2020). Association of cardiac injury with mortality in COVID-19. JAMA Cardiology, 5(7), 802–810.

[43] Spyropoulos, A. C., et al. (2020). COVID-19 thromboinflammation. Journal of Thrombosis and Haemostasis, 18, 1890–1897.

[44] Taquet, M., Geddes, J. R., Husain, M., Luciano, S., & Harrison, P. J. (2021). Neurological and psychiatric outcomes after COVID-19. The Lancet Psychiatry, 8(5), 416–427.

[45] Tavazzi, G., et al. (2020). Myocardial localization of coronavirus in COVID-19. European Journal of Heart Failure, 22(6), 1042–1045.

[46] Thygesen, K., et al. (2018). Fourth universal definition of myocardial infarction. Circulation, 138, e618–e651.

[47] Wadhera, R. K., et al. (2021). Trends in cardiovascular disease during COVID-19. Journal of the American College of Cardiology, 77(14), 1590–1600.

[48] Wang, D., Hu, B., Hu, C., et al. (2021). Clinical characteristics of COVID-19. JAMA, 323(11), 1061–1069.

[49] Witberg, G., et al. (2021). Myocarditis after COVID-19 vaccination. Circulation, 144(22), 1871–1873.

[50] Wong, H. L., et al. (2022). Myocarditis following mRNA vaccines in young males. JAMA Network Open, 5(3), e221850.

[51] Xie, Y., Xu, E., & Al-Aly, Z. (2022). Long-term cardiovascular outcomes of COVID-19. Nature Medicine, 28, 583–590.

[52] Zheng, Y. Y., Ma, Y. T., Zhang, J. Y., & Xie, X. (2020). COVID-19 and cardiovascular disease. Journal of the American College of Cardiology, 75(18), 2352–2371.

[53] Zhou, F., et al. (2020). Clinical course of COVID-19 in China. The Lancet, 395(10229), 1054–1062.

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Published

2026-04-30

How to Cite

Gouniyal, T., Chaudhary, S., & Kumar, P. (2026). Influence of COVID-19 Pandemic on Early-Onset Myocardial Infarction in Adults. Journal for Research in Applied Sciences and Biotechnology, 5(2), 145–150. https://doi.org/10.55544/jrasb.5.2.19

Issue

Vol. 5 No. 2 (2026): April Issue

Section

Articles

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Copyright (c) 2026 Tanishq Gouniyal, Shreya Chaudhary, Pradeep Kumar

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

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