Perfect Storm: COVID-19 Associated Cardiac Injury and Implications for Neurological Disorders

Coronavirus disease 2019 (COVID-19) can lead to considerable lung damage and even death. Less is known about the effects of COVID-19 on the cardiovascular system. In their recent JAMA Cardiology article, Shi and colleagues reported an association between cardiac injury and higher risk of in-hospital mortality in patients with COVID-19. Approximately 20% (82 patients) of the study cohort presented with a cardiac injury. The investigators identified cardiac injury as an independent risk factor of mortality during hospitalization (52% with cardiac injury vs. 5% without cardiac injury, p < 0.001). Consequently, their findings are highly relevant for patients with pre-existing cardiovascular and cerebrovascular diseases. Among those are patients with neurological disorders. There is a considerable prevalence of myocardial injury in patients with acute neurological illness, which appears to adversely affect prognosis. Individuals with an underlying neurological disorder are particularly vulnerable to increased cardio-cerebrovascular disease risk due to physical limitations and the pathophysiology of their condition. Thus, we would like to specifically highlight the attention of health care professionals treating patients with pervasive neurological disorders to their potentially elevated risk of poorer COVID-19 related outcomes.