Figure 2.

Potential cardiac injury mechanisms in COVID-19. This figure illustrates the proposed mechanisms of cardiac injury in COVID-19. Systemic infection is likely mediated through angiotensin-converting enzyme 2 (ACE-2) receptors found on multiple cell lineages, including the alveolar and cardiac cells. The proposed mechanisms of injury include myopericarditis through direct viral infection or systemic inflammation, hypercoagulability leading to coronary bed microthrombi, vasculitis, stress cardiomyopathy, acute coronary syndrome, and type-II myocardial infarction from supply-demand mismatch.