Fig. 1.

Proposed access routes for SARS-CoV-2 particles to the heart. Following access to the lung, SARS-CoV-2 induces an inflammatory reaction leading to the release of inflammatory mediators and recruitment of inflammatory cells (A). SARS-CoV-2 particles exit pulmonary tissues via extracellular vesicles, or in circulating blood cells as “Trojan Horse”. (B) SARS-CoV-2 can either infect pericytes or cardiomyocytes since both express necessary proteins for this process, thus leading to cardiac abnormalities. (C) Myocarditis has been noticed in vaccinated individuals using both the mRNA or the virus-based vaccines.