The COVID-19 pandemic has had both direct and indirect influences on the practice of cardiology.

Patients with pre-existing conditions such as hypertension, diabetes, obesity, coronary artery disease and advanced age suffer more severe illness and have a greater chance of dying when they contract COVID-19.

The intense inflammatory response that accompanies the illness frequently results in myocarditis-like injury, evidenced by a rise in high sensitivity troponin levels.

While this myocardial injury may result in cardiac dysfunction and arrhythmias, its extent is generally limited and will have minimal functional consequences.

Frank myocarditis is extremely rare.

And though the rise in hs-troponin is generally minor, an elevated level independently predicts mortality.

The COVID-19 pandemic has generated a tsunami of publications in medical literature. While knowledge of the disease has increased remarkably, the urgency with which answers to the problem have been sought has resulted in many small observational studies of questionable quality being published with less stringent review of the data before it is presented.

Add to this the controversial contributions of conspiracy theorists and it becomes clear that uncertainty and many questions remain…

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