Introduction
The spread of COVID-19, a disease caused by the infection with the SARS-CoV-2, has reached pandemic proportions and dramatically impacted public health and the global economy. As of June 15, 2020, more than 7.5 million people have been infected worldwide, and more than 400,000 died. Most COVID-19 patients suffered from lung damage, but the virus has been shown to affect other systems as well. The angiotensin-converting enzyme 2 (ACE2) receptor plays a vital role in the infection of cells by the SARS-CoV-2 [1]. Although myocardial cells express ACE2 receptors, myocardial biopsies and autopsy of COVID-19 patients did not reveal significant heart damage caused by a viral infection. Despite the absence of sufficient evidence in the cardiac autopsy reports, various findings indicate that in some clinical cases, the virus may not directly attack the myocardial cells, but affect the function of the heart through alternative mechanisms. Given the paucity of reports on cardiac pathology in COVID-19, the direct impact of the virus on the heart remains unclear.
Previous studies have demonstrated a close connection between the brain and the heart, but the possibility of an interaction between these two organs in COVID-19 patients has not been raised thus far. Therefore, we would like to advance the hypothesis that that COVID-19 may affect the function of the heart through the interaction between the brain and the heart. We hope that this analysis will provide new ideas for research and suggest treatment methods that could be applied clinically.