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COVID-19: Updated Data and its Relation to the Cardiovascular System
1Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS - Brasil.
Insights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a pandemic illness. COVID-19 may worsen underlying cardiovascular conditions and impact patients using ACE inhibitors, necessitating careful risk-benefit assessment.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- The emergence of SARS-CoV-2 has led to a global pandemic (COVID-19).
- COVID-19 presents with respiratory symptoms and is associated with cardiac complications.
- Patients with pre-existing cardiovascular conditions or on specific medications may face increased risks.
Purpose of the Study:
- To explore the relationship between COVID-19 and cardiovascular health.
- To investigate the potential impact of ACE inhibitors and ARBs on COVID-19 progression.
- To inform healthcare professionals about managing COVID-19 in cardiac patients.
Main Methods:
- Literature review and synthesis of current evidence regarding COVID-19 and cardiovascular disease.
- Analysis of the role of ACE2 receptors in viral entry.
- Discussion of clinical implications for patients with hypertension and diabetes.
Main Results:
- A significant number of hospitalized COVID-19 patients have cardiovascular or cerebrovascular diseases.
- Systemic inflammation and immune dysregulation may link COVID-19 to cardiac damage.
- No current evidence supports discontinuing ACE inhibitors or ARBs due to COVID-19 risk.
Conclusions:
- COVID-19 can exacerbate underlying cardiovascular conditions.
- The use of ACE inhibitors and ARBs requires careful consideration of risks and benefits in the context of COVID-19.
- Cardiologists and healthcare providers must remain vigilant and protect themselves during the pandemic.
Abstract:
In December 2019, a new human coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) by the World Health Organization, emerged in the city of Wuhan, China. Spreading globally, it is now considered pandemic, with approximately 3 million cases worldwide at the end of April. Its symptoms include fever, cough, and headache, but the main one is shortness of breath. In turn, it is believed that there is a relationship between COVID-19 and damage to the heart muscle, and hypertensive and diabetic patients, for example, seem to have worse prognosis. Therefore, COVID-19 may worsen in individuals with underlying adverse conditions, and a not negligible number of patients hospitalized with this virus had cardiovascular or cerebrovascular diseases. Systemic inflammatory response and immune system disorders during disease progression may be behind this association. In addition, the virus uses angiotensin-converting enzyme (ACE) receptors, more precisely ACE2, to penetrate the cell; therefore, the use of ACE inhibitor drugs and angiotensin receptor blockers could cause an increase in these receptors, thus facilitating the entry of the virus into the cell. There is, however, no scientific evidence to support the interruption of these drugs. Since they are fundamental for certain chronic diseases, the risk and benefit of their withdrawal in this scenario should be carefully weighed. Finally, cardiologists and health professionals should be aware of the risks of infection and protect themselves as much as possible, sleeping properly and avoiding long working hours.
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