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Published on: April 19, 2019
COVID-19: A Personalized Cardiometabolic Approach for Reducing Complications and Costs. The Role of Aging beyond
1Prof. Saban-Ruiz, MD, PhD, d-médical Clinic, Madrid, Spain, psaban@gmail.com.
Insights
COVID-19 involves more than infection; cardiovascular and metabolic factors significantly impact outcomes. This review integrates these aspects, considering aging and immunosenescence for better management of high-risk patients.
Area of Science:
- Cardiovascular Medicine
- Metabolic Health
- Immunology
- Gerontology
Background:
- COVID-19 presents complex challenges beyond SARS-CoV-2 infection, involving disproportionate immune responses.
- Key risk factors include older age, diabetes, and pre-existing cardiovascular diseases like hypertension, heart failure, and coronary artery disease.
- Hospitalizations are frequently complicated by hyperglycemia and heart failure, with other cardiovascular events like stroke being less common.
Purpose of the Study:
- To provide the first integrated review of cardiovascular and metabolic aspects of COVID-19, aligning with Cardiometabolic Health/Medicine guidelines.
- To analyze personalized treatment strategies, including ACE inhibitors (ACEIs), ARBs, statins, and heart failure management in diabetic patients.
- To explore aging as a dynamic process and immunosenescence, aiming to improve resilience against infectious diseases.
Main Methods:
- Literature review focusing on cardiovascular and metabolic comorbidities in COVID-19.
- Analysis of personalized medicine approaches for managing high-risk patients.
- Investigation of molecular mechanisms of aging and immunosenescence, including endoplasmic reticulum stress and autophagy.
Main Results:
- Older age, diabetes, and cardiovascular disease are critical risk factors for severe COVID-19 outcomes.
- Hyperglycemia and heart failure are common during hospitalization, impacting patient prognosis.
- Aging and immunosenescence, linked to endoplasmic reticulum stress and autophagy, play a role in disease severity and resilience.
Conclusions:
- An integrated, personalized approach to cardiometabolic health is crucial for managing COVID-19 in high-risk populations.
- Understanding aging and immunosenescence can lead to strategies for healthier elders resistant to infections.
- This review offers insights for physicians to reduce hospital stay, complications, and costs associated with COVID-19.
Abstract:
COVID 19 is much more than an infectious disease by SARS-CoV-2 followed by a disproportionate immune response. An older age, diabetes and history of cardiovascular disease, especially hypertension, but also chronic heart failure and coronary artery disease among others, are between the most important risk factors. In addition, during the hospitalization both hyperglycaemia and heart failure are frequent. Less frequent are acute coronary syndrome, arrhythmias and stroke. Accordingly, not all prolonged stays or even deaths are due directly to SARS-CoV-2. To our knowledge, this is the first review, focusing both on cardiovascular and metabolic aspects of this dreadful disease, in an integrated and personalized way, following the guidelines of the Cardiometabolic Health/Medicine. Therefore, current personalized aspects such as ACEIs and ARBs, the place of statins and the most appropriate management of heart failure in diabetics are analysed. Aging, better than old age, as a dynamic process, is also considered in this review for the first time in the literature, and not only as a risk factor attributed to cardiovascular and non-cardiovascular comorbidities. Immunosenescence is also approached to build healthier elders, so they can resist present and future infectious diseases, and not only in epidemics or pandemics. In addition, to do this we must start knowing the molecular mechanisms that underlying Aging process in general, and immunosenescence in particular. Surprisingly, the endoplasmic reticulum stress and autophagy are implicated in both process. Finally, with a training in all the aspects covered in this review, not only the hospital stay, complications and costs of this frightening disease in high-risk population should be reduced. Likely, this paper will open a gate to the future for open-minded physicians.
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