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Microvascular disease confers additional risk to COVID-19 infection

Bradley Field Bale1, Amy Lynn Doneen1, David John Vigerust2

  • 1Washington State University School of Medicine, Spokane, WA 99204, United States.

Medical Hypotheses
|June 23, 2020
PubMed

Insights

COVID-19 pneumonia causes high fatalities, especially in elderly patients and those with chronic conditions like diabetes, hypertension, and cardiovascular disease (CVD). This study explores biological and pathophysiological reasons for increased mortality risk in these vulnerable groups.

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Cardiovascular Medicine

Background:

  • The COVID-19 pandemic has resulted in a high number of fatalities, primarily attributed to pneumonia.
  • Increased COVID-19 fatality rates are observed in individuals with pre-existing conditions such as chronic pulmonary disease, cancer, diabetes, hypertension, and cardiovascular disease (CVD).
  • Elderly populations exhibit significantly higher mortality rates, with rates escalating in older age brackets.

Purpose of the Study:

  • To propose a biological basis for the elevated mortality risk in specific demographic and comorbidity groups during the COVID-19 pandemic.
  • To present pathophysiological explanations for the heightened danger faced by vulnerable populations.
  • To identify potential therapeutic targets for improved management and prevention strategies.

Main Methods:

  • Literature review and synthesis of existing clinical data on COVID-19 outcomes.
  • Analysis of reported fatality rates across different age groups and comorbidity statuses.
  • Formulation of biological and pathophysiological hypotheses based on current scientific understanding.

Main Results:

  • Data indicates a clear correlation between advanced age, specific chronic diseases (pulmonary disease, cancer, diabetes, hypertension, CVD), and increased COVID-19 mortality.
  • The study identifies specific biological mechanisms that may predispose these groups to severe pneumonia and higher fatality rates.
  • Pathophysiological pathways contributing to increased risk are elucidated, offering insights into disease progression.

Conclusions:

  • Understanding the biological and pathophysiological underpinnings of increased COVID-19 mortality in vulnerable populations is crucial.
  • These findings can guide the development of targeted therapies and preventative measures to mitigate severe outcomes.
  • Further research into these mechanisms may lead to improved clinical management protocols for COVID-19 patients with comorbidities.

Keywords:
COVID-19Innate immunityMPOMicrovascular disease

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