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SARS-CoV-2 and cardiovascular complications: From molecular mechanisms to pharmaceutical management
Lin Wu1, Aislinn M O'Kane2, Hu Peng3
1Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai 200032, China.
Insights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes COVID-19, leading to significant cardiovascular damage. Patients with pre-existing heart conditions face higher risks, requiring specialized cardiovascular care during treatment.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is a global health emergency.
- Beyond pulmonary effects, SARS-CoV-2 infection triggers diverse cardiovascular complications.
- Pre-existing cardiovascular diseases exacerbate COVID-19 morbidity and mortality risks.
Purpose of the Study:
- To review the cardiovascular manifestations of COVID-19.
- To explore the mechanisms behind COVID-19-associated cardiac injury.
- To emphasize the need for cardiovascular considerations in COVID-19 patient management.
Main Methods:
- Literature review of studies on COVID-19 and cardiovascular complications.
- Analysis of postulated mechanisms of cardiac damage.
- Synthesis of clinical observations regarding patient outcomes.
Main Results:
- COVID-19 is linked to myocardial injury, myocarditis, arrhythmias, cardiomyopathy, heart failure, and coagulation disorders.
- Mechanisms include ACE2 activation, cytokine storm, hypoxemia, stress, and drug cardiotoxicity.
- Patients with prior cardiovascular disease show significantly worse outcomes.
Conclusions:
- COVID-19 poses a substantial threat to cardiovascular health.
- Understanding the mechanisms of cardiac damage is crucial for effective treatment.
- Integrated cardiovascular care is essential for managing COVID-19 patients, especially those with pre-existing conditions.
Abstract:
The coronavirus disease 2019 (COVID-19), elicited by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is a pandemic public health emergency of global concern. Other than the profound severe pulmonary damage, SARS-CoV-2 infection also leads to a series of cardiovascular abnormalities, including myocardial injury, myocarditis and pericarditis, arrhythmia and cardiac arrest, cardiomyopathy, heart failure, cardiogenic shock, and coagulation abnormalities. Meanwhile, COVID-19 patients with preexisting cardiovascular diseases are often at a much higher risk of increased morbidity and mortality. Up-to-date, a number of mechanisms have been postulated for COVID-19-associated cardiovascular damage including SARS-CoV-2 receptor angiotensin-converting enzyme 2 (ACE2) activation, cytokine storm, hypoxemia, stress and cardiotoxicity of antiviral drugs. In this context, special attention should be given towards COVID-19 patients with concurrent cardiovascular diseases, and special cardiovascular attention is warranted for treatment of COVID-19.
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