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Cardiovascular involvement during COVID-19 and clinical implications in elderly patients. A review

Claudio Napoli1,2, Isabella Tritto3, Giuditta Benincasa1

  • 1Clinical Department of Internal Medicine and Specialistic Units, Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", Naples, Italy.

Annals of Medicine and Surgery (2012)
|August 18, 2020
PubMed

Insights

Elderly individuals with COVID-19 face higher cardiovascular risks due to aging factors and SARS-CoV-2

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Gerontology

Background:

  • COVID-19, caused by SARS-CoV-2, significantly impacts the cardiovascular system.
  • Elderly individuals (≥65 years) experience higher COVID-19 incidence and severity, potentially due to comorbidities, frailty, and immunosenescence.

Purpose of the Study:

  • To review the cardiovascular implications of COVID-19 in the elderly.
  • To discuss the molecular mechanisms by which SARS-CoV-2 affects cardiac aging and exacerbates inflammation in older adults.
  • To highlight clinical management strategies for cardiovascular complications in elderly COVID-19 patients.

Main Methods:

  • Literature review of current evidence on COVID-19 and cardiovascular involvement.
  • Analysis of molecular pathways linking SARS-CoV-2 infection to cardiac aging and inflammation.
  • Discussion of clinical manifestations and therapeutic considerations.

Main Results:

  • SARS-CoV-2 can accelerate cardiac aging in the elderly through pro-inflammatory mechanisms (cytokine storm).
  • This leads to severe cardiovascular events including myocarditis, heart failure, arrhythmias, and acute coronary syndromes.
  • Elderly patients exhibit unique responses to SARS-CoV-2, necessitating tailored cardiovascular care.

Conclusions:

  • COVID-19 poses significant cardiovascular risks, particularly for the elderly, exacerbating age-related cardiac decline.
  • Targeted cardiovascular treatments and careful management of repurposed drugs are crucial for elderly patients with COVID-19.
  • Understanding the interplay between aging, SARS-CoV-2, and cardiovascular health is vital for effective clinical management.

Keywords:
ACE2COVID-19Cardiovascular drugsCytokine release syndromeHeart failureInflammationMyocarditisSARS-Cov 2TroponinVasculitis

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