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Sex differences underlying preexisting cardiovascular disease and cardiovascular injury in COVID-19

Lejla Medzikovic1, Christine M Cunningham1, Min Li1

  • 1Department of Anesthesiology and Perioperative Medicine, Division of Molecular Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA.

Journal of Molecular and Cellular Cardiology
|August 25, 2020
PubMed

Insights

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, causing COVID-19, can lead to heart damage. Males with pre-existing cardiovascular disease face higher risks of severe outcomes and death.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Sex Differences in Medicine

Background:

  • COVID-19, caused by SARS-CoV-2, often results in respiratory failure but significantly contributes to mortality via cardiovascular injury.
  • Preexisting cardiovascular disease (CVD) is a major risk factor for severe COVID-19 outcomes, including hospitalization and death.
  • COVID-19 pathogenesis can directly promote cardiovascular injury, exacerbating mortality risk.

Purpose of the Study:

  • To review the basic science and clinical observations of cardiovascular injury in COVID-19.
  • To explore the interplay between sex differences, pre-existing CVD, and COVID-19-related cardiac injury.
  • To highlight the disproportionate risk observed in males with CVD.

Main Methods:

  • Review of current clinical observations.
  • Analysis of basic science perspectives on COVID-19 pathogenesis.
  • Synthesis of data regarding sex differences in COVID-19 outcomes.

Main Results:

  • Males with pre-existing CVD exhibit a higher risk of severe COVID-19 outcomes.
  • COVID-19 infection can independently cause or worsen cardiovascular injury.
  • Sex-based disparities in COVID-19 mortality are linked to CVD and cardiac injury.

Conclusions:

  • Cardiovascular injury is a critical factor in COVID-19 mortality, particularly in males with pre-existing CVD.
  • Understanding the mechanisms underlying sex differences in COVID-19 cardiac injury is crucial for risk stratification and management.
  • Further research is needed to elucidate the complex interactions between sex, CVD, and SARS-CoV-2 infection.

Keywords:
ACE2ArrhythmiaCOVID-19CardiovascularSex differencesThrombosis

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