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COVID-19 and cardiovascular problems in elderly patients: Food for thought
Raffaele Costa1, Alberto Castagna2, Giovanni Ruotolo1
1Geriatric Unit Center for Cognitive Disorders and Dementia Azienda Ospedaliera Pugliese-Ciaccio di Catanzaro Catanzaro Italy.
Insights
This review examines how vascular inflammation and coagulopathy in COVID-19 patients, particularly the elderly, impact outcomes. It highlights the potential of cardiac biomarkers to improve prognosis in severe cases and those with comorbidities.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathophysiology
Background:
- COVID-19 has caused millions of infections and deaths globally.
- Vascular inflammation and endothelial dysfunction contribute to hypercoagulable states in COVID-19.
- Coagulopathy in sepsis is linked to multi-organ damage, with thrombin inhibition potentially reducing mortality.
Purpose of the Study:
- To review the protection strategies for vulnerable populations, focusing on the elderly.
- To explore the role of cardiac biomarkers in assessing COVID-19 patient prognosis.
- To understand the pathophysiological implications in severe COVID-19 cases with comorbidities.
Main Methods:
- Literature review focusing on COVID-19, vascular inflammation, coagulopathy, and elderly populations.
- Analysis of existing data on sepsis, coagulopathy, and mortality reduction strategies.
- Examination of the utility of cardiac biomarkers in COVID-19 patient stratification.
Main Results:
- The elderly are a particularly vulnerable group requiring specific protection strategies.
- Vascular inflammation and hypercoagulable states are significant concerns in severe COVID-19.
- Cardiac biomarkers show promise for prognostic stratification, especially in patients with comorbidities.
Conclusions:
- Protecting the elderly is a primary concern in managing the COVID-19 pandemic.
- Understanding pathophysiological mechanisms like vascular inflammation is crucial for patient management.
- Cardiac biomarkers can aid in identifying high-risk COVID-19 patients for targeted interventions.
Abstract:
The global number of COVID-19 infections, as of December 23, 2020, stood at approximately 79 million, with over 1.7 million deaths. The development of vascular inflammation may also contribute to a hypercoagulable state and endothelial dysfunction in such patients. It is known that multi-organ damage is more likely in patients with sepsis if they develop coagulopathy and that inhibition of thrombin synthesis can have a positive impact in reducing mortality. In this review, we will focus on the protection of the most fragile groups of the population, such as the elderly. This segment of the population will be a key issue and probably of primary interest to all. Biomarkers appear to be extremely useful as an indicator of what is happening from a pathophysiological point of view in the heart, allowing us to better stratify the prognosis of our patients affected by COVID-19, especially in the most severe cases and those with comorbidities.
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