Long-term effect of SARS-CoV-2 infection on cardiovascular outcomes and all-cause mortality

Area of Science:

• Cardiology
• Infectious Diseases
• Molecular Biology

Background:

• Patients with cardiovascular disease (CVD) face heightened risks from COVID-19.
• SARS-CoV-2 infection triggers systemic inflammation and coagulopathy, leading to severe outcomes.
• Cardiovascular complications from COVID-19 can occur even in mild or asymptomatic cases, and persist long-term.

Purpose of the Study:

• To review the molecular mechanisms underlying COVID-19's cardiovascular effects.
• To summarize the acute and chronic cardiovascular complications associated with SARS-CoV-2 infection.
• To highlight the impact on cells expressing angiotensin-converting enzyme 2.

Main Methods:

• Comprehensive literature review of studies on COVID-19 and cardiovascular disease.
• Analysis of molecular pathways triggered by SARS-CoV-2.
• Synthesis of current understanding of cardiovascular manifestations.

Main Results:

• SARS-CoV-2 infection leads to endothelial dysfunction, inflammation, and myocarditis.
• Impaired coagulation, myocardial infarction, and arrhythmias are significant complications.
• Multisystem inflammatory syndrome in children (MIS-C), resembling Kawasaki disease, is a noted outcome.

Conclusions:

• SARS-CoV-2 profoundly affects the cardiovascular system through molecular mechanisms involving ACE2.
• Excessive inflammation and coagulopathy are key drivers of acute and chronic CVD complications.
• Understanding these mechanisms is crucial for managing COVID-19 patients with or without pre-existing CVD.