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Pathological Interplay and Clinical Complications between COVID-19 and Cardiovascular Diseases: An Overview in 2023
Sufeng Zhou1, Anchen Zhang1, Hua Liao1
1Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
Coronavirus disease 2019 (COVID-19) significantly impacts cardiovascular health, increasing critical illness and mortality in patients with pre-existing heart conditions. COVID-19 can also directly cause heart damage and long-term cardiovascular issues.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathophysiology
Background:
- Coronavirus disease 2019 (COVID-19) affects multiple organs, with significant interactions with the cardiovascular system.
- Cardiovascular comorbidities are prevalent in severe COVID-19 cases, leading to increased critical illness and mortality.
Purpose of the Study:
- To review the complex interplay between COVID-19 and cardiovascular disease.
- To elucidate the pathological mechanisms, clinical manifestations, and long-term consequences of this interaction.
Main Methods:
- Literature review synthesizing existing research on COVID-19 and cardiovascular disease.
- Compilation of therapeutic and rehabilitation strategies for post-COVID-19 cardiovascular complications.
Main Results:
- COVID-19 patients with hypertension, coronary heart disease, heart failure, and cerebrovascular disease face higher risks.
- COVID-19 can induce myocardial injury via direct viral effects, immune overactivation, and microthrombi, potentially causing acute myocardial infarction, arrhythmias, and heart failure exacerbation.
- Long-term sequelae, including postural tachycardia and cardiovascular autonomic dysfunction, are observed in survivors.
Conclusions:
- The interaction between COVID-19 and cardiovascular disease is multifaceted, involving direct cardiac injury and exacerbation of existing conditions.
- Standardization of therapeutic and rehabilitation programs for cardiovascular complications following COVID-19 is crucial.
Background:
The coronavirus disease 2019 (COVID-19) involves all organs of the body, of which the interaction with cardiovascular diseases is the most important.
Summary:
Numerous studies have reported that COVID-19 patients complicated with cardiovascular comorbidities (hypertension, coronary heart disease, chronic heart failure (HF), cerebrovascular disease) are more likely to develop into critical illness and have higher mortality. Conversely, COVID-19 may also cause myocardial injury in patients through various pathological mechanisms such as direct virus attack on cardiomyocytes, overactivation of immune response, microthrombus formation, which may lead to fatal acute ST-segment elevation myocardial infarction, arrhythmia, acute worsening of chronic HF, etc. In addition, the symptoms of the so-called long-COVID may remain in some patients who survived the acute viral infection. Positional tachycardia has been widely reported, and cardiovascular autonomic disorders are thought to play a pathogenic role.
Key Message:
The review summarizes the interaction between COVID-19 and cardiovascular disease in terms of pathological mechanism, clinical features, and sequelae. Therapeutic and rehabilitation programs after COVID-19 infection are compiled and need to be further standardized in the future.
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