open access

Vol 27, No 5 (2020)
Review articles — COVID-19
Published online: 2020-08-07
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Cardiovascular disease during the COVID-19 pandemic: Think ahead, protect hearts, reduce mortality

Guoliang Li, Ardan M. Saguner, Jiaqi An, Yuye Ning, John D. Day, Ligang Ding, Xavier Waintraub, Jie Wang
DOI: 10.5603/CJ.a2020.0101
·
Pubmed: 32789839
·
Cardiol J 2020;27(5):616-624.

open access

Vol 27, No 5 (2020)
Review articles — COVID-19
Published online: 2020-08-07

Abstract

Coronavirus disease 2019 (COVID-19) is rapidly spreading globally. As of October 3, 2020, the number of confirmed cases has been nearly 34 million with more than 1 million fatalities. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is accountable for COVID-19. Newly diagnosed and worsening cardiovascular disease are common complications in COVID-19 patients, including acute cardiac injury, hypertension, arrhythmia, myocardial infarction, heart failure and sudden cardiac arrest. The mechanisms contributing to cardiac disease burden include hypoxemia, inflammatory factor storm, dysfunctional angiotensin converting enzyme 2 (ACE2), and drug-induced cardiac toxicity.
Notably, the macrophages expressing ACE2 as direct host cells of SARS-CoV-2 secrete chemokine and inflammatory cytokines, as well as a decrease in cellular immune responses to SARS-CoV-2 infection due to elevated exhaustion levels and dysfunctional diversity of T cells, that may be accountable for the “hyperinflammation and cytokine storm syndrome” and subsequently acute cardiac injury and deteriorating
cardiovascular disease in COVID-19 patients. However, no targeted medication or vaccines for COVID-19 are yet available. The management of cardiovascular disease in patients with COVID-19 include general supportive treatment, circulatory support, other symptomatic treatment, psychological assistance as well as online consultation. Further work should be concentrated on better understanding the pathogenesis of COVID-19 and accelerating the development of drugs and vaccines to reduce the cardiac disease burden and promote the management of COVID-19 patients, especially those with a severe disease course and cardiovascular complications.

Abstract

Coronavirus disease 2019 (COVID-19) is rapidly spreading globally. As of October 3, 2020, the number of confirmed cases has been nearly 34 million with more than 1 million fatalities. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is accountable for COVID-19. Newly diagnosed and worsening cardiovascular disease are common complications in COVID-19 patients, including acute cardiac injury, hypertension, arrhythmia, myocardial infarction, heart failure and sudden cardiac arrest. The mechanisms contributing to cardiac disease burden include hypoxemia, inflammatory factor storm, dysfunctional angiotensin converting enzyme 2 (ACE2), and drug-induced cardiac toxicity.
Notably, the macrophages expressing ACE2 as direct host cells of SARS-CoV-2 secrete chemokine and inflammatory cytokines, as well as a decrease in cellular immune responses to SARS-CoV-2 infection due to elevated exhaustion levels and dysfunctional diversity of T cells, that may be accountable for the “hyperinflammation and cytokine storm syndrome” and subsequently acute cardiac injury and deteriorating
cardiovascular disease in COVID-19 patients. However, no targeted medication or vaccines for COVID-19 are yet available. The management of cardiovascular disease in patients with COVID-19 include general supportive treatment, circulatory support, other symptomatic treatment, psychological assistance as well as online consultation. Further work should be concentrated on better understanding the pathogenesis of COVID-19 and accelerating the development of drugs and vaccines to reduce the cardiac disease burden and promote the management of COVID-19 patients, especially those with a severe disease course and cardiovascular complications.

Get Citation

Keywords

COVID-19, angiotensin converting enzyme 2, cardiovascular complications, inflammatory factor storm, endotheliitis, online consultation

About this article
Title

Cardiovascular disease during the COVID-19 pandemic: Think ahead, protect hearts, reduce mortality

Journal

Cardiology Journal

Issue

Vol 27, No 5 (2020)

Pages

616-624

Published online

2020-08-07

DOI

10.5603/CJ.a2020.0101

Pubmed

32789839

Bibliographic record

Cardiol J 2020;27(5):616-624.

Keywords

COVID-19
angiotensin converting enzyme 2
cardiovascular complications
inflammatory factor storm
endotheliitis
online consultation

Authors

Guoliang Li
Ardan M. Saguner
Jiaqi An
Yuye Ning
John D. Day
Ligang Ding
Xavier Waintraub
Jie Wang

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