Cardiovascular Risks in Patients with COVID-19: Potential Mechanisms and Areas of Uncertainty

Curr Cardiol Rep. 2020 Apr 29;22(5):34. doi: 10.1007/s11886-020-01293-2.

Abstract

Purpose of review: COronaVirus Disease 2019 (COVID-19) has spread at unprecedented speed and scale into a global pandemic with cardiovascular risk factors and complications emerging as important disease modifiers. We aim to review available clinical and biomedical literature on cardiovascular risks of COVID-19.

Recent findings: SARS-CoV2, the virus responsible for COVID-19, enters the cell via ACE2 expressed in select organs. Emerging epidemiological evidence suggest cardiovascular risk factors are associated with increased disease severity and mortality in COVID-19 patients. Patients with a more severe form of COVID-19 are also more likely to develop cardiac complications such as myocardial injury and arrhythmia. The true incidence of and mechanism underlying these events remain elusive. Cardiovascular diseases appear intricately linked with COVID-19, with cardiac complications contributing to the elevated morbidity/mortality of COVID-19. Robust epidemiologic and biologic studies are urgently needed to better understand the mechanism underlying these associations to develop better therapies.

Keywords: ACE2; Arrhythmia; COVID-19; Cardiovascular risk factors; Mortality; Myocardial injury.

Publication types

  • Review

MeSH terms

  • Angiotensin-Converting Enzyme 2
  • Betacoronavirus / metabolism
  • Betacoronavirus / pathogenicity
  • Betacoronavirus / ultrastructure
  • COVID-19
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality*
  • Cardiovascular Diseases / physiopathology*
  • Cardiovascular Diseases / virology
  • Comorbidity
  • Coronavirus / metabolism
  • Coronavirus / pathogenicity
  • Coronavirus / ultrastructure
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / mortality*
  • Coronavirus Infections / physiopathology*
  • Coronavirus Infections / virology
  • Humans
  • Pandemics
  • Peptidyl-Dipeptidase A / metabolism
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / mortality*
  • Pneumonia, Viral / physiopathology*
  • Pneumonia, Viral / virology
  • Risk Factors
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2