COVID-19: A Matter Close to the Heart

Abstract

The world is facing a new challenge, the novel coronavirus disease 2019 , caused by a betacoronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), phylogenetically identical to the SARS-CoV (severe acute respiratory syndrome coronavirus) and the MERS-CoV (Middle East respiratory syndrome coronavirus) responsible for innumerable deaths in China in 2003 and in the Middle East in 2012, respectively. On March 11, 2020, the COVID-19 outbreak was characterized as a pandemic by the World Health Organization (WHO). 1 Twenty-three days after that announcement, the cases reported reached 1,056,777 in 182 countries, with 55,781 deaths, most of which occurring in Italy, Spain, France, China and Iran. So far, Brazil has registered 8,195 cases and 335 deaths, while Portugal, 9,886 cases and 246 deaths, figures that have increased steeply since the beginning of the pandemic. 2

Brazilian Cardiology Interventional Registry during COVID-19 pandemic (RBCI-COVID19)

“…Direct myocardial injury, systemic inflammation effects, myocardial oxygen demand-supply mismatch, acute coronary event, a state of hypercoagulability and endothelial dysfunction appear to be the most common mechanisms responsible for cardiac injury and have been associated with increased levels of biomarkers, such as troponin I, B-type natriuretic peptide (BNP), and D-dimer. [10][11][12][13][14][15] When treating patients with COVID-19, cardiologists should be aware of new clinical manifestations, such as myocarditis, arrhythmias, left ventricular dysfunction and systemic embolism, which may be associated with the condition, as well as the occurrence of a myocardial infarction triggered by the concomitant SARS-CoV-2 infection. [16][17][18][19] The COVID-19 pandemic could also affect delivery of care to patients with acute CVD, such as acute myocardial infarction (MI).…”

“…[20][21][22] In addition, it is important to distinguish MI caused by unstable plaque rupture from type 2 MI or myocarditis on the differential diagnosis of AMI. [10][11][12][13][14][15] The challenges imposed during the pandemic are great, not only in the management of patients with CVD who need to continue their treatment and may or may not be affected by COVID-19, but also in the treatment of the complex cardiovascular manifestations of SARS-CoV-2, such as myocarditis, Takotsubo cardiomyopathy, and myocardial injury, which can mimic STEMI. Adding to this equation are a delayed care seeking due to fear of contamination, an increased incidence of MI with and without obstructive lesion, and a poorer prognosis in cases of myocardial infarction associated with COVID-19.…”

Challenges in Pharmacological Management of Cardiovascular Diseases in Covid-19: do Benefits Outweigh Risks?

“…In this context, studies point to the relevance not only of chronic conditions, such as hypertension, but also of the age and immunological status of the host, characterizing a complex, multifactorial, and bidirectional model that can comprehend the drugs used to treat these pathologies. 3 It is important to note that there is no vaccine for prophylaxis, nor specific drug therapy for the treatment of COVID-19. The repositioning of medications such as chloroquine, hydroxychloroquine, and some antivirals has been considered for the treatment of this disease.…”

A multidisciplinary approach to prevent and treat pressure sores in proned COVID-19 patients at a quaternary university hospital

“…An estimated 10-15% of patients with respiratory disease resulting from coronavirus disease 2019 (COVID-19) develop acute respiratory failure and require intensive care ( 1 ). In order to improve breathing patterns in patients with severe acute respiratory syndrome (SARS), prone positioning can make ventilation more efficient.…”