Cardiovascular Implications of the COVID-19 Pandemic: A Global Perspective

Abstract

The coronavirus disease 2019 , caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), represents the pandemic of the century, with approximately 3.5 million cases and 250,000 deaths worldwide as of May 2020. Although respiratory symptoms usually dominate the clinical presentation, COVID-19 is now known to also have potentially serious cardiovascular consequences, including myocardial injury, myocarditis, acute coronary syndromes, pulmonary embolism, stroke, arrhythmias, heart failure, and cardiogenic shock. The cardiac manifestations of COVID-19 might be related R ESUM ELa maladie à coronavirus 2019 (COVID-19), caus ee par le SARS-CoV-2 (severe acute respiratory syndrome coronarivus-2 pour coronavirus du syndrome respiratoire aigu s evère 2), est la pand emie du siècle; en mai 2020, on d enombrait quelque 3,5 millions de cas et 250 000 d ecès dans le monde. Bien que les symptômes respiratoires dominent g en eralement le tableau clinique, on sait maintenant que la COVID-19 peut aussi avoir de graves cons equences sur le plan cardiovasculaire, par exemple des l esions myocardiques, des myocardites, des syndromes coronariens aigus, des embolies pulmonaires, des accidentsThe coronavirus disease 2019 (COVID-19) is a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 1 which infected 3,524,429 patients and was linked to 247,838 deaths worldwide as of May 4, 2020. 2 SARS-CoV-2 infection is triggered by binding to angiotensin-converting enzyme-2 (ACE2), which is highly expressed in the nasopharynx and lungs, as well as in the cardiovascular system and gastrointestinal and genitourinary tracts. 3 Although respiratory symptoms usually dominate the clinical presentation of COVID-19, SARS-CoV-2 infection might also be responsible for a variety of potentially severe cardiovascular manifestations, particularly in patients with pre-existing cardiovascular conditions. 4-6 Indeed, subjects with cardiovascular diseases do suffer worse outcomes when infected with SARS-CoV-2. 5 Moreover, COVID-19 could

The effect of vascular risk factor burden on the severity of COVID-19 illness, a retrospective cohort study

“…Given the vast number of people living with prevalent vascular risk factors and the rapid global spread of the COVID-19 pandemic, it is essential to know how vascular risk factors influence the risk of developing severe COVID-19 disease. Most previous studies showed an association between vascular risk factors (such as hypertension and diabetes) and COVID-19 severity [7]. However, little is known about how patients stratified by burden of vascular risk factors differ from each other, and whether the number of vascular risk factors is associated with COVID-19 disease severity.…”

Prevalence of Pulmonary Embolism in COVID-19: a Pooled Analysis

“…Risk stratification methods such as Caprini, IMPROVE, Padua models, and VELTAS (Venous and Lymphatic Triage and Acuity Scale) are proven to be useful for clinical assessment of VTE and PE in COVID-19 [ 8 , 9 ]. Prophylactic anticoagulant therapy is recommended with LMWH or unfractionated heparin with or without mechanical compression [ 10 ].…”

Mechanical Thrombectomy of Large Vessel Occlusions in COVID-19 Related Stroke: Endovascular and Clinical Outcomes

“…All patients had elevated D-dimer on presentation. One of the patients had new onset Ab with RVR after 7 days of respiratory symptoms with elevated troponin I, which could be a sequalae of COVID-19 related myocardial injury [16,17], illustrating exasperation of underlying conditions and COVID-19's prothrombotic state. COVID-19 related myocardial arrhythmia with elevated Troponin may be yet another potential etiology of ischemic stroke, independent from the hypercoagulable state.…”