Cardiovascular system and COVID-19: manifestations and therapeutics

Abstract

The world is currently in the midst of a daunting global pandemic due to SARS-CoV-2 viral infection and associated COVID-19 disease. Healthcare professionals are tasked with the challenge of managing diverse multisystem clinical manifestations of this infection. Although acute hypoxic respiratory failure is the hallmark of severe COVID-19 disease, there have been diverse manifestations within the cardiovascular (CV) system that each pose unique therapeutic challenges. Of these manifestations, myocardial injury and right ventricular dysfunction are the most common, however, heart failure, circulatory shock, cardiomyopathy, arrhythmia, and vascular thrombosis have been noted as well. Furthermore, these CV related manifestations portend greater morbidity and mortality, which requires clinicians to be familiar with the most recent information to provide informed patient care. Although there are limited treatment options available for COVID-19, it is imperative that the potential cardiovascular implications of these therapies are considered in these patients. This review highlights the pathophysiological mechanisms of and therapeutics for CV manifestations of COVID-19 as well as the CV implications of proposed COVID-19 therapies. Since our hospital-based providers are the frontline caregivers battling this pandemic, the aim of this review is to assist with clinical decision-making for optimal patient outcomes while maintaining a safe environment for healthcare personnel.

Role of Global Alliance against Chronic Respiratory Diseases (GARD) in achievement of the UN sustainable development goals (SDG) and targets

“…It occurs in approximately 8-12% of all patients along with the heart failure, circulatory shock, cardiomyopathy, arrhythmia, and vascular thrombosis. Nonetheless, it has been shown that the presence of pre-existing CVD and development of acute cardiac injury are associated with significantly worse outcome in these patients (19).…”

Potential Physiological and Cellular Mechanisms of Exercise That Decrease the Risk of Severe Complications and Mortality Following SARS-CoV-2 Infection

“…In addition to the hyperinflammatory state and coagulopathy, the pathophysiological features of the cardiovascular system observed in COVID-19 patients include detrimental effects on the heart and vascular compartment [ 190 ]. Regarding cardiac health, exercise training and endurance training, in particular, generate anatomical, functional [ 191 ], and metabolic [ 192 ] effects on the cardiovascular system that promote overall health and physical endurance.…”

COVID-19 pandemic impact on cardiac emergencies and future perspective in Turkey

“…Ten percent of the patients in the second stage progress to the hyperinflammation stage. The hyperinflammation phase is characterized by the development of acute respiratory distress syndrome (ARDS), acute cardiac damage, multiple organ failure, secondary bacterial infections, sepsis, and increased need for intensive care (10)(11)(12). Although the exact mechanism of cardiac injury remains unclear, some possible mechanisms have been suggested.…”