COVID‐19 and cardiovascular problems in elderly patients: Food for thought

Costa, Raffaele; Castagna, Alberto; Ruotolo, Giovanni

doi:10.1002/agm2.12149

Cited by 4 publications

(3 citation statements)

References 71 publications

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“…This evidence occurred despite the increased clinical and pharmacological experience and the start of the immunization program in December 2021 in Italy. Many risk factors have been associated with acute respiratory distress syndrome development and worsened clinical outcomes from COVID-19 [ 17 , 18 , 19 ]. As shown in previous papers, some comorbidities are closely related to intensive care admission and poor prognosis (e.g., hypertension, CLD, diabetes, and CKD) [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Renal Function at Admission and COVID-19 in-Hospital Mortality in Southern Italy: Findings from the Prospective Multicenter Italian COVOCA Study

Galiero

Simeon

Loffredo

et al. 2022

JCM

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Background. Evidence has shown a close association between COVID-19 infection and renal complications in both individuals with previously normal renal function and those with chronic kidney disease (CKD). Methods. The aim of this study is to evaluate the in-hospital mortality of SARS-CoV-2 patients according to their clinical history of CKD or estimated glomerular filtration rate (eGFR). This is a prospective multicenter observational cohort study which involved adult patients (≥18 years old) who tested positive with SARS-CoV-2 infection and completed their hospitalization in the period between November 2020 and June 2021. Results. 1246 patients were included in the study, with a mean age of 64 years (SD 14.6) and a median duration of hospitalization of 15 days (IQR 9–22 days). Cox’s multivariable regression model revealed that mortality risk was strongly associated with the stage of renal impairment and the Kaplan–Meier survival analysis showed a progressive and statistically significant difference (p < 0.0001) in mortality according to the stage of CKD. Conclusion. This study further validates the association between CKD stage at admission and mortality in patients hospitalized for COVID-19. The risk stratification based on eGFR allows clinicians to identify the subjects with the highest risk of intra-hospital mortality despite the duration of hospitalization.

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Section: Discussionmentioning

confidence: 99%

Association between Renal Function at Admission and COVID-19 in-Hospital Mortality in Southern Italy: Findings from the Prospective Multicenter Italian COVOCA Study

Galiero

Simeon

Loffredo

et al. 2022

JCM

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“…Often, those highly vulnerable present with common comorbidities not limited to chronic heart disease, arrhythmias, cardiomyopathies, diabetes, coagulopathy, hypertension, and immuno-senescence. Followed by severe infection during the early phases of contracting the virus, patients may have a direct cardiac injury, increased inflammation, endothelialitis, and a cytokine storm (Costa et al, 2021).…”

Section: Geriatric Carementioning

confidence: 99%

Sequelae and Comorbidities of COVID-19 Manifestations on the Cardiac and the Vascular Systems

et al. 2022

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COVID-19 patients with pre-existing cardiovascular conditions are at greater risk of severe illness due to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) virus. This review evaluates the highest risk factors for these patients, not limited to pre-existing hypertension, cardiac arrhythmias, hypercoagulation, ischemic heart disease, and a history of underlying heart conditions. SARS-CoV-2 may also precipitate de novo cardiac complications. The interplay between existing cardiac conditions and de novo cardiac complications is the focus of this review. In particular, SARS-CoV-2 patients present with hypercoagulation conditions, cardiac arrhythmias, as significant complications. Also, cardiac arrhythmias are another well-known cardiovascular-related complication seen in COVID-19 infections and merit discussion in this review. Amid the pandemic, myocardial infarction (MI) has been reported to a high degree in SARS-CoV-2 patients. Currently, the specific causative mechanism of the increased incidence of MI is unclear. However, studies suggest several links to high angiotensin-converting enzyme 2 (ACE2) expression in myocardial and endothelial cells, systemic hyper-inflammation, an imbalance between myocardial oxygen supply and demand, and loss of ACE2-mediated cardio-protection. Furthermore, hypertension and SARS-CoV-2 infection patients’ prognosis has shown mixed results across current studies. For this reason, an in-depth analysis of the interactions between SARS-CoV2 and the ACE2 cardio-protective mechanism is warranted. Similarly, ACE2 receptors are also expressed in the cerebral cortex tissue, both in neurons and glia. Therefore, it seems very possible for both cardiovascular and cerebrovascular systems to be damaged leading to further dysregulation and increased risk of mortality risk. This review aims to discuss the current literature related to potential complications of COVID-19 infection with hypertension and the vasculature, including the cervical one. Finally, age is a significant prognostic indicator among COVID-19 patients. For a mean age group of 70 years, the main presenting symptoms include fever, shortness of breath, and a persistent cough. Elderly patients with cardiovascular comorbidities, particularly hypertension and diabetes, represent a significant group of critical cases with increased case fatality rates. With the current understanding of COVID-19, it is essential to explore the mechanisms by which SARS-CoV-2 operates to improve clinical outcomes for patients suffering from underlying cardiovascular diseases and reduce the risk of such conditions de novo.

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“…Another study conducted by Costa suggested that patients with cardiovascular comorbidities such as hypertension and coronary heart disease (CHD) are more at risk for more severe manifestations if infected with SARS-CoV-2 and contribute to the majority of deaths in COVID-19. This is thought to be due to higher ACE2 expression in patients with cardiovascular disease (Costa, 2020). Continuously high blood pressure causes damage to the arterial system slowly.…”

Section: Funnel Plotmentioning

confidence: 99%

A Meta-Analysis: Correlation between Hypertension of Comorbidity on Mortality in Patients with COVID-19

Simatupang¹,

Widyaningsih²,

Sumardiyono³

2021

J EPIDEMIOL PUBLIC HEALTH

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Background: SARS-CoV-2 is a new type of coronavirus that has never been previously identified in humans. In severe cases of COVID-19 it can cause pneumonia, acute respiratory syndrome, kidney failure, and even death. Hypertension causes a number of pathophysiological changes in the cardiovascular system such as left ventricular hypertrophy and fibrosis. This can make a hypertensive heart particularly vulnerable to SARS-CoV-2. This study aims to analyze and estimate the effect of comorbid hypertension on mortality in COVID-19 patients. Subjects and Method: This was a systematic review and meta-analysis conducted with PRISMA flow diagram. Article searches through journal databases include: Google Scholar, PubMed, Science Direct, and Springer Link by selecting articles published in 2020 and 2021. The keywords used are "Hypertension" OR "Hypertensive Patient" OR "Blood Pressure", "Systolic Pressure" OR "Diastolic Pressure" AND "Mortality", OR "death" OR "loss" AND "COVID-19" OR "SARS-COV-2" OR "coronavirus" AND "multivariate". The inclusion criteria were full paper articles with observational research methods, the results of the analysis used the aOR value, the exposure given was comorbid hypertension, the research subjects were COVID-19 patients, with mortality outcomes. Eligible articles were analyzed using the Revman 5.3 app. Results: A meta-analysis of 18 articles showed that confirmed COVID-19 patients who had comorbid hypertension had a 1.27 times risk of mortality compared to those without comorbid hypertension and were statistically significant (aOR= 1.27; 95% CI= 1.14 to 1.41; p <0.001). Conclusion:Comorbid Hypertension affects the mortality of COVID-19 patients.

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COVID‐19 and cardiovascular problems in elderly patients: Food for thought

Cited by 4 publications

References 71 publications

Association between Renal Function at Admission and COVID-19 in-Hospital Mortality in Southern Italy: Findings from the Prospective Multicenter Italian COVOCA Study

Association between Renal Function at Admission and COVID-19 in-Hospital Mortality in Southern Italy: Findings from the Prospective Multicenter Italian COVOCA Study

Sequelae and Comorbidities of COVID-19 Manifestations on the Cardiac and the Vascular Systems

A Meta-Analysis: Correlation between Hypertension of Comorbidity on Mortality in Patients with COVID-19

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